DENTAL VIDEO GALLERY AT SMILES4OC, COSTA MESA

It’s never too late! Did you know that Oral cancer is the 6th most common cancer globally and 650,000+ new oral cancer cases are found each year worldwide. More than 300,000 people will die because of oral cancer each year, according to the WHO. Are you at risk? Signs and symptoms to look for – A sore, or soreness or irritation that doesn’t go away. Red or white patches or pain tenderness or numbness in mouth or lips. Lumps thickening tissues, rough spots, crusty or eroded areas. Difficulty chewing, swallowing, speaking or moving your jaw or tongue. Change in the way your teeth fit together when you close your mouth. Catch it early with Self-examination and have regular dental visits.

Step 1 – press along the sides and front of your neck and face to feel for any tenderness, swelling or lumps.

Step 2 – Pull back your lips and look for sores and color changes on your lip and gums.

Step 3 – Use your fingers to pull out your cheeks, look for any colour changes like red, white, or dark patches. With your index fingers and thumb, check the outside of your cheeks to feel for any lumps.

Step 4 – tilt your head back and open your mouth wide to look for lumps or colour changes.

Step 5 – Examine the top, back, and sides of your tongue for swellings or colour changes.

Step 6 – Touch the roof of your mouth with your tongue and look at the underside and floor of your mouth for colour changes and lumps. Using one finger inside your mouth and one finger on the outside fell for any unusual bumps, swelling or tenderness. It’s not too late to quit your bad habits for your loved ones. Let’s beat oral cancer today.

In just a few seconds we are going to meet Doctor Christina Doe. Hello everyone welcome to Doc Talks, today we have a special get. Dr. Christina Do, I don’t know if you guys can hear that – but right outside my window there was a car accident. Well that is not the way we normally want to start a talk but today we are going to listen to Tips and preventative health concepts with one of my favorite specialists. I always use her as my 911 when I need a second opinion about a dental question. Her name is Dr. Christina Do, and we are live so welcome any questions you might have. I am going to give you guys a little background on Dr. Do and ask for questions as we go through 7 highlighted topics that come to me quite often when I see patients in my office. You will see them as streaming though the bottom of the screen, actually I am going to open this up so you can see us, I am using a very new platform so I apologize if this is a little bit held up.

So here we are – this is Doctor Christina Do, she is a graduate of Llama Linda University of dentistry. She is a master of laser dental surgery in dentistry, the technology that she uses she lectures on worldwide and people often refer to her when they are looking at new applications of their lasers. She is on an executive board for the Coleman research group. She has created her own animated children’s educational DVD called tooth tales, she has been featured numerous times on the show called doctors, and she has performed various dental procedures for them, she has published in PBS, American Health Journal, Educational Health videos and multiple dental magazines. For Dr. Do I know that dentistry is truly a passion of hers and it started in her college days at UCSD. She was inspired by a homeless women who had no access to dental care and from there that point forward Dr. Do knew that she had a calling to perform dentistry to the under privileged in her community and towards the citizens in other countries. Since 2000 she has served in various countried including Mexico, Peru, Bolivia, Guatemala, Honduras, Papua New Guinea and Haiti. I have o say since I have known her, before the pandemic she was often travelling on medical mission trips, and I appreciated learning so much about her through our new friendship. Our friendship began I actually had a colleague and friend who was friends with Dr. Do and as I found myself referring more and more patients to her I found that the most true sincere appreciation from feedback that she was someone to trust so I have sent her plenty of preneoectonomies, She did my own daughters, sorry I am getting myself caught in finding my own camera, so I have asked her to be a resource for us today to talk about some of the common questions that I get in my office. Doc Talks is focused on bringing you preventative health tips that you can apply in your home, I have at least an hour with my patients because I am a concierge pediatrician but most people are not afforded that luxury with their doctor so I am trying to bring my favorite specialist to you – so Dr. Do we are going to start with if you want, do you want to share waiting about you I know that people can find you at Smiles for OC and I will list that at the end, she practices in Costa Mayas. Is there anything I missed? She is also the mom of a beautiful 2 year old boy and her husband happens to be a dentist so I am curious if you guys have a lot of dental discussions at home. No we don’t talk about dentistry at home our main goal in dentistry is to brush and floss our own teeth and make it enjoyable for our 2 year old son, but we don’t really talk about dentistry but yeah its ok. But I am honored to be here today and I definitely hop that everyone learns lot toady and dentistry is a passion of mine and preventative dentistry is also a great passion of mine, it’s great that today Dr. BB and I can share what we love the best – which is taking care of our patients, our pediatric patients, my specialty as she spoke is laser dentistry but you know I am pretty much a family dentist so you know I love treating kids from when they were born all the way to treating their great grandparents so we are just so happy to be here today to share everything that we know together. Right. So let start with some of the most difficult but mundane of topics, how do we get our kids to floss and brush their teeth? Anyone who has a toddler in the house know that it is one of the most unwanted chores and takes morning and night.

So I wanted Dr. Do to give us any tips that she knows of, and I want to share a few picks, so I am going to pull those up right now. Yeah so I have been practicing dentistry for over a decade now and you know before we would do a consultation with parents and then see their little kids and talk about brushing an flossing and you know very matter of factly, and then 2 years ago I had my own child, and it just opened a whole new world for me. Now on top of being the clinician who advises parents on how to take care o their kids, I was thrown into the throngs of it. So I have picked up a lot of different tips, but mainly our goal for taking care of our kids teeth, is just to set them for the precedence of great oral health for their entire lives. Making sure that when we introduced the tooth brush and we really really want to introduce that tooth brush the minute you see a tooth pop up. So there are multiple tooth brushes that you can use to make this tooth brushing time very enjoyable. There is no one tooth brush that is the best for you child. It is whichever one they like, and I would start with one utilize that until they are not really interested in brushing anymore and move on to another one. You know when you first seethe first tooth that pops up usually at the bottom in the front you use like a small little tooth brush one that your child can hold. They have these banana brushes they have the infant brushes, they have the finger brushes. The minute you see a tooth you start brushing those teeth, and if you are an even more motivated parent and you want to start introducing items into their mouth early they have gauze spiffy wipes, that you can wipe down their gum tissue. So the sooner or earlier you introduce anything to yoru child’s mouth, they will start to accept tooth brushing time as something enjoyable and a part of the routine, of course as a parent we know that does not always – every night is not always going to be wonderful but you have different things that you can introduce. For example changing the tooth brush making it a part of a nightly routine, net to something that they enjoy such as bath time, or having a toy that they really like, definitely is positive reinforcement – something that you really really want to introduce to them. Everything we do should be positively reinforced. Brushing you r teeth should be very well rewarded for it. Introducing tooth paste before the age of 2, we have non fluoridated tooth paste; with you know great flavors that they can try out, so you know it becomes a part of something that they love to do.

Also kids love their stuffed animals or they love their siblings, with their stuffed animals you can brush their stuffed animal’s teeth, with their siblings and with mom and dad you can have them mimic mom and dad brush their teeth, or do it as a whole team with their siblings, and brush together as family time. SO there are a lot of different ways that of course there are day when you kid doesn’t want to brush their teeth is you have to do different tactics. My child’s creams, my child cries but honestly I still brush his teeth – we sing songs, we count down and I know that he is not in pain, I just know that today is not one of the days he wants to do it. But unfortunately if you don’t make it a part of their routine they may get cavities, and cavities are a whole new gamut of problems, so you know every day – kids all the time do not want to do anything. We can impart to make it a really fun experience for the, on the days that you don’t want to you lie them down and you just brush and they cry and that opens up their mouth and there you go but you get all the food out and you know – you feel good about putting them to sleep without food and milk and bacteria inside their mouth. So I just want to emphasize that we need to start this process when the first tooth erupts if not before. Yes – yeah, I know the first three months are very difficult for moms and parents and so you get a little window of a break but if you can’t start imparting like wipes or little hand clothes just to wipe the gums down, you get extra credit. It does make your life easier. Anything you do earlier in life makes it that much easier later in life. I am going to take off the Philips Sonic care but I want to mention that because I know the difference between using electric I am starting to figure out where I am in my camera, electric vs. the regular standard tooth brush this is something I introduced very early on and children do complain, adults do complain of sore gums that last about a week once you start these tooth brushes. So you want to start them mild and then it continues and then we do rotate tooth brushes, but this one happen to do the best job at keeping their teeth clean so we went through phases where we loved grabbing the tooth brush when she saw her big brother doing it but then now I actually have to wait for her to cry so I can get her teeth done, so it is a fake cry. Some days are much better than others, of most things. They see other kids brushing their teeth, how fun it is and the songs. It is just about the distraction and getting it done, and flossing is too very important right Dr. Do? Flossing is really important because unfortunately we cannot take x-ray until about 4 years and so you will get cavities in-between the teeth and no one will be able to see it. I am ok if you don’t introduce flossing till around age 2 when their back molars start to touch because you don’t get your true 2nd molars until you are about 2 and a half years but if you start flossing earlier and you get to floss the front teeth it is so much easier than wait for the back ones. They have flossers for kids, you can introduce that it is fun for them, and much easier the sooner you get that in, as both parents Dr. Vivi and I know how busy we can get but if you just introduce that earlier, then eventually you move that floser to the back less resistance you will get. Yeah it is about introducing them – the Crayola ones have a nice flavor the berry flavor – the kids love that I am not sure at what point you can use the sharp one as well – I am getting some comments that you are not on the screen again but I do see you – I see myself, I took you off just to highlight the tooth brush the Sonic Care which I will take off, there we go – but they can still hear me? Yeah and if you are on, I am showing it live on my fb page – and looks like you are on there. I took you off for 2 mins. Real quick one thing I do want to add is that you do want to switch your tooth brush every 3 months, and then also if you child is sick then throw away the tooth brushes you have been using. Toothbrushes are big bacteria harboring. We see that with strep throat. You can’t really see with some other things, but strep throat will come back 24 hours after you have been on Amoxyllin you got to toss that tooth brush. Yeah you have to. Then there is a new tooth brush called the auto buddy or auto brush, it is like a tray that you put in your mouth and turn it on, it is pretty expensive like a 100 dollars, but it does not show the true effect of brushing teeth one by one, so I have a lot of parents ask about that it is s newer shark tank type of item that is out on the market – I have seen it advertised actually I remember that. Yeah so I would be pretty hesitant about utilizing that because you might cripple your child from brushing correctly as they age. I will put that in the comments when I finish the talk so we can get back to it. Okay and then someone has also asked for the links to the flossers, I’ll put those in. i like the Crayola ones you can find those on amazon. Yeah the Crayola ones are the best, because the picks at the end are not sharp the way the adult ones are. Correct, then they have reach flossers which have long handle for parents to hold on to, okay, so they can get to the back. So I’ll just put a little – Crayola and Reach flossers. And then one thing that I noticed when we used those type of flosses when you floss from tooth to tooth, you have to wipe off or rinse, before you move to the ex-tooth, otherwise you are moving bacteria from one tooth to another and I think a lot of people forget that. I don’t know why but my husband started and I wish he would watch this. He is reusing the flossing sticks, that just – does he clean them? He doesn’t! That is really not a good idea at all right, he will rinse it and leave it on the side of the sink – but just from everything that I know about bacteria and tooth decay it would just be a potential for bringing bacteria in between the teeth. Yes so ideally you can use one floser, per day but rinsing it in between each – he probably learned that from Dr. Woo because he would not do that on his own, so he would probably use one in the morning and one in the evening after he rinses it. Oh okay and then toss – because they are not meant to be reused per se. thank you for clarifying that I am glad it came up. Ok. We got through 3 of those questions; let’s move on to the next topic. So the fluoride now – there is nothing that we love more as doctors and dentist that the realization of fluoride will prevent cavities. So I am wondering if you hear the something as I do and then some about peoples fear that fluoride is dangerous or damaging – can you speak to what the positives or the negatives – so definitely you know if you think about it, we give our children and ourselves vitamins. So if you think about it – how can you not get cavities? So the only thing honestly that we can potentially protect ourselves is through fluoride, and not a lot of fluoride right. Everything in moderation. We brush our teeth 2 times a day with floured tooth paste – really no one drinks tap water anymore and that does have fluoride so you know the communities are hoping we would drink tap water and have some form of protection for your teeth. Honestly I would say 90 percent of our world does not do that or our community does do that. So really the only protection we have is the fluoride from our toothpaste and maybe fluoride from when you visit the dentist. So think of fluoride it is not an evil thing quite honestly. People think it is a medication people think it is a toxin, but at the end of the day fluoride is a mineral that is naturally occluding and it is virtually the only vitamin you can give to your teeth. So of course if you inject a whole tube of tooth paste in one sitting, you will probably get a tummy ache right. It is not meant to be eaten in the regard, but if you give some to your child a little smear of it onto the tooth brush not a pea size until they are able to spit out then that is enough to help prevent decay in the mouth. Anytime you eat food, food turns into plaque. Plaque is very acidic and it adheres to your teeth like barnacles and now it is slowly starting to secrete acid onto your teeth. Now if your child doesn’t let you brush properly, you are never going to get that white fluffy stuff off your child’s teeth and then that acid is going to start burning into your child’s tooth. So if you cannot brush it off then the only other thing you can do is if you can introduce fluoride from a prior tooth brushing time or the fact that it has like properties from when you introduced it, the acid gets neutralized by the fluoride which means that now the acid that is burning into your teeth is blocked from maybe the night before where you were able to brush your child’s teeth properly. So what you can do if you know for sure that you are an amazing brusher and you can get every single piece of plaque off your child’s teeth then that reduced acid and maybe you can get away with not giving any fluoride to your child. I am not saying that you need to give fluoride supplements, I don’t recommend fluoride supplements by any means fluoride rinse is ok once your kid can spit, but at least for me and my husband we want to give our son protection because there are days when he eats sticky stuff and we just can’t get in there as best as can, even though we are fighting him to brush well, at least we know we have dispelled a little bit of smear layer on to his tooth paste to help him combat the acidity that gets introduced from all the food that he eats, and so the process of fluoridation is called demineralization to get the teeth enamel stronger so plaque cannot eat as easily or demineralization when the tooth turns white because of the acidity that burns into the teeth that turns it white. So we see a lot of white spots on children that is because unfortunately acid burns holes into the teeth and the fluoride tooth paste that you have introduced can redirect that and harden the enamel again, so honestly if you use fluoride in moderation you are going to get great health for your teeth that will keep them healthy for the rest of your life because you have not introduced it backed to those bacteria that causes cavities into your saliva. Thank you so much for that explanation and I will tell everyone out there that there is always been a push in the pediatric office for dental health and fluoride treatments for the underserved communities. I have always recommend using a perio filter because of the minerals that are in water that you can be providing yourself if you drink tap water that is somewhat assured from impurities but fluoride like many things that people fear are going to be found in soy, almond milk, everything else that you eat so there shouldn’t be a fear when it comes for a recommendation at the dentist and the dental office. Yeah it is just preparing your child’s teeth for a better future, and we only utilize a small amount that is completely safe so you know kids will always eat things that we don’t want them to eat and foods always turn into carbohydrates into sugars, and sugars into acid so you really need some form of protection for your teeth and I want to mention that for kids who have reflux there is an issue with the acid that does destroy the teeth especially when they grow up having the reflux and it is not ideal correct to be brushing it after you have a reflux effect that can be damaging to the teeth is that right? That is correct so unfortunately the acidity is very detrimental to our teeth so you do want some time for your basic saliva because the PH is so acidic from the acid that comes from your gut, you want the salivary flow from the base of your mouth to kind of start coating over your teeth so they do say wait half an hour before you start brushing. That would be true for someone who is vomiting? Who is sick? Yes maybe rinse your mouth with some water wait a bit and then brush. But you still definitely have to brush after otherwise you are leaving so much acid in your salivary flora that now you are going to start having a lot of teeth problems. Got it yeah, ok I don’t see any other questions let me see if here is a way to go, I need this I am going to see what happens, alright so the end topic that we have is, cavities in primary teeth and why even care – this didn’t even cross my mind as a question until a parent said they are going to lose them anyways right they have a few cavities or you know why am I going ti brush, spend all this time fighting to brush and I have to say the coincidence the health awareness and the dental pediatric dental health awareness re in the same month and is so imprint to me in that question we know that seeding effect peers into our blood stream from our mouth and the cavities are a source of that – studies have shown, so specially someone who has any type of abnormal heart valve or holes in the heart is between the ventricles these are a source of clots that can seep through the body back to the clots so I would love for you to speak – here let me show –speak to brushing and caring and taking care of cavities in our primary teeth. Ok, so think about it like this when your child is born everyone starts with a clean slate, you don’t have diseases you don’t have bacteria you don’t have little viruses in your system per se, now when you start introducing foods and things like that, you start to get cavities and so then the cavities are caused by different types of bacteria called Structo – Structo and there is a whole slew of them, if you think about it, when you start with 0 bacteria inside your mouth and now you are introducing all these bacterial flora and then first you start with one cavity then you start with two and so now you eave those cavities inside your mouth you don’t treat them, bacteria what it does it proliferates once it proliferates now you are introducing more bacteria into your saliva – now when your 10 or 11 year old now you have way more bacteria that causes cavities in your system when you are born now you have adult teeth – now all this new bacteria that you introduced into your salivary flora starts eating away your adult teeth – so your baby teeth gives you a precedence and give you a precursor to what your adult teeth would look like if you have 3 cavities in your baby teeth which out of 20 – think of it, multiply it infinitely to having more cavities in your adult teeth and you are right you are not going to lose your adult teeth and then you are going to be filing them basically for the rest of your life and then also small cavities lead to large cavities and large cavities leads to root canons, baby root canals lead to crowns, crowns lead to extractions. Now you need to keep your baby teeth at least till1 2 years of age – now you have all these baby teeth that have been extracted prematurely you have no landscape for you jaw to form anymore, as you are losing teeth and then adult teeth to come in, they cannot figure out where to go. You lose a tooth the adult tooth is below it. It is supposed to come up straight but if you have all these missing teeth when adult teeth come up, they will come up wherever they feel like it. They don’t have the proper placement of following the eruption pattern of where the baby teeth are and your jaw does start to shrink your lattet and your lower jaw shrinks because those teeth are no longer place holders those baby teeth that you pulled out because of all the cavities, so you know cavities at 3 years old are going to be extractions by probably 6 years old or 7 years old, and so then when your adult teeth come in it is going to come in wherever it feels like and then your jaw is going to shrink and now you are going to be left with a very shrunken palatal arch and a shrunken arch on the bottom so then it is going to change your whole entire landscape of how your face is.

Now if you are going to have a nice rounded arch then your face is going to have a nice rounded – now it is going to be shrunken in with teeth that are mismatched and crooked and now you are going to be in orthodontics, you are going to have expansion, you might have to do jaw surgery it is a whole domino effect quite honestly so important to here you say this. I know it is important to brush the teeth, and I know it is important to see the dentist to take care of cavities but especially during the pandemic it has been so easy to say – well we’re brushing why go to the dentist but wow so interesting, thank you – you explained it perfectly. It Is very important, I mean it build landscape for your entire adult hood so it is so much easier to fix a small tiny cavity than waiting for it to fall out, because honestly your child will probably be in too much pain to wait until it falls out – so those premature thing that you do, do cost them into their adult hood. Ok, so really quick some question that have popped up – one is and we can, I don’t think I am looking at our other so I think we will just talk about it now, under bite in a 5 year old, whenever she is smiling her bottom teeth are always in front – do you want to talk about this, we can talk about pacifiers and bottles or?
No we can talk about it now – so the great news is her daughter is only 5 – at 5 it is beautiful because 5 means she is groin still. Usually we do start seeing an orthodontist these days around ages 6 to 8. 8 years is usually for those who have nice spacing of their teeth not a lot of crowding, but 6 is a great time to start in the sense when we start seeing an under bite, so we start seeing too much gum tissue or the bite is too deep – anything that looks like where a collusion is going to be a problem, where your top teeth is coming together to your bottom teeth that is a problem we start with orthodontics early because we can do expanders, we can do so basically an expander will expand your lower jaw, expand your upper jaw and correct your bite without waiting until it is too late where you have to do jaw surgery. Can I interrupt you – orthodontist visits will use, will start around a float 6 or 7 years of age? Mhmm, and then someone like this may need to go early before then? So early would be 6 years because you do want the 6 year molars to have erupted and then if you have an under bite you would go after you see those 6 year molars come through. Because that is when the orthodontist can do something. So I think the point is, the question is – her dentist would guide her but she should not expect to go before 6 years. if there is something going on with the bite we still wait till 6? Yes because we do need the molars. There are other appliances that you can use before age 6 but they are harder to sue because they deal with patient compliance so you can put mouth guards and mouth pieces into a child’s mouth earlier than 6 but they can reach in and pull it out. When you are 6 the orthodontist can place permanent expanders, inside the mouth and the child can’t take it out – so unless you know your child will be completely complaint with these mouth pieces, then yes you can have intervention earlier but honesty the compliance on that I like 5 percent. It is very low, and it is an appliance that is on the top and the bottom that they hold inside their mouth while they sleep. Is there a way that a parent can prevent such an under bite or overbite if they were not doing anything but pacifier? I know mouth breathing at night – I am very proactive asking my patients if their children breathe with their mouth open at night, because of tonsils and adenoids and how that can shape the mouth differently. What would you say about prevention, what are some sign that someone can pick up on that this might happen? well you know certainly – things like pacifying thumb sucking, putting fists objects indie the mouth, lounge thrusting, lip ties, so a lot of those things should be checked when they’re younger and then if all those things have reached normal limits, then potentially the under bite if it is a skeletal concern that is when the orthodontics will come in. so some kids could have prevented it but some children – it is genetic. So if both parents have under bites and their grandparents have under bites, the most likely early intervention would be awesome for the child, but yes those other factors if she was lounge thrusting and pacifying, thumb sucking – would probably make it worse. Ok, and we will talk about pacifiers because I have some questions about that.
Ok. Awesome learning for me from you. Ok this is my favorite question – so how often or ever have you ever seen someone come to you with pediatric I think it happens more with big procedures but how many times would you say that someone has recommended cavities or fillings or some sort of orthodontic procedure I am not sure of your comment of orthodontics when they come see you, but would you say a 2nd opinion if it is something invasive is worthwhile in the pediatric population – in Orange county we are not like a community but do we just assume you are giving a good opinion if they are well versed in pediatric dental care or is it worth getting a second opinion sometimes. So I would say whoever your clinician is in all regards, dermatology, concierge pediatrician, dentistry, physical therapy – if you go somewhere and you are not comfortable then a 2nd opinion is something substantial because you want to trust who your clinician is, you want to make sure you have a good working relationship with who is treating your health so honestly I like the way my officer runs things – we do a consultation and we give our concerns and our opinions and our advice, and then the parent for patient goes home and thinks about it – we never do treatments that day – because I think it is important, it’s like an interview. The parent or child interviews us and we review the patient, and it should be a relationship where you start somewhere you are comfortable there and you trust them, then you continue forth. I do see second opinions in the pediatric word, because a lot of it comes up with ‘oh your child has a couple of cavities, they need to be general anesthesia sedated’ and that is a big thing for apparent to swallow becaue number 1 they didn’t think that having a cavity was that big of a deal per se and then all of a sudden someone is recommending let’s put your child to sleep and fix everything, so I think that its valid because putting a child to sleep is scary. Putting anyone to sleep is scary and we are lucky that we do have amazing anesthesiologists who can safety take care of us, but if it brings up warning signs and make you and your family uncomfortable I think about getting a second opinion and then also dentist do practice differently, some are more preventative and some are more aggressive and some take a more conservative route – so you know if you are a friend who is conservative with decision making, sometimes you get along better with someone who makes more conservative decisions vs. someone who might just hop on a plane that goes somewhere so quickly so you might develop a better relationship with someone else, and there is never any hard feelings because at the end of the day every clinician is trying to take the best are of the patient before them, and it is still very imprint that the parent or the patient gets the best results and they are comfortable with it. So I think we are always asking for second opinions from friends and family about everything and so, I don’t think it is a big deal if a parent feels uncomfortable or just curious to get a second onion. Honestly I have had a lot of parents who have come in to see me for 2nd opinions about sedation and you know luckily and rightfully I have dental laser where I can do no shot, no anesthesia one by one and fillings for children but it is going to take longer and I only do one cavity at a time for a child vs. if you sedate your child you can get all ten done but I mean we have been, parents have been very patient, they bring their kids one by one but in the end they don’t have to have them sedated, so it is a matter of preference what the parent is most comfortable with. So in surgical procedures, medical surgical procedures – It is no different. We do want people to feel comfortable with the decision to go forward and want them to get the 2nd opinion. A good surgeon would always ask that they get a second opinion to go ahead and share that with them and come back if they are comfortable so it sounds like it is exactly the same with cavities if they have to be sedated. Ok good, I did know that t I just assumed if they have cavity it should be filed and then once I hear these stories where it was rely questionable where they had to fill 6 or 7 cavities but it is really how the parent feels about their relationship with the doctor. True and then also in dentistry a tooth has 3 parts the enamel, the dentin and the pulp. So cavities – if a cavity is in the enamel but some dentists will do a filling if it in the enamel and if it is not in the dentin yet. Some dentists will do a filling if it it’s in the enamel but penetrate it into the dentin. So that might be a difference in 5 cavities vs. 2 and then it might become an issue when you – when is this tooth going to come out when you are 6 or 7 and you are going to lose the tooth, right got it. Yesterday I gave an opinion to a patient. She has a cavity touching another baby tooth but it was going to come out in a year – I gave her the option of extraction or a filling and if you do a filling a lot of the tooth was already missing, so there is really nothing below but you don’t really want to leave the cavity because it will spread to other areas and introduce more bacteria that causes cavities into the flora, so that could be a different in opinion and unfortunately sometimes money plays a factor you know like an extraction is cheaper than a filling – different things like that. That’s why if you are uncomfortable a second opinion or if you are just curious for a second onion, there is no downside per se – good. Alright so that brings us to our next topic that I am trying to pull up some of the images, but let me get back to – the new topic is now on I think we are about to do Lip and Lounge tie and let me share my screen – you are going to jump off so that I can get the image on the screen I believe. We are going to show this just to make it bigger I am going to take you off – I will hide you and bring into view this. I believe we can still hear you go ahead – oh shoot I think people could not hear you so let’s recap – lets summarize a bit you could do a quick summary for us. So what we are showing here is basically the 4 different classification of lip tie and what I said before is basically I didn’t realize how important lip ties and tongue ties are and so I started delving deep into understanding this area because 2 years ago when I delivered I realized breast feeding, feeding my son was a huge factor in just his growth and development and we were very much stifled by the fact that he was tongue tied. Now constantly as infants and new burns come in we constantly look for this – because if a child has classification 2 3 or 4 of a lip or lounge tie unfortunately there is going to be some future problems and for the current problems, the child is not going to get proper nutrition, the child is going to have to work harder to drink milk whether it is from the breast or from the bottle, if you really do want to breast feed which is you know my own prerogative – which was painful and pain leads to chapping, bleeding, sadness, depression, going in and out of lactation offices, you know also trying to get laser procedures trying to help on the maternal side because we are always trying to fix the things on our side but if a child is lip ties, if a child is tongue ties, you can correct that problem you know within 5mintues and that will lead them to better eating, better feeding a whole gamut of great advantages for their future so currently it is basically no more pain for the mom, no more problems with the latching for the child, no more problems with gassiness for the child, no more problems with milk coming out the sides of their mouth, no more issues with digestion, especially like the burping issues. Yeah it is just- so many advantages if you can find someone can diagnose these lip ties or lounge ties. In the early stages, so there is no downside to doing it too early because it is just going to help you as the parent whether it is bottle feeding or breast feeding and the child does not have to work five times as hard, because my son was breast feeding for 5 mins and falling asleep and I – after I clipped his tongue, released his tongue, he could breast feed for 45 minutes and be full and satiated and then fall asleep. You know he was not struggling with his weight back then, and so you just have to make sure if you start to have any signs of gas, or milk spillage or pain to breast feeding or not pursing and getting a vacuumed seal over the bottle or the breast you should have someone start to look into that. Then with the tongue tie you really need to make sure that is not a problem because that when they drink milk from a bottle or a breast they need their tongue for that movement of capturing the milk, and you know a lot of kids they are all survivors, what will happen is they will work around the problem of being lip or tongue tied but it just means that they have to work that much harder when it could be so much simpler for them. Then if you leave lip and tongue ties it leads to a whole other gamut of problems later in life. I did a tongue tie release yesterday on a 4 year old because no one had caught his problems before and he had speech impediments. He could barely formulate words because he could barely use his tongue for certain letters, and within 5 minutes his tongue he could touch the roof of his mouth, he just had so much mobility to his tongue and his mom she cried in my chair because she could not believe how much mobility he could have and then he started talking more, and it was phenomenal to see quite honestly and we might not see that immediately for some infants but just to see a lot of moms being able to breast feed painlessly is just a life changer and so I think these lip and tongue tie are very important to attach and quite honestly Dr. Vivi is one of the few who really do that thorough examination because my pediatrician honestly didn’t say a word to me and even when I told her I released my sons tongue she was kind o like oh okay, like it didn’t even require a conversation for her. So a couple of comments – we have about 12 minutes remaining but this is such a great topic because until I was doing concierge well I have always spent a lot of tie with my patients, but parents know – the reason I am doing these shows is to correct misinformation but there is something about the internet that has brought to light this growing group of infants and newborns who have tongue tie and honestly I think a lot of pediatricians think that this is from a mom blog this is bogus, there is just too much of it, so I have delved deep into it, and I was able to work with a lactation consultant in my office for many years and then I started giving her lectures when I was sick and then I started looking at latching and because I do the concierge practice I spent an hour to 2 hours on average in my office especially with new borns and infants so the latch is so important because like Dr. Do said growth in the first year of life is so paramount as an indicator for good health and I can’t believe how many times I am seeing some strange ear gaps or things that cued me that something was not right and then I look and then there is a huge tie right here, just so tight, and at that point I look and I think oh Gosh and Dr. Do also has had the unique experience of working with me in there since she does the laser surgery without needing any sedation and is local and is available to consult without a beep and so I have been you know I stalked myself after a year, and so many of my patients were going – and I thought even my daughter thought I have gone to a couple of laser dental surgeons and they have explained to me yes that this is actually 40 to 50 percent of the population with ties, and one thing we know is, the human body is not perfect there are plenty of people black footed at a certain age so we put an orthodontic in so that they don’t have hip problem and other functional anatomical issues, so cutting the lip is not that invasive if you are using a laser and heels so I was one of those hesitant parents. My daughter was always at the 100 percentile – was there really a reasons to do anything and I pressed Dr. Do and she said you can wait because a procedure is a procedure and in medicine we don’t want to do anything harmful but on year, a little over one year we did it we were in and out and the holding was painful but yes she is also moving her lips she did look a little different, I have heard from patients, but we probably waited too long because she had a big space between her teeth. So I am going to show the next image and you can see how if you leave it how sometimes you do get these other issues right. You do and I did see a question there – so you can pick a question while I pull up however you want to manage it. So it is true at some point if you don’t sever the lip or a tongue tie maybe it won’t cause a problem, however if it is a lip tie and is left until they are older and is suggested to release it upward is for the fact that helping the 2 front middle teeth. So it si called that space it is called a Diastema, so when a tie is too low, to the teeth when you speak you start to see everything pull upward. When everything pulls upward the 2 teeth in the middle they separate. With orthodontics you move it back together but if you don’t release that tie it opens up again. So it is constantly going to be fighting back and forth, and so that lip whenever you talk is going to pulling up and down and is going to give you gum tissue recession. Where the papillae that nicely protects your teeth now gets pulled upwards, with ageing our gums always gets pulled upwards but now it is getting puled upward at an expediential rate. So it depends on why the clinician suggested the lip release at age 14, as to the question but there are reason s as to why you would do it later in life if it was not caught earlier and so unless maybe a child does like a gap in-between the teeth but now they are going to get recessional and recession leads to basically bone loss because if you gum recedes the bone recedes too. So if the bone recedes the gum recedes. Eventually your bone is protected by 3 walls of bone and when you are older your tooth just falls right out in front and so recession is very bad because it make you get bone loss and you know as dentist we are definitely trained frenectomy. A lot of dentists do not because when we were trained we were trained on the scalpel technique which is a lot of what medical doctors do and nobody really wanted to because it is not a really fun procedure when there are sutures and cloths and bleeding but the reasons why I do them is because I use my dental laser where I don’t have to give a shot I just use topical and there is no sutures involved and then when using a scalpel you can’t get a chance of reattachment with the laser you don’t have that because if you are using scissors or a scalpel your body think you have got hurt. When using a laser is cauterizes it and it does not allow it to reattach the way a scalpel or a scior would. Maybe now we are noticing a lot of lip ties and tongue ties because we are looking for them more before I mean one of my colleagues who are older said I don’t know how to do them so I don’t even bother. Yeah there is actually a comment here that, one of the listeners had to go to a special doctor and was not allowed into the room during the procedure and that is really traumatic. Not all dentists do them, some pediatricians are trained to do them actually, but I have seen them bleed so massively that I don’t want to take on that responsibility. If you use a scalpel or scissors it is like getting hurt at home so you have, I am sure a lot of people don’t want ot do that because it is not very pretty but luckily I am covered. We had a patient, unfortunately when we find out first time that there is a bleeding disorder, we don’t want to – I don’t want to do it in my office. Yeah exactly luckily the laser can cauterize and with a normal patient, we cauterize any bleeding if bleeding becomes a concern. We don’t have to use sutures, I have all my mom’s breast feed immediately in the room as part of the procedure just so they can el the difference in the initial breast feeding or after the released ties. And I can actually attest oth the fact that she cried her head off, my one year old she got out of there was playing, she ate on the way home yeah, I got her to stretch the upper lip and we were doing it and Dr. Do is asking how is the stretching and I’m not sure people even do it, I have seen people who don’t do it and it re-at attaches so we were doing aggressive stretching over the week and there was no downtime she ate normal everything was great, it was phenomenal, so I do recommend – I had a baby do it really early because they needed it and it really attached but you just said that and there are those rare cases where they go and do it again. Correct? Yeah so for babies if you can do the stretching obviously that is an added bonus, for babies they are constantly using their lips to fed and cry and so that in itself is great stretching so a lot of times that – you actually have to stretch if you are doing it the traditional way with the scalpel and the scissors. Otherwise it will just reattach and some that are thicker than the average may reattach. So sometimes you have to do revision later in life. And sometimes the motivation I had was you said that tooth brushing is going to be a pain, she is not going to like a tooth brush up there and that’s when her teeth cam e and I thought ok it time. So if you look here in this picture up here in the top left – she was eating and growing just fine, breast feeding, she had a little bit of a type of different breast feed where she would jump off a little bit but it was time when she as ready to brush her teeth. We think as pediatricians, that earlier you do things the pain receptors perhaps are not as fully developed so it is better to get in early or they will remember. Yeah if you do it early too they don’t have to retrain the way they drink so that s easy. So everyone they have habits from before because they have to work around this, and so if you do it earlier you are not going to have as much retraining or they are not going to have to retrain themselves as much and then earlier you definitely want to get it done before those two front teeth come in, because a lot of kids if they have a low front they don’t want you brushing their teeth because a lot of times you front their frenulum too an it hurts. So we have a few quick, we will make these 2 points quick. X-rays I personally wanted to avoid them, it was a little bit of silliness thank goodness I am friends with Dr. Do so she could talk me back to reason. Can you explain what the reasoning is and at what age would you recommend them? And of course it is going to be dependent on the patient, but I would love to hear reason to do them and can you ever decline them? So the best, the first thing you have to know you make sure your dentist has digital radiographs, digital x-rays – that is the only way you should take x-rays – digitally, because that takes down the rads which is the radiation around a 100 folds. Usually – I don’t know the numbers any more but basically say it was like 800 rads per x-ray now it is only 8, so taking digital x-rays honestly with the recommendations you don’t even need to wear the lead shields if you are taking digital x-rays, but we definitely still use it. We start with a panoramic x-ray at age 4 as long as the patient is able to stand and take it if no tit is no big deal, we want the experience to be positive and easy for the patient so then we just push it for the next year. So that shows growth and development it checks for pathologies it checks the sinuses it check the condyles it checks all things we cannot see clinically and visually, but we don’t push x-rays for kids if they are not comfortable with them. You talk the parents through it if they don’t want them? Or if the child is having a hard time? If the child is having a hard time – now if the parent doesn’t want them, basically we do ask the reasons behind it. So say the child comes in at age 7 and the parent doesn’t want x-rays so I do my clinical casual exam but by now the child has adult teeth, teeth that touch each other when I do my clinical casual exam I can’t see in between the teeth and so if I can catch those cavities early then it is just a tiny little filling. By the time we can clinically see a tooth infected it is near the nerve so it will basically be a root canal so I don’t know if a parent really wants to put their child through a baby root canal and then a crown after it. Earlier in this commentary we discussed all that follows after a baby root canal. The Sequence of changing in the mouth, well early in the show you already outlined all the negative effects and the cascade of events that happens if you do have just one baby root canal. Yes, by the way you are getting a lot of thank you’s in the commentary. Yeah so I mean we definitely try to be respectful of the x-rays but at some point we just, you just can’t handicaps up from doing work correctly. If you ended up having an ulcer or a stomach ache there is only so much someone can see clinically and visually. Right so at some point we just cannot treat our kids correctly anymore if it is consistency being declined so I understand like when they are younger in the beginning, but if you have a problem, there is no way to catch it just clinically and visually. We are now at 3’oclock, do you need to leave, and no I’m fine! Ok then on to when to discontinue pacifiers and bottles – ok so honestly that is a big one because parents need those pacifiers they need those bottles but it is very detrimental to our kids, so I am fine if a child wants to use it till 2, but it is a hard cut off after 2. If you want your child to grow correctly the way your child is supposed to – around age one and a half, I start telling parents maybe you should start like doing positive reinforcements on switching out these pacifiers and bottles because you are changing the whole entire landscape once again if you use these pacifiers and bottles beyond age 2, the worst part is – and Like we see it all the time, basically the tongue thrusts forward into the space that the child has created with the pacifier or the bottle and then the tongue grows and it gets bigger, and nobody really wants or need a big tongue and then they start getting something called the open bite, but you know when we bite down we want our top teeth to go perfectly on the bottom but we don’t want this big hole, and that is unfortunately what a pacifier and a bottle does to our patients. I have a screen of that do you want me to share that? Yes that would be awesome. Let’s see if I can find the right one, there were 2 – yeah the first one was just what it shows for baby teeth, the 2nd shows how it follows into adulthood so you are creating a poor landscape for your adult teeth. This is called an open bite, look at the gap it has formed for the adult teeth, and your tongue need to fill the void and when you speak you start thrusting your tongue forward because it does not have a blockage because there is an open gap there.

Eventually you are going to start spitting more your tongue is going to come through that open bite and then your orthodontist is going to do a lot of correction to realign your palette and your lower jaw correctly so all this can be prevented as long as you stop the pacifier early. Now you can see the spacing issue – yeah, actually this is different. This is- if you were good about stopping the pacifier early. SO that is how you want your teeth to look? That’s the more ideal picture, there is one more with like baby teeth but that’s fine. I mean everything is correctible but how much do you want to correct? So if you nip things early in life, it is going to be so much easier. This is a lot of orthodontics – this is patients who say I was in orthodontics for 8 years, I have braces for 10 years, and this I s like head gear and – this reminds me of 16 candles right now. Oh boy – I always thought that we shod move right to the orthodontic pacifiers that have a thin center where the bite comes and like a nubbin on the inside but still I am – we tend to be happy if a baby can take a pacifier but usually by 6months I am trying to get them to wean to a blanket that is soaky something to suck on yes that is better but what will happen is eventually they will figure out oh I have t=my thumb and thumb is bad too. Mhmm, yeah so as much as you can stop it – kids start putting things in their mouth and then start taking it our early – yeah so you can replace it, substitute it with food – it just baffle me because in pediatric they won’t say anything you know they are happy, they throw that in the- when the baby is born they give you a pacifier and I have always been baffled by that, and it has never made any sense. It is nice for babies to self soothe but you know they should be able to do it without the pacifier. What I realized though is that pacifier does play a pretty good role in the beginning of their early life, because it helps them with sensory that tactile sensation of having things in their mouth and chewing on this – so I still support pacifiers but unfortunately not past 2, and actually even one and half is a good wait. I usually wait to stop them at one and a half because they don’t stop at 2 if they really need it. So you start to wean them off around 15 but I still do believe it is an important tool to have for some children to help with the tactile sensory portion. So up to 6 months if you can wean them off after that it is perfect. Ok! And then our last and final and I have tried to make any comments that were useful, I’ve put them under comments and you are welcome to comment more over there later – any tricks I’m putting that on just because it is a common question and speaking to people who think their babies teething at 4 months, that is so rare they are very oral at that stage so they have- correct me if I am wrong quite of a lower jaw incompetency where they are closing their mouth when everything is happening. Like the sense you said that their environment is their mouth so they are not necessarily teething and at that – only once you actually I feel the tooth at the edge you really need to worry about align the gum and soothing that correct? Yeah there are a lot of teething toys and tools out there that you can use that are all very good – if you want to add more teething and soothing options basically you can take those teething tools and put them in the freezer. Or if you don’t want to buy any we’re all plastic free now and they have silicone straws you can put in the freezer and have the babies’ naw on them too. Oh so that is a great idea – the more you can make popsicles out of breast milk that the kids can, that the infact can teeth on and get nutrition, but you can definitely give them things to get through that teething stage, and the only time I would really give, like our suggestion in terms of medication is that if they develop a fever but beyond that or if you think that – if parents think they are pretty uncomfortable but usually you just give them a teething tool and add some frozen options to it, it should be pretty fine for the child but you are right very child is different and maybe they need a little bit extra. So I just put some extra comments in there about my teething tricks – for people to read them but it is usually something cold, like cold corn on the cob even when they are really little – cold carrots frozen whole grain waffle bagel, a frozen wash rag, celery teething rings, and when they are older water melon and things that they can bite off that are soothing or cool on the gums, an if you do the popsicle I like to wrap it with a paper towel and a rubber band so that when the baby is holding it they won’t get frost bite. There is something called Popsicle peninulitis where they do get these rash on their chees when they start loving the popsicles. OH I see – and it happens commonly when they are sucking up a popsicle for too long and take some time but I love your suggestion on the silicone straw, and there I something called sensory chew toys that you can look up on amazon they are for kids who like to do their nails that are dirty so you can get these fun they are like plastic little pieces that are probably silicon and shark tooth and other cool things and the kids can rip it off easy to it is not checkable and kids can put it in their mouth. Yeah – so! Is there anything you want to close with I want to make sure everyone knows where they can find you at Smiles for OC. Yeah so I mean I thank you for inviting me today and these are all things I am passionate about and will love for people to understand and share with their own children and I mean as a mom now I get it, it is awesome to be able to see it form the clarions side and the parents side, so I am super blessed that we have had that opportunity. I would take as many questions as anyone wasn’t to email me or text me or if they want a consultation, you know – do you mind I don’t want oth bother you for too much of your free time but if you have a chance maybe later today check the comments here if you can see any new comments that would be great or you can let me know, I would probably reach out to you actually so I won’t bother you so this is Dr. Christina Do – this is the 2nd of what I hope will be a long term speaking event where we get to share our time with the public to correct misinformation that is always circulated in logs that aren’t verified and trusted resources. We are lucky to have plenty of ties with our patients, but we know not everyone gets that. So we’re glad to share what we can in this live team, so thank you every one for this – thank you Dr. Do I am so lucky to know you and the patients are so grateful when I send them your way they feel so lucky to have you! Thank you for everything and thank you too! Thanks everyone for coming in and bye.

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Freddy and Bobby Tooth tales – Hey bobby we are going to play basketball – do you want to go? I can’t Freddy my mom is taking me to the dentist for the first time. What do you mean first time? I have never been to the dentist before. My dentist told me you are supposed to go after you get your first baby tooth. I know but I am scared to go. Have you been to the dentist before? Yeah I like going to the dentist. Really it is not scary? I thought it was scary but it turned out to be really fun. Really what does she do? My dentist is really fun and she made my visit a blast!
Hi Freddy I am Doctor Linda and it is so nice to meet you! Um, hi. Your mom told me you were a little scared to see me today – well.. I assure you, you have nothing to worry about Freddy – first you get to sit in this really cool chair. Second after every visit you get a prize! Really? What do I have to do? Hop up and we will get started! Alright Freddy today we are going to look inside your mouth and count your teeth with my little mouth mirror and tooth picker, open real big like and alligator so I can see all your teeth. You have got 20 teeth inside your mouth! A B C D E F G H I J K L M N O R P Q S T! Ok now we are going to check for plaque on your teeth. What’s Plaque Dr. Linda? Plaque is the yellow sugar bugs that attack your teeth. It can cause cavities if you don’t crush them up after you eat. What is a cavity? A cavity is a hole in your tooth caused by sugar bugs. How can I stop the sugar bugs so I don’t get a cavity? You can brush and floss your teeth in the morning and just before going to bed. Let me show you how to properly brush and floss your teeth. First you want to put a small amount of tooth paste on your tooth brush, usually the size of a pea. Move your brush in small circles over your front teeth. Start by cleaning the front teeth and the top teeth and finally the sides. Start with the teeth in the back and slowly move to the front teeth. Don’t forget to keep your tooth brush moving the entire time. To make sure you get all the sugar bugs, time yourself. It should take 2 minutes to brush your entire mouth. Oh yes, this is very important don’t forget to brush your lounge. Sugar bugs like to hang out on your tongue and make your breath smelly. Now it is time to floss. We use floss to get rid of the Sugar bugs in between your teeth. If you are just learning to floss then your mom and dad can help you with it. Make sure they floss too. Take a piece of floss and wrap each end around your middle finger, 2 or 3 times. Don’t wrap it too tight. Then hold the floss with your thumb and finger, now wiggle the floss in between two teeth and wrap it around one tooth in a c shape and move it up and down and then wrap it around the other tooth and move it the same way. After you are done cleaning both teeth wiggle the floss to get it out repeat on your next set of teeth until you have flossed all of them. Wow my teeth feel so clean, no sugar bugs here. Good job Freddy just make sure to brush and floss 2 a day and your mouth will stay sugar bug free.

Now it is time for your fluoride treatment. What is a fluoride treatment? Fluoride is a tooth vitamin that helps your teeth get stronger and protects them from cavities. Four ide is also in your toothpaste and the water you drink it is important when you are growing up to get enough fluoride so your teeth stay healthy and strong. The fluoride goes in this tray and the tray goes in your mouth for one minute and after one minute you spit the fluoride out. Wow that is easy just like strawberries. Next time we can try cherry cheesecake it is my favorite. Well Freddy you are all don great job today. Thanks Dr. Linda I cannot wait until my next dental visit. So what do you think you were right! There is nothing to be afraid of! I can’t wait to go to the dentist. Make sure you go to the dentist every 6 months for a checkup ad cleaning to keep sugar bugs away from your plaque and teeth, gums and tongue make sure to brush and floss 2 a day. Remember that tooth vitamins like fluoride are very important for your teeth. Fluoride can be found in your toothpaste and the water you drink. Eating healthy snacks like fruit and cheese instead of cookies candies or soda can help you avoid cavities. First visit by the first birthday is when your child should visit a dentist.

Tooth tales! This movie is awesome I wish I had a laser. Me too! Pew Pew Pew! Laser bean attack. Ouch! Are you ok Freddy? I don’t think so my tooth really hurts. Remember what our dentist said? Candy and soda can make holes in our teeth. They are called Cavities. Do you think I have cavities? Does that mean I am going to get a shot? Hmmmm.

The next day at the dentist’s office – Hi Freddy! Humph! You remember me? I am Dr. Christina, it’s great to see you again. Excited to see me huh? Well, let’s see if we can cheer you up – Come on back – your mom tells me you have a tooth ache. Please show me here it hurts? It hurts right here. I am going to take my tooth counter and tooth mirror to take a closer look at your tooth. Open wide! It looks like you have a really big cavity. Alright Freddy I have a few questions for you. Ok… Have you been brushing your teeth 2 a day? No. Have you been eating a lot of sweets like candy and soda? Oh yeah. Well you have developed a hole in your tooth called a cavity. Is it big? Hmmm, in order for me to see how big it really is – I need to take an X-ray of your tooth. What is an x-ray? An x-ray is a picture of your tooth that I take with a very special camera. It is special because an x-ray gives me the ability to see the special structures inside of your mouth, such as your teeth and bones. Oh… Don’t worry; we have a special cape that you can wear so nothing will hurt you. Next I put this little sensor in your mouth that tells us the camera which tooth to take a picture of. Alright hold really stills o I can get a clear picture of your tooth. Perfect, now we have a picture of your tooth and more importantly how big your cavity is. Can I see it? The tooth we took an x-ray of is right here, and the black dot right there is your cavity. That’s kind of big! Well it is definitely something that we are going to have to fix. I think your mom and I will need to have a little talk. I’ll be right back. Wait before you go Dr. Christina, why is there a poster of laser wars on your wall? Oh that I will explain as soon as I get back.
The treatment consultation – Well mom it looks like Freddy’s tooth ache is being caused by a really big cavity. I recommend that we remove the decay, and put in a filling that should take away any discomfort that Freddy is having in that area. As you know conventional dental treatments require the use of a high speed drill to remove the decay and fill the cavity. However there are a couple of downsides to using the drill, first the drill creates tiny micro fractures on a tooth surface and can leave debris behind that can leave bacteria behind or cause the filling to fail. Heat and friction caused by the drilling of the tooth surface can be very painful. In most cases a shot must be first administered to numb the surrounding area, and normally the numbness can last a few hours and children can accidently bite their lips and tongue. The exciting ness i that we have a new laser treatment known as the WaterLase, we can use this instead of the drill to beat Freddy’s cavity the best part of the drill is that laser causes little to no discomfort so a needle is not required most of the time. Let me show you how it works. The WaterLase uses a unique combination of laser and water spray to clear the decay. Since the water creates cooling sensation on the tooth pain caused by heat and friction is eliminated. More importantly the laser treats the tooth in a very conservative manner, clearing away Debris resulting in a healthier smile. Now that you understand the amazing benefits of dentistry with a WaterLase, let’s tell Freddy the good news. A few minutes later, and that is how WaterLase dentistry works. Awesome! Exactly now before we get started, there are a couple of things you should know. We have to protect our eyes from the water spray and laser so everyone in the room needs to wear these cool protective laser glasses. Cool! 2nd – the laser makes a popping sound on your tooth like popcorn. Let me show you how safe it is. Awesome! 3rd I am going to place a tooth pillow in your mouth. It should make your mouth comfortable and prevent you from accidentally biting down. One last thing, if you feel any discomfort, just raise your hand and I will stop, okay.
Captain Freddy has no fear let’s go! Okay Captain Freddy with my WaterLase cannon, these sugar bugs attacking your teeth won’t stand a chance. No more sugar bugs captain, how does that feels? It feels like you were spraying cool water on my tooth the whole time! Now all I have to do is fill in the hole that we just made with the WaterLase and paint your tooth so that it matches the rest of your smile. Perfect, let’s check your bite. Chew on this paper for me. Does it feel comfortable when you bite down? Yep everything feels great. Well Freddy your cavity is filled, your tooth is healthy again and most of all no numb feeling. How do you feel? No pain or anything. I am ready to watch laser wars again. Sounds like fun but before you go Freddy, your mom and I had a little chat about your dental hygiene.
The new and improved Freddy – Dr. Christina has this laser called the WaterLase and it zapped those sugar bugs just like they did in laser wars. It didn’t even hurt It felt like cool water thought. Awesome!
The benefits of WaterLase Dentistry – the WaterLase avoids the trauma of the drill to preserve more healthy tooth structure. WaterLase treatments can avoid the needle, meaning easier treatments and no uncomfortable after effects, like a numb lip or tongue. WaterLase treatments are more comfortable and relaxing, reducing stress and anxiety. The WaterLase supports a concept or conservative dentistry. There is enough retention of the WaterLase so the dentist only needs to remove the decay and the filing material will stay strongly in place. WaterLase treatments may not require anesthetics. Thus the patients is able to let the dentist know that their bite is perfect. Since the patient is not numb with the WaterLase, the patient can eat and drink immediately after the procedure.

Because sometimes we need thing out of our mouth, loose teeth in fact take a look at this. Look at this don’t pull it down because that is the wrong way to go we have to go up. (shouts) (Laughs) oh my God! Ow! We got it! It’s off show daddy! So what is the best way to get a tooth out? Kyla is here because Kyla apparently has a loose tooth that is close to being ready to come out and to help us with this procedure, and to help us with this procedure is dentist Christina Do – welcome everyone! Thank you. And that video is a little bit frightening – freaks me out just the oaf! Rip it out – so what is the best way to get rid of a loose tooth? Well before i answer your question let’s get rid of door knobs let’s get rid of strings because that is not the best way to pull out a tooth – because if you use a tooth attached to a string and if you attach it to a door knob or a handle to a heavy object you can really risk injuring your child and causing injury to their neck or head. So luckily there is a really easy way to do that – simply use your fingers grasp the tooth rock it forward roc if backward twist and pull out gently. If it doesn’t come out with that motion then it’s not ready to come out and that is okay! So luckily we are here today and we have Kyla! Kyla today is your lucky day because we are going to count your teeth and check to see if your tooth is wiggly enough to come out. Does that sound fun? Perfect! Wow we are thrilled huh. Ok we are going to wear the little fish – nice! So Kyla what we see when we open up our mouths – so Kyla open up really wide? Perfect – we always see the alligator, the bear and the crocodile, the donkey, and oh my good ness there is the elephant. Is the Elephant really wiggly? So we just touch the elephant and remember we just talked about wiggling it forward backward and if we twist and it doesn’t come out gently – then it’s not quite ready to come out so Kyla your tooth is not ready to come out yet. When it is ready to come out it will just fall out on its own – you definitely don’t want to force the tooth out. Well Kyla I have something for you – this is from the show and the tooth fairy when you get, when the tooth finally comes out you are going to put it in there and in the morning I think there will be a special surprise for you! Pretty cool huh – thank you! Thank you for coming Kyla

Now, how many of you out there have had a cavity filled? Now, I know many of you hate this sound. Fortunately for us that sound is becoming a thing of the past, we have a new Star Wars like laser beam that makes getting the kid’s cavity filled absolutely painless. We have Dr. Christina Do – she is a pediatric dentist. She is here with her patients – 8 year old Zac, and Zac you have no fear right buddy? What did you tell everyone during the break that you were going to do to me after – when we are playing some hoops? Beat you in basketball blindfolded. There we go! So he is going to beat me blindfolded but first things first you are going to be a brave patient right? So this is painless procedure you are not using Novocain? No Novocain no shots – this is great way of doing dentistry. 5 mins from start to finish. 5 mins from start to finish and no cavities afterwards. Are you ready Zac? Oh yeah – open the mouth and let’s get started. Say Argh! I am really serious to see how this works. Ok let’s get started the WaterLase dentistry is the greatest way of getting your dental fillings done these days. Gone are the days of pain shots fillings where you leave the office with a numb lip and lounge but now I can get you start from start to finish without a shot without any fear r anxiety. With the WaterLase you drop in the chair – and Zac you don’t want a shot – of course not! And you are not going to get one that is the beauty of this. Yeah! So the WaterLase is like a water gun – it squirts water into the mouth, chips away the decay and then the cavity is all gone. The patient feels no pain nice and comfortable and wants to come back to the dentist because he had the best cavity filled ever.so now this is great tool for adult patients too they can also hop in the hair and get their fillings done and leave without having a numb lip or lounge – so you are actually doing the drilling right now – yeah immediately we just put the patient down and get started. So Zac I am going to use my water gun to take out all the decay which are the sugar bugs that eat your tooth so the sugar bugs which are the plaque on your tooth which is like a mushy type of material and because of this there is a lot of infection in the tooth and eventually is you just leave the decay there which happens to a lot of patients because they are so scared to come to the office they end up needing a root canal which a lot of times we don’t want to have root canals – so this is the best and easiest way of prevention to take the decay out ad earlier today without having to get a shot. So the laser is within the machine here and it comes out as a beam of light and it breaks off the water molecule. So that right there is the lean – yeah correct. And you don’t feel anything right Zac? It doesn’t hurt at all? So naturally – the WaterLase is like a high powered water gun or hose that chips away the decay and ends up removing the decay. So you can have a very nice and conservative restoration just by using water to take out the cavity. So once I know I am back into hard tooth structure that means we have moved all the of the cavity which is great – so Zac are you doing okay? With all the cavity gone you can now have a rock solid hard tooth and the cavity is gone? It is all gone – now we are half way done, the bad part is gone and now we have to seal it? Yes the easiest part is the sealing bit – and now Zac we are going to paint your tooth in 4 different layers, so first we are going to use the material called H which is like a soap that cleans off the tooth which is really great so that way you sterilize the area that you are working on and that way you ensure that your cavity filling will stay on for a life time. So we leave the H on for a while. So the 2nd layer we are going to put on is called the Prime – so the prime is the kind of prepares the tooth material that prepares the tooth to receive the composite resin and then the dentists in the past used to use materials called the silver filling which is an Amalgam filling the old ugly filler fillings that you have in your mouth – so now we are priming it and now are going to the next which is called bond- bonding right there is to prepare the tooth like glue that attaches the composite resin to the tooth structure. So we also have something called the magic light and it hardens well. So once we put our composite resin it starts of as a petty material very liquid light, and ten with the magic light it hardens it up. So are most dentists offices going to have this water lase? Or is it pretty new? A dentist has it be well trained in order to use it and dentistry you know we want to be on the cutting edge of technology. Is there any solution for the sore jaw when you have your mouth open for so long? Well that is why we are using a tooth pillow – it kind of cushions for how long your mouth is open but for us luckily laser fillings are really quick – we are going to have Zac bite on this blue paper here just to make sure they filled it up perfectly go ahead Zac chew for me – chew like you are chewing bubble gum. Good job! And Zac you feel good right buddy? Perfect! How does the bite feel? Good! (Audience claps) thank you! You have been such a good sport here is your own basketball signed by all the docs alright! So you can beat me blind folded! Thank you so much Dr. Do!

Heart attacks are usually the results of inflammatory changes in the arteries around the heart. They are among the leading causes of death in the western world. Can periodontitis and other inflammatory conditions of the mouth effect the development and course of other disease such as Atherosclerosis or diabetes?

Cell to cell communication, oral health and general diseases.
Chapter 1 – spread of bacteria in periodontitis

Periodontitis is caused by a bacteria that trigger a destructive inflammatory response in the periodontal tissues that support the surrounding teeth, these results in the formation of periodontal pockets lines by ulcers around the roots of the teeth. The total areas of this ulcerated wound can range from 5 square centimeters to 20 square centimeters about the size of the palm of the hand. Periodontal bacteria repeated enter the blood vessel of the Gingiva through the ulcerated areas – especially when eating or brushing locally produced inflammatory substances are also released into the blood stream. Bacteria and inflammatory substances spread throughout the entire body, periodontitis can thus have an impact on the health of other organs located far from the oral cavity.

Chapter 2 – impact of periodontist on the cardiovascular system – Atherosclerosis.
Some bacteria can penetrate the endothelial cells that line the blood vessels. Well hidden from the immune system, these bacteria can multiply and infect other cells of the vascular wall. The endothelial cells. He endothelial cells recognize the bacteria and in response they produce substances that promote inflammation. And create further contact points of the cell surfaces. This attracts blood cells monocytes which then bind to the endothelial cells. Some infected endothelial cells subsequently die. Then the blood vessels lose their elasticity this so called endothelial dysfunction is the first stage of Atherosclerosis. The next step in the development of Atherosclerosis is the formation of so called fatty streaks. Some white bod cells travel into the vessel wall and differentiate between macrophages. By absorbing harmful cholesterol they turn into foam cells. Periodontal bacteria promote this process, leading to even more fatty deposits in the blood vessels wall. So the foam cells de off gradually forming a dead core within the fatty deposits, which becomes even larger as other cells like T-Lymphocytes are added. The narrowing of the artery reduced the blood flow. The affected tissues specially in the case of coronary arteries do not relieve enough nutrients or oxygen. Bacteria that causes periodontitis additionally promote the emergence of substances that attach the connecting underlying tissue as a result of the tissue damage the vascular deposits eventually brake up leaving a wound where blood coagulation takes place. A blood clot develops, this clot further narrows the blood vessel and may even cause complete closure. A heart attack or stroke may occur as a result. The inflammatory substances produced by the damaged endothelial cells are spread throughout the body by way of the blood stream. The periodontal bacteria in the blood causes a generalized inflammatory response which further stimulates the progression of Atherosclerosis.

CH. 3 – Effects of Periodontitis on sugar metabolism – type 2 diabetes.

The general inflammatory reacting triggered by periodontitis can also affect the regulating of blood sugar glucose. The high sugar causes the pancreases to produce insulin to reduce blood sugar – normally insulin receptors bind to the insulin when it appears in the blood. The binding of insulin to these receptors allow the sugars to be transported into the cells. The sugar contained the blood stream after a meal is thus inside cells where it is processed for energy or storage and the blood sugar level drops.in the presence of generalized inflation, substances are formed and interfere with this mechanism. They inhibit the binding of inulin and reduce the sugar update into the cell, the blood sugar level remains elevated. The inflammatory substances that are formed during periodontitis seem to play a special role. A severe case of periodontitis may cause elevated blood sugar levels even in the absence of diabetes, leading to so called insulin resistance, a situation in which the body’s cells no longer respond to the messengers. F diabetes is already present, peritonitis makes it difficult to control blood sugar levels and increase the risk of late complications of diabetes, such as kidney or heart disease. Conversely diabetes can contribute to the deterioration for the patients periodontal status. Here chemical compound made of sugar and protein molecules play a role – the sugar in the blood for example binds to the hemoglobin and the red blood cells, that transport oxygen – the relative amount form the resulting chemical compounds is important for the diagnosing and management of diabetes, if blood sugar levels stay high – other proteins will also start binding the excess sugar – this results in the so called AGEs that promote inflammatory complications such as periodontitis in different ways. For example – AGEs cross link the fibers of the connecting tutus this makes tissue remodeling more difficult and interferes with wound healing oral cavities and elsewhere. AGEs are recognized by the body’s cells such as white blood cells of the vascular wall. This triggers the formation of messengers attempting to cause inflammation – these messengers summon inflammatory cells while disturbing the wound healing process both factors accelerates the destruction of periodontal tissues.

Ch.4 – Dental Treatmentr

Research has shown that periodontitis as well as smoking, high blood pressure and Lipid or fat levels are risk factors for cardiovascular diseases. In the case of diabetes the 2 diseases may amplify one another. The successful treatment of peritonitis can therefore not improve only oral health but also general health throughout the body this is particular true of endothelial dysfunction which is the first step in the develop of Atherosclerosis and which improves with successful periodontal therapy. In many cases the successful fight against periodontitis also improves blood sugar levels as well as blood fat levels. The key to this success is a deduction of inflammatory substances in the blood – an important step towards breaking the vicious cycle of inflammation in the body

Our nation can only be as strong as our health. And we are not doing well now. We have two times the chronic disease of Europe and four times that of Mexico, China Japan and India. 75% of our medical costs are caused by chronic disease, by things that we can prevent only if America stops the influx of chronic disease. Only if each individual stops their own chronic disease, can we lead in health care and can America be a vibrant country with a high standard of living.
Within creation of health we are helping to take a person who is not yet sick who has not developed a problem and prevent them from ever going down the path to sustaining that illness so as I am identifying patients with the disease I would have a subset of patients who couldn’t find a cause of the problem. Then when I discover the amazingly strong association between the mouth disease and the things that I do treat, like blood resume, heart disease, lung attacks and strokes, even things like pneumonia and a whole long list of systematic diseases that can originate form diseases in the mouth – that was another turning point in my career. Once I looked inside the mouth I find the source of a lot of problems of people who otherwise might have not had their problems identified. The mouth and the rest of the body related anatomically and functionally, and that is why the oral systematic connection is absolutely inherent in the way we are put together. From a disease stand point when we have different situations in the mouth we respond our body responds with inflation and that is where we start the inflammatory cascade that is affecting these inflammatory diseases. I want you to think about this – inflammation and there is concept called inflammatory burden – when you get more inflation the accumulation of that will have a tipping point where you get an inflammatory disease. Inflammatory diseases are heart attacks, strokes, diabetes rheumatoid arthritis, various cancers, kidney disease, pancreatic cancer and the list goes on and on and on. We are in a state of chronic inflation and that is the basis for every disease that everyone has it is the basis for cardiovascular disease and it is the basis for cancer, when you are dealing with periodontal disease there is this entire inflammatory cascade going on that people don’t understand. When you get a cute for example your body is trained to health that cut and that goes through a process of inflammatory response due to solving the problem and resolve if you always have a chronic inflammatory bacterial condition in the mouth then you never turn off the process of inflation. In other words you never get the opportunity to resolve and go away – there is too much that the body can’t react to them and the body gets sick – periodontal disease. Periodontitis gum disease whatever you call it – it all begins with bacteria. Bacteria are microscopic organisms that are in your mouth – there are billions. Over time these bacteria can stick together and multiply over and over again. Thy can then form a colony when joined together to create a thick layer called a pale bio film. Then over a short period of time, it can dramatically spread through all of your mouth teeth, gums, lounge, and cheeks – everywhere. If there is an opening in the blood stream in your mouth, the harmful bacteria can enter causing the body to have many sicknesses, but there is another problem that occurs in response to the bacteria as your body tried to fight back, inflammatory cells are triggered as your body tried to kill bacteria but bacteria builds its own strong defenses an battles back, this microscopic war ensures an the result is chronic inflation and inflation is the basis for so many diseases. So bacteria is basically an organism that comes into our body and attacks our body and causes diseases and that can be picked up from a door handle or I have strangely enough had patients that have transmitted periodontal disease transition form their dogs – from feeding them treats and not washing their hands afterwards and eating or letting their dogs kiss them. So when you are growing up and your mom would say dna drink after your brother or don’t share that popsicle with that friend down the street, you are going to get germs or go wash your hands you were just outside you might have germs. Those germs are bacteria that then can go into your mouth and set up infection. So we say to the dental patient – you have an infecting in your gums. The total area of your gums is about the size of the palm of your hand if you looked at the palm of your hand and you saw an open wound about the size of your palm of your hand would you just decide not to do anything about it and yet people are choosing every day not to address the infection in their mouths. People think that it is normal when they brush their teeth to have their gums bleed and I don’t know where they came up with that. If there is a little blood in the sink that means there is a problem. The bacteria that causes inflammation in the mouth will typically cause inflammation in the rest of the body. If there is a little inflammation between the teeth then that means there is a problem with those high risk bacteria maybe getting into the blood stream and causes any of those systematic diseases that can originate bacteria in the mouth. We’ve always had a keen inters in our work regarding the mouth to prevent heart attacks and strokes and that is just intensified as science has evolved. We now have great science telling us that the cause of arterial disease is inflammation and another source of arterial inflammation is an infection in the mouth with the most recent study coming out that actually implies that up to 50 percent or more of acute heart attacks are triggered by oral infections – that is huge! Heart attacks are the number one killer in this country – strokes are the number one cause of disability and the current cost of cardiovascular disease to our healthcare system is about 518 billion dollars and it is all preventable.
The mouth and diabetes – inflammation sets up a reaction that causes things in our body that makes us less responsive to insulin which is how we develop type 2 diabetes. So whether it is inflammation from just a fat belly or whether it is inflammation from gum disease or whether it is inflammation because you got a chronic abscess some place because it is the same process of resistance to insulin which leads to type 2 diabetes and it is the hallmark of type 2 diabetes. Even mild periodontal infections, when it occurs in combination with some other secondary infection it could cause severe or adverse outcomes, and for periodontal disease it tends to be ignored because ti doesn’t kill – but I think what we are showing here is that periodontal disease does kill because if the bacteria gets into the blood circulation it gets into the uterus and it can kill the baby.
The mouth and hospital infections – they now tell us that half of America has a condition known as periodontal disease, but what concerns me the most is that people that now go into surgery have this condition and we know what happens with this condition in surgery, the body can only fight infection on so many fronts. It is like a war, it has only certain amount of resources it can allocate to that fight and when you have an infection elsewhere in your body it has allocated resources to that infection site and then when you go in and do that surgery you create another wound and that wound demands that your body puts attention to it too so the reasons you don’t do surgeries on patients who have infections because it diminishes their ability to recover from the surgery and it increases the likelihood that nay other bacteria can take hold of just enough antibodies to fight that infection. It is clear to see that the inflammation cause by periodontal disease is a serious problem. For the mouth of America to get healthier there is a specially trained group of men and women in this country who will have to step forward and provide preventative care. Some refer to them as oral medicine specialists. We know them as the dentists. Now the deist is looking through a wider scope a wider view finder and a new design of a screener looking at a wider context treating the whole person vs. just the mouth – and we are not saying that dentists are going to replace medicine – they are not they are partners with and they are the first line of defense because the mouth is the first indicator and check this out. 9/10 patients who go to a dental office do not have a primary care physician on their medical history form. The public government insurance care givers and even dentists themselves have to being to think of dentistry as part of the first line of defense against disease and sickness. The distinction between a standard dentist and a complete health dentist is extremely important. The standard dentist does a good job of taking care of teeth in the mouth, but a complete health dentist focuses not only on teeth care and the mouth but also for the complete care of the individual. I now we are going to make some vast changes in people’s lives for better but we are going to save a lot of lives we are going to save a lot of health care costs and I have no doubt that the world would be better place because of all the work that these passionate individuals are doing. There doesn’t have to be any on hero there just has to be a whole lot of heroes working together. One for the keys in everyone getting healthy is decreasing inflammation and the most powerful thing we know about is decreasing inflammation is taking care of your gums and dentistry has a key role in that.

Large stain molecules have a dark colour making teeth appear dark, oxygen molecules from KöR Whitening Gel break down large dark stain molecules to tiny white molecules making teeth appear white. KöR seal whitening trays seal whitening gels in and seal damaging saliva out like other whitening systems, this seal in combination with KöR whitening gel provides hours of effective whitening. Ordinary whitening trays do not seal in whitening gel or seal out saliva. Enzymes in saliva immediately start entering in ordinary whitening trays, destroying whitening gel on contact.

Hi I am Dr. Rod Kurthy; I am the developer of the KöR Whitening system. I am going to go over all the details that you need to know to do your whitening at home; I would still like to have you read those instructions that came with the kit! It is very important and it will answer a lot of your questions.  

Always refrigerate your whitening gels

First thing to remember is to always keep you whitening gels in the refrigerator. Now every night when you are going to bleach you are going to wait until bed time. Now that does not mean you can put your whitening trays in your mouth and watch television or read a book. You have to be ready to actually sleep. Now what you want to do is you want to brush your teeth first, ideally floss. Then the next thing you are going to do is to apply your desensitizer. Now you are going to apply your desensitizer only the first 2 nights. You will also apply it each mooring but in the beginning just night one and night two. 

Applying the Desensitizer

Okay now that you have brushed your teeth the next thing to do is to apply the desensitizer. Take one of the slots from the kit and the desensitizer, and then drop some of the desensitizer to the swab until you can see this thoroughly moist. Madison her you go. Now Madison is going to show you how to apply it, as you can see she is applying force on the outer surface of the teeth near the gum line. Then what she is going to do is apply it right to the edge of the biting surfaces of the front teeth, both top teeth and bottom teeth. Now as you are doing this throughout the mouth, whenever you feel you need to re-wet the swab you can just add more drops to it as needed. Now let’s pretend that Madison has applied it to all of the teeth top and bottom. Notice how she is keeping her lip away from the teeth as best as she can. She is going to do that for about 30 seconds and after that she will rinse out with water. 

Filling your KöR Whitening trays 

Next we are going to fill the whitening trays. Remove them from the aces and notice how flexible they are and remove the cap of the whitening gel. Now let’s go over the technique for filling your trays with the whitening gel. Notice that I am not going to put any gel on the last tooth here? I am going to start on what is called your first molar, now the bicuspid, capsid, the larger the tooth is the more whitening gel you need to place, and notice how I am placing it only on the outer side. This is what it should look like when you are done, next let’s look at the lower tray. Again start on the molar, I go to the bicuspid , the capsids tooth and now on the smaller lower front teeth I am going to be using less gel, than we did on the upper. This is what it looks like filing the lower tray. 

Insert your KöR Whitening tray 

Ok we fill the whitening trays with gel, and now remember the gels were in the refrigerator before we placed within the tray so the gel is a little bit cold. If you are one of those people that get a little bit of teeth sensitivity, so what you might want to do is you would want to fill your trays before you brush. Now remember that these trays are flexible. When I place these trays in Madison’s mouth the thick gel is going to push the gel away from the teeth that is not good. So what you need to do is you are going to have to push this back against the gum, now I am going to show you that. Ok now let’s place this on the teeth, be sure to push this all the way up, and notice as I mentioned before how the thick gel is pushing the tray away from the teeth a little bit so what you do – this is very very important. You need oth gently push it back and please notice that as I push this back a little bit of gel is just peeking out over the edge. That is very important. If you don’t put enough gel in and you don’t see it peeking out over the edge, you will not be able to seal against saliva and you will have a problem and not get as white. Then just wipe off any excess gel here and then of course insert the lower one in after, then we are done.

When you wake up in the morning…

When you wake up in the morning take your trays out, rinse your mouth, brush your trays and then you can clean your trays. Clear then by running them under cool water, and use a cotton tip swab to clean then in the water, but be sure not to use the cotton tip swab that comes with your bleaching tip. That is meant only to be used with the desensitizer. Once you thoroughly clean your rays, shake the water off an place them back in your tray case. 

Final Tips

Every morning after you brush your teeth be user to use your desensitizer on teeth in the same way that we showed you before. During your whitening you want to avoid staining foods. Examples of foods to avoid – Coffee, Tea, Red wine. A good set of foods to avoid is anything that would leave a permanent stain on a white coat like what I am wearing. 

Ensure a lifetime of white teeth

After you are finished with your whiting you can go back to your normal diet, as long as you maintain it. You are putting forth a lot of effort to get your teeth whitened. It is very important to keep that whiteness your entire lifetime. The wee to do that is with the KöR whitening gels. The dentist will be able to supply you with that. The dentist will go over a suggested maintenance routine to follow at home. Most often we like to see people wearing their whitening trays maybe once a month or so.

Do not skip nights during at home whitening

If possible don’t skip nights when ya do whitening at home, the result is much better if you whiten ever night consecutively. If you have a problem at all, please call your dentist and let them know. I am sure you are going to be thrilled with your whitening results; you could not have selected a better method.

The maintenance of clean teeth and gums revolves around brushing and flossing. Place the toothbrush bristles next to the gum line, on the outer surfaces of the teeth. Brush gently using back and forth technique with the toothbrush. For the inner surface of the teeth place the bristles next to the gum line and brush in a circular motion. The inside of the mouth is where the most plaque accumulates. Brush the surface of the teeth where the chewing of food takes place, in the same circular motion. To clean those places between the teeth where a toothbrush can’t reach. floss once a day to remove food and plaque before it can cause gum disease. So, eat a well-balanced diet, brush twice daily, and schedule regular checkups with the dentist.

Do you snore excessively? Do you suffer from daytime fatigue? Do you awake during the night with shortness of breath? You may suffer from the life-threatening sleep disorder known as sleep apnea. About 1 in every 15 Americans suffer from sleep apnea and it is a problem that many don’t even realize they might have. But what does this have to do with dentistry? Because sleep apnea is caused by an airway obstruction, the disorder can be treated through the mouth. The Thorton adjustable positioner, or Tap appliance is one of the more popular ways to treat sleep apnea. When the jawbone yes lax, the tongue and soft tissue obstruct the airway. The tap appliance advances the jaw bone, allowing the air to flow freely and making sleep more restful throughout the night. If you think you might suffer from sleep apnea, talk to your dentist today about possible treatment options.

At a young age our teeth are healthy white. But overtime the enamel coating the tooth is so slowly worn down. Causing our teeth to become stained and yellow, which is why teeth whitening is become increasingly popular today. There are a few methods for whitening. They include at home and in office. With in office treatments, you will see faster results, receive the safest treatment for bleaching the teeth, and yield the whitest smile. So, don’t settle for teeth that have become stained from years of coffee drinking, tobacco use, or just aging. Ask your dentist about whitening options that may be right you.

Veneers are thin handcrafted porcelain shields worn on the front of the tooth which improve the appearance of teeth that are chipped, cracked, stained or worn. Veneers are thin as contact lenses, and are an aesthetically pleasing option of closing gaps, lengthening teeth, and providing symmetry to make your smile more natural. Veneers are intended to last for many years without changing color. They are one of the most popular cosmetic procedures in dentistry. Ask your dentist if veneers may be right for you.

Fact or myth? Expensive toothpastes are always better than cheaper ones. Myth. Different toothpastes are better for different teeth in situations. Sometimes moderately priced toothpaste can be more effective. Ask the dentist about what might be best for your teeth. And always look for the ADA seal of approval. Fact or myth? If a tooth is white, it must be healthy. Myth. Under the surface there may be cavities, problems with the root or other abnormalities. Fact or Myth? Teeth whitening is harmful because it damages enamel. Myth. There are many modern teeth whitening processes that have minimal harmful effects. Teeth whitening isn’t for every mouth or person though. Consult the dentist before you proceed with whitening treatments. Fact or myth? Dentists should be feared. Myth. With today’s advancements in technology and safety practices there is nothing to worry about. Procedures are as quick and painless as ever. Fact or myth? You should visit your dentists at least twice a year. FACT.

Fact or myth? If you have a cavity, you will know it. Myth, Mild tooth decay has no symptoms. Sensitivity begins to occur when the tooth decay is already causing damage to the nerve. Today’s dentistry prevents tooth decay with sealants and other conservative methods. Fact or myth? Sugar is the prime cause of cavities. A fact and also a myth. Acid is the main trigger in producing the bacteria that causes cavities. The bacteria is then fueled by the consumption of carbohydrates. Sugar is a trigger in cavities, but carbs as a whole are the main cause. Fact or myth? Cavities are the prime reason for root canals. Myth. Root canals are a result of nerve damage. And untreated cavity could lead to nerve damage, but root canals are on set by number of different factors. Facts on myth? Brushing and flossing are the best way to prevent cavities. Fact. Fact or myth? Expensive toothpastes are always better than cheaper ones. Myth. Different toothpastes are better for different teeth in situations. Sometimes moderately priced toothpaste can be more effective. Ask the dentist about what might be best for your teeth. And always look for the ADA seal of approval. Fact or myth? If a tooth is white, it must be healthy. Myth. Under the surface there may be cavities, problems with the root or other abnormalities. Fact or Myth? Teeth whitening is harmful because it damages enamel. Myth. There are many modern teeth whitening processes that have minimal harmful effects. Teeth whitening isn’t for every mouth or person though. Consult the dentist before you proceed with whitening treatments. Fact or myth? Dentists should be feared. Myth. With today’s advancements in technology and safety practices there is nothing to worry about. Procedures are as quick and painless as ever. Fact or myth? You should visit your dentists at least twice a year. FACT.

Dental implants are titanium roots, that are replaced with in the jawbone to resemble a tooth or group of teeth. A screw is inserted through the gums and into the jawbone. A porcelain crown is then attached to the screw to become the new tooth or teeth. They can be used to support dental prosthesis including crowns, dentures, and bridges. Today’s treatments are so natural looking, no one will know you had surgery. There’s approximately a 95% success rate for all implants. With modern advances in dentistry, some implants can be restored immediately with life like all porcelain crowns. For more details ask your dentist.

Root canal therapy is a very common procedure. It has a reputation of being undesirable and painful. But when done properly it is actually painless. Every tooth in your mouth is composed of a crown and a root. When a cavity or bacteria penetrates the tooth, the root and its nerves become irritated. As a result, the bacteria within the pulp cavity needs to be removed and cleaned in order to restore the tooth to its healthy state. Following the procedure, the tooth is fragile and consequently is restored with the natural crown for a lifetime of durability. Root canals have a success rate of 95% or greater. Most root canal are diagnosed by patients’ sensitivities to a specific tooth. Be sure to consult your dentist any symptoms or discomfort occur.

A bridge is a non-surgical way to replace one or many teeth. A bridge uses the adjacent teeth as anchors to support the missing tooth or teeth. With today’s dental advancements, a bridge can be fabricated in a fairly short period of time, using a metal or nonmetal foundation. Don’t let that missing tooth affect the way you speak, eat, and smile. Bridges yield immediate results that last a lifetime. Ask your dentist what type of bridge may be right for you.

The 3 stages of gum disease are gingivitis, periodontitis, and advanced periodontitis. Gingivitis is caused by toxins irritating the gum line as a result of plaque buildup. Signs and symptoms of gingivitis includes swelling, sensitivity, and bleeding of the gums during brushing and flossing. Gingivitis can be easily reversed through professional care and good home oral hygiene. Periodontitis is categorized by irreversible bone loss that results from untreated gingivitis. The gums may begin to form a pocket below the gum line which traps food and plaque. Dental treatment and home care can help prevent from further damage, but at this stage, the results are not reversible. Advanced periodontitis is when the fibers and bones supporting the teeth destroyed. This may cause teeth to shift or loosen. Teeth may have to be removed depending on how advanced the disease has become and if treatments are not effective. You can begin by preventing gum disease with good oral health. Pick up a brochure or ask your dentist today.

A dental implant is an excellent treatment for replacing missing teeth. Root form implants – the most common kind of dental implants are small titanium posts that replace the roots of the missing teeth. Custom fitted artificial teeth are secured to the implants which hold the teeth firmly in place. Some restorations like single crowns and bridges are not removable. Other like many full arch dentures can be removed for sleeping or cleaning. Depending on the situation placing an implant involves several phases, and treatment times can vary widely. Frist we must determine if an implant is right for you by discussing you health history and treatment goals and performing a comprehensive exam to heck the health of your gums and jaw bone. Will also determine if you need any additional procedures such as bone grafting or gum sruegry. To begin the procedure we shape a channel in the bone and then place the implant into the prepared space. At this point it may be possible to place a temporary restoration. Over the course of the next few months the implant will become securely fused to the bone. The last step is to secure your beautiful final restoration. Implants have several benefits. They stimulate the jaw bone when you chew, and preserve the jaw bone and keep it healthy. They are also strong and comfortable and secure and they look and feel just like nature teeth. With careful home care and regular checkups and cleaning, here in our office an implant can be an excellent long term solution for missing teeth.

Sometimes when a tooth is broken off due to a fracture or decay there is simply not enough tooth remaining to place a crown fortunately there is a wee to replace the missing portion and save the tooth. By bonding one of the new plastic resin filings material and building the tooth back up prior to preparing it for a crown. The first step and place in the bonded build up is making sure the tooth is free of decay. A mild etching solution is placed to prepare the tooth for bonding and then the resin filing material layer upon layer and harden upon the high intensity light. Building a tooth up prior to a crown strengthens the tooth, provides better retention for the crown that is placed over it and may reduce sensitivity by providing insulation from the sensitive inner pulp. A core build up is a necessary and important step before crowning for teeth that have been significantly damaged due to decay or fractures.

I owned an older erosion of the WaterLase. I loved it and the things that it can do in my practice, and with the new IPlus it is just smile above the old laser the technology is biter, the tip selection is better and I am acutely seeing more patient in the given hour using the given WaterLase for doing my filings that I would be if I am using traditional drill and fill anesthetic. The IPlus for me has been amazing. It is amazing in a sense that it is so user friendly. It has the buttons it has the finger tips and you touch button and basically the IPlus will go the setting that you want it to go to. It is really a simple technology to use because it is a dental hand piece. Ever dentist is trained in the use of a dental hand piece all of us use a dental hand piece in various degrees of motion and various degrees of pressure, and the laser is that same thing – it works entirely different but the feel to the touch of it, is something that we already have as dentist – but I found that the learning curve to be fairly negligible to tell you the truth I mean the  screen is quite intuitive and there are only quite  a few buttons to push to get the right procedure up on the screen, I found it virtually effortless to get trained and using the water lase. When you first think about incorporating a new instrument into your practice, you always have a little bit of hesitation and just like anything new, it takes a little time to get used to. But the ROI has definitely gone above and beyond our expectations. With the new turbo hand piece it can be just as fat and just as rapid as a regular hand piece also with the new I plus the settings and the intensity and the tips allow us to cut more effectively, more efficiently, fatter and easier and gives us the ability to do it without anesthesia. What I am hearing form patients is that the procedure that they enjoy the most is you having a WaterLase procedure done on them, because for them not having shot and being in and out of the office usually in minuets is a profound new experience. One of the other things that I like about the WaterLase is the ability to work on hard tissue, and then if it is called for to go ahead and do a soft tissue prouder. You would then have to switch to another procedure before the WaterLase does the hard tissue and the soft tissue. I like that. I believe that the water lase is a great experience for a patient, it is a great way to treat our patient better and it is a great way to give our patients fully conservative dentistry and it is a really great way of staying on top of technology. I saw it as an incredible opportunity to incorporate something in my practice that the general public will be interested in and that would excite me about being a dentist. We are able to do some much more dentistry on a daily basis and now we can pretty much do everything in our office. The experience of the patient – they are left with; this is unbelievable. I don’t have to come back and I did not get a shot. That is that I like about the WaterLase.

Gingiva is another name for gums, attached are sometimes called marginal Gingiva to be recorded. The amount of actual attached Gingiva is the visible gum tissue minus the pocket depth that is indicated by the white arrow. Attached gingival tissue may appear to be adequate under visual examination, but can be diagnosed inadequate with a thorough periodontal examination. In this case there is no attached gingiva associate with this lower interior tooth. The reasons it is important to identify these areas is to prevent localized gum or bone recession. There are various periodontal procedures to increase attached gingival tissues and prevent this from happening. If left untreated this recession and bone loss can progress, to such severe levels that a tooth actually fall lout on its own. This movie shows how it can perform root coverage and how to treat recession with in sufficient gingival in the area. The tooth roots that are exposed are then treated with different types of preparations such as citric acid, to increase tissue attachment. A connective tissue graph is placed over the root areas. The gums are then moved higher up on the tooth and sutured into place, covering the root areas. A protective packing may then be placed. The attached gingival tissues heal and cover the areas and roots. Connective tissue is harvested form the pallet. It is tissue that is taken from the inner layer taken from the outside tissue and the palatal bone. Once removed the incision line is closed with sutures and the area heals. Teeth may experience recession where the roots become exposed. This movie demonstrates a situation where some teeth have also lost their top gum tissue or attaché gingival. Attached gingival holds the gums firmly to the teeth and presents calculus or tar tar building up between gums or teeth. To treat this condition the flap is reconnected oth the teeth. A prefabricated human graft tissue can be placed into the area. The graft is adjusted to fit. And sutured into place. The flap is then repositioned back on top, covering the graft completely and sutured into place. With time the graft will promote the growth of new tough gum tissue, or attached gingival over the lost areas to the desired levels. Here we see that the results we can expect from the surgical correction of recession are dependent on the level of adjacent bone. The exposed root area is outlined in white dashes. If interproximal bone high is normal, we can get ideal results – the lower the level the less ideal the result are. When there is recession of the gum, the roots of the teeth are exposed. The roots are not as hard as the crown enamel – improper brushing techniques such as brushing side to side such as a hard tooth brush can cause abrasion of the tooth root. The tooth brush acts like a saw especially if it is a hard tooth brush/ these areas may become severe and cause more recession and severe tooth sensitivity.

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If you have deep gum pockets infected with periodontal disease we may perform flap surgery to help the area heal. This procedure sometimes called a pocket reduction maybe necessary when gum pockets are so deep that scaling and root planning cannot remove the infection. To begin the procedure, first make sure that all the areas, are completely numb. Then we gently separate the gums form the tooth. This creates a flap and gives us access to the bone and tooth root. We remove any plaque tar tar, bacteria and infected tissue form the area. We may then smooth the bone around the teeth. This will limit the areas where the bacteria hide and reattach the gums to the tooth. In some cases, we may also apply special proteins or other treatments that help reattachment. The gums are then secured with a few stitches. As the gum tissue heals it tightens more closely around the tooth. Periodontal flap surgery removes a source of infection, reduces the size of the gum pockets, and helps the gum tissue heal and reattaches to the bone and makes it easier to keep the area plaque free. It is an effective method to treat the deep seated periodontal disease and restoring your health.

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When all the teeth in an arch are missing an excellent treatment for replacing them is a denture secured with implants. Depending on your situation the denture may snap onto the implants of your jaw. Or it may clip to a bar that is attached to the implants. These systems keep the denture secure in your mouth but allow you to remove it en necessary. Placing an impact retained denture, generally involved several phases. Frist we completely numb the area to make you comfortable. Openings are made in your gums, and a channel for each implant is made in the bone. Then we place the implants into the repaired channels covers are placed on the implants and the gums maybe stitched closed for healing. During the healing period you might wear a temporary denture or your own denture can be modified to fit over the implants. Healing may take several months as the implants become securely fused to the bone. The next phase starts with a series of appointments to fabricate your final denture. If your gums were stitched close we will gently expose the implants. We generally take impressions, and bite registrations. The lab uses these materials to make an accurate model of your mouth. They will use the model to create a final denture that precisely fit the implants and your bite. When it is ready we will place the denture oth the impacts, check the ft. and your bite and you will aver your beautiful final denture. Dentures attached to implants have several advantages. The implants slow or stop the loss of jaw bone that occurs when the denture is missing. The denture is stable in the mouth which makes it more comfortable to take and chew, and the dentures are removable for easier cleaning and heck ups. With proper home care and regular checkups, your implant retained denture can provide a secure and natural looking smile.

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Bone Graft – sometimes a tooth is removed and a dental implant is not placed right away without a tooth the jaw bone usually shrinks. The result is often significant bone loss. This bone loss is not the person’s fault, it is the natural reabsorption process that typically causes bone deterioration, in order to had a dental implant and teeth at a later date – the person may need more bone to anchor the implant. There are several ways to reproduce the bone so that you jaw will be able to accept the dental implant. These are called bone grafting techniques. Socket grafting is bone added at the tooth removal. The tooth will be removed and the bone grafting material will placed in the hole that will be removing the tooth for a 4 month healing process. The bone heals and then the dental implant can be placed. A tooth is placed on the dental implant. For patient that have more bone missing a technique involving placing block of bone with missing bone works well. The blocks are shaped in the desired size or place with titanium screws. They are left to heal for 4 to 5 months. When the bone heals there is plenty of bone for an implant when it is not possible to use a block a softer mix of bon substitute is placed where the bone is missing and is covered with a tarp membrane. This graft also grows bone. When the bone heals a dental implant is placed and allowed to heal and the final tooth is placed on it. Bone grafting procedures are safe and the process keeps improving with new technology. Still they are not a hundred percent successful and several efforts may be needed for success. The main complication that can happen are: failure to grow bone, infraction, pain and all of these complications are usually easily controlled and treated with appropriate antibiotics and pain medication. The advantages far outweigh the risks giving you new permanent teeth that should last you a life time.

If you have a crown it was placed because the outside of the tooth was damaged and needed more than just a filing. But the crown does not protect the inside of the tooth called the pulp. The pulp contains the nerves blood and veins that keeps the tooth alive. If this pulp becomes infected it will need root canal therapy. Infected pulp will not heal on its own. If we don’t perform root canal therapy the infection can spread and cause a painful abscess.

The 3M – true definition scanner. Live patient demonstration of full arch scanning with the 3M true definition scanner. Your doctor for clinician moves the wand around your mouth capturing videos of all sides of your teeth and gums. You can watch the 3D model of your teeth appear on the monitor in real time. When the scan is complete you and your doctor can review, zoom in and out, and rotate the image to get a true picture of your oral anatomy. You can then ask questions about your mouth and better understand what treatment options your doctor recommends.

Dr. Timothy Rolfes – what is digital scanning. Digital scanning is where we eliminate the need for the old impression which is sometimes called the goopy impressions. How does the digital impression scanner work? It takes a 3D impression of a patient’s teeth. What is the benefit of digital scanning?  With digital scanning you take a 3D accurate impression and send it to the in-house mill which will design the crown and prepare it for the patient on the same day. Can all this be done in one visit? Yes so now what we are able to prepare the tooth, scan it, mill the crown on the same day and send the patient home with the final crown all in one visit. If you are interested in learning more about comprehensive dentistry solutions available at SMILES4OC, we welcome you to book an appointment soon – (714) 557-0700

To watch more videos visit: www.doctorandme.tv

What do you do to simplify the insurance process? It is not a secret our lives would be easier if we didn’t have to bill insurance because it is time consuming and often frustrating to keep a track of all the different 25-40 different insurance carriers that we deal with. As a courtesy to our patents for no extra fee, we will dig deep and be the detective to try to find everything about your insurance so that we can inform you before we perform, with the benefit that might be available to go towards your patient cost. Then we will bill the insurance for you.  So do we have to pay the whole fee? The payment can come her and that way we only ask for the difference, you don’t have to come up with the whole fee. Our patients do really appreciate that. A healthy smile is priceless. Proactive dental care can minimize future expenses, and keep you smiling for years to come. Smiles4OC brings you the financing options to make it happen. To watch more videos visit: www.doctorandme.tv

We go now to Lora Windsor here has this report. If you are like most people a trip to th dentist can be quite scary – even more so for a child. WaterLase technology makes a safe and gentle alternative to traditional dentistry as we learn from Dr. Christina Do – a researcher for the leading laser company Biolase who explains how the new WaterLase technology works. WaterLase is a laser dental instrument that can cut away enamel bone and dentin. So basically what it does for us instrument for us to do laser fillings. There are many differences in the way that dentistry was done before in the olden days, vs. WaterLase dentistry today. It is just amazing – n the olden days the child would come in knowing that they would get a shot and immediately they would be filled with anxiety and it would just be a very uncomfortable and very phobic filled experience for the patient. But now – with WaterLase, patients come in they sit down immediately in the chair and then we just start. The way that I educate my children patients is basically I just let them know that the water will remove the decay inside their tooth and so basically it is like giving their tooth a car wash or giving their tooth a bath and I actually name all of the teeth indie the mouth – so for example if the alligator had a cavity basically we are just giving the alligator a bath with the WaterLase and then removing the decay giving the child a very healthy mouth and putting in a very nice white filling. From start to finish he WaterLase procedure is much fatter because you don’t have to wait 10 minutes or the patient to get numb and I you think about it if you are seeing a patient knowing that they are going to get a shot you spend 5 minutes coaxing them into the shot and then 10 minutes waiting for them to get numb and then another 5 minutes for them to calm down. So you do save so much time by doing a WaterLase filing because you eliminate that 20 minute of pretty much psychologically coaching them back into comfort. We daintily have a lot of kids who come in who are very scared of the dentist, in the past they have probably been to a pediatric dentist or a dentist who has not had the laser – the water lase in their practice and because of that they are very fearful because they have not had a shot at these dentists who did not have the WaterLase. So whenever they come to our practice, you use WaterLase to do all of our filings here in our practice and so that eliminates the shot complete giving our patients a really positive fun experience here.  I didn’t actually have any pain; i didn’t actually feel anything really like it didn’t really hurt. You don’t feel much you only feel like the water splashing in your out. It does not hurt a bit. If you think about the WaterLase it is just using water to remove the decay in the tooth so even you know how kid children are very squirmy. Well if the kids move basically all that happens is their mouth gets wet. So there is nothing safer than the WaterLase, because you cannot cut the child and basically it is very safe. Basically what they can say is that it is equal in speed to the drill and if you had to compare the drill to the WaterLase they work at the same sped, considering that you have a WaterLase who can adequately use the water. This is definitely in the future of dentistry – I love WaterLase because I know that I am treating my kid patients very well and very comfortably so I totally believe that WaterLase dentistry is the way of the future for our patients.

Biolase celebrates 15 years of WaterLase – American Dental Association Annual Session – 2014. New Orleans, Louisiana. Here in New Orleans for the annual session we are talking to – my name is Christina Do, I am a general dentist in Costa Mesa, California. Thank you for taking the time. We are here to talk about the WaterLase celebrating its 15th anniversary. So tell me what the WaterLase has done for you in California. The WaterLase has been amazing for me in my practice, basically I was very lucky to start using the WaterLase straight out of dental school and so I created a whole new Niche for myself, by introducing the WaterLase into my dental career. So I have ben able to grow a practice from virtually zero to having at least half my practice consigning pediatrics than adults. Whereas before I would only have senior or adult patients but it has really helped with anxiety for patients, and just transforming their dental experience. So how to do you position the laser in your practice, is it something that they get excited about especially the kids? Well obviously patients do not like shots, so a lot of times I tell my patient that if they have a laser filling they have the possibility of not having any anesthesia for their dental treatment and at the same time they can leave the office without having to numb their lip or lounge.  But a lot of times if you don’t introduce a shot, then third dental experience is amazing and it is less painful because post-operative sensitivity is much less. What is the reaction from your patients? Well okay patients are often initially very surprised, very pleasantly surprised and they get through it very fast which they like because no one likes to sit in the dental chair longer than necessary, but the fact that they just had water squiring inside their mouth and then they had all their teeth cleaned out and a filling done, In virtually less than 5 minutes – it makes them very happy. Thanks so much of talking to me. Yeah sure.

Hi I am Dr. Christina Do – I am Dr. Tom Rolfes, Hi I am Dr. Terry Dun. Our staff our doctors and I are really excited to meet you and we look forward to helping you with our dental health care. Our ability to do the types of dentistry often referred to specialists allows our patients to have their dentistry done confidently, in a safe familiar and friendly environment. We have the latest technology; we offer laser dentistry, allowing our patients to get great care without getting shots, and without any dental anxiety. I had my filling done and I just love Dr. Do she’s so nice. I have been coming to Dr. Rolfes for almost 12 years or more and I have nothing but a wonderful experience from the time I walked through that door till the time I leave. The staff is very professional, very easy to work with, and it is just a pleasure to come here. Our patients love coming here because it is very fun and a very caring environment. We hope to help you create a healthy and beautiful smile and we hope to see you soon. We offer flexible scheduling as well as many affordable options. So thank you for visiting our website and I look forward to seeing you soon.

An orange county doctor just got back from an unbelievable adventure that was not part of his original travel plans. A cosmetic dentist from Costa Mesa was on vacation in Fiji, when he came across a local fisherman whose arm was nearly bitten off by sharks. Christina Gonzalez is here live with the doctor who became a south city hero. Yeah he is a dentist and h is also a surfer and when he goes out he likes to bring along a first aid kit in the event someone gets hurt although he never had seen anything quite like this. When I looked down I just looked away because the arm was just mangled. The arm of a fisherman in a Fiji village where dentist Tom Rolfes was surfing with his son and a friend until the fisherman was bitten by 3 sharks. This guy’s needs and arm surgeon and he needs somebody now. You know and they said well there is no arm surgeon as a matter of fact we can’t even get a car to get here you know we probably can’t even get him to a hospital for 4 to 5 hours. That’s when Dr. Rolfes’ travel emergency kit tuned into a surgical kit. This is what I actually used. His friend and son – his assistants. It just looked like his arm had hit a propeller off a about to do something like that. I kept sedating him a little bit along the way to make sure he was comfortable and then we just started putting the arm back together. The victim barely made it. The village was so grateful they had a special ceremony to thank the doctor. This was quite an experience and it was a n amazing father son bonding experience which was unique which is why we were there to begin with. Proud of you dad – I was – very proud. Dr. Rolfes was more amazed than the fisherman. The reason the sharks attacked him was because he was carrying live fish and you know he did not want to let that fish go – for his family and the shark actually attacked the fish but the arm got in the way because he was holding it – in the shark’s defense. (Laughs) and guess what? The fisherman also got to keep the fish – he bagged it and to quote my engineer he can now still count 10 fingers and actually use them. So all’s well that ends well – I am Christina Gonzalez for Fox News.

Our teeth natural lose their white colour as we age from things such as smoking, coffee, tea and red wine just as we name a few. A laser teeth whitening procedure not only offers cosmetic but medical benefits. Dr. Christina Do a researcher for the leading dental company Biolase tells us how laser whitening works. Our laser whitening system called Epic instrument that we use for it, and basically it has been around for about 2 years but prior to that there was an easy lase that we used also to do laser whitening. So laser whitening has probably been around for about 5 years. Laser whitening is a great way for us to get brightening whiter teeth. So basically the patient don not have to do anything at all. The patient comes in to the office, sits down in the observatory and basically would prepare the area to whiten the teeth for the patient, by just isolating the gum tissue and making sure that the gum tissue is completely protected. We place the bleaching gel on to the teeth and then we use the wand which is a very small instrument which is basically the size of a pen, and we start to whiten in quadrant. So basically when we whiten in quadrant we use the laser light over the teeth for about 8 minutes total and so basically in 8 minutes our patients can get really bright white teeth and the best part about that is there is no sensitivity. So that is one of the greatest points of laser whitening it is fast – in 8 minutes you can get greater and whiter bright teeth and eliminate all the sensitivity tat in the past you would have gotten with other whitening system. So many of our patients want to be able to whiten you teeth but the one thing that really hinders them from whitening I that the sensitivity level. With a lot of patients that have so much sensitivity and in the past we have always wanted to help them brighten and whiten their teeth and unfortunately we have not been able to until now with the laser whitening we are able to put the gel on for way less amount of time but still get the exact same result that the gel had been on for the prior 60 minutes. So now patients who have sensitive teeth can still get their teeth done whiter and brighter, with the laser whitening system. Laser whitening is very safe for our patients – the greater thing is that we are working in a controlled environment we know all the techniques on how to do it, so we make sure that we protect he gum tissue and when we put the gel on the teeth there is no damage to the enamel – and the fact that we only leave the gel on for a maximum of 8 minutes there is no sensitivity – so in terms of safety it is perfectly safe and there is no side effect to it. The long terms result of whiting is different for everybody – so once you whiten your teeth basically the pore are open and if you decide to drink coffee within 24 hours then your long term results will not be as effective as someone who waited 24 hours, but after you do whitening you can drink as you please actually. It just depends on how soon after you eat these coloured foods or coloured liquids that your long term results get affected. The reaction of my patients whenever I do laser whitening for them is basically wow. They are so excited because when you have a brighter whiter smile in about 20 minutes then you are very confident about the way you look about yourself, the way you feel about yourself you just feel very beautiful basically inside and out because as they say a smile speaks a thousand words – and a beautiful brighter whiter smile – you can definitely articulate that to everyone around you.

Then there is this box and it was moving and I thought oh my gosh what is that – so I looked down and this little creature was in there and it was adorable. Biscuit as he is now called – he was just dumped in a box near some trash cans of a dental office – this was in Costa Mesa. Well the little guy immediately won everyone’s heart – of course bringing a smile to everyone’s faces so biscuit was adopted by one of the workers and now he is safe and playful and has a great home.

This is Dr. Rolfes, and I always knew that he would turn out to be absolutely fabulous I can see that since he was 7 that great things were in store for him – no ladies and gentlemen his Dr. Timothy Rolfes and he did a fabulous job today – now the only reason I am here today is because of y wonderful teachers. We were both left handed so – yes even better.

The chargers go their 5th straight win on Sunday but on Tuesday the team celebrates their 5th straight year with Smile to provide free dental care for 300 under served children. Biolase joined in on the partnership this year as well. The kids from Los Angeles unified school district got their checkups in a super fun environment here at Star Pub center and even got to meet some of their favorite charger players while learning about the importance of proper dental hygiene. I think this is our fifth charger event for the local kids in the neighborhood. That are underserved and don’t have dental insurance so what better way than to do it here with the energy that the chargers provide. It is like we are going to see about 2 to 300 children, and they are going to get freed dental care from cleanings to x-rays to fillings, even cosmetic. I have seen so much – first thing the kids getting all their dental treatment where really this could be the only time they see a dentist or the first time they see a dentist and to be involved in something like this is just wonderful. It means a great deal to me because as a kid I didn’t see a dentist until I was like 14 years old – but these kids would be able to come out here and be able to get their teeth cleaned so just to have this experience is pretty great.

Okay so we are doing first name and last names. Christina Do. And the official title – I am the lead dentist for the team smile event today. Okay so what does it mean to be a part of an event like this today – it means it is a time for us to get together as dental professionals really to really get together to help the kids in our community there are so many kids here who really need dental treatment and who just don’t have that aces to care and we are here as dental professional o really help them out there in any way that we can. What can you say about the Chargers in the hospital today – the chargers are exciting for us because they are here to grace the event and it is exciting for the kids to meet them – don’t forget they get to meet some of the players and the cheerleaders and they get so excited when they get to see football players and cheerleaders so it really boosts the morale of them when coming to the dentist. Yes I was going to say does it kind of help them get through the process a little bit? Oh most definitely you can see the smiles on their faces – right when – if you get a child who is scared you have a player who comes over or a cheerleader who comes over and it really alleviates their fear and it helps them to get through the dental procedure and at the end, all smiles just because the player helped them to get them through the procedure. So lastly this is the 5th time team smile is taking part in his – uh huh, what can you say about their continuing involvement in the event and giving back to the community. Oh okay i love the chargers and I met a whole bunch of them and they are all big hearted people – and we know they look forward to this event every year just to get to know the team smiles team the dentist who work and the dental professionals and all the kids. So I know every year they are looking forward to reaching out and participating in dental procedure sand taking care of them.

It maybe the off season but that does not stop the Chargers from giving back to the community – on Friday the team partner with Biolase and team smile to provide their 7th clinic free dental care to 300 students from  the Los Angeles unified school district. So not only do we provide free dental care for them but having the support from all of our volunteers and dentist that truly care about making these kids happy and making a difference in their lives. Just that one volunteer can make a change in that kids life and the outlook and not everything so that is really why we do this – really cool to see the players so as soon as we see this, the kids we meet the players and their eyes just brighten up and they get super excited about dentistry and it kind of districts them a little bit form the fact that they might be getting a filling here in their teeth. I am just happy that I can be in a position where I can maybe just help a little bit more but I am sure they are just most importantly they are scared like I don’t think pain is a big issue but I just don’t think they have their parents here so as a football player I can help and say wow you are being so tough and that helps and I think that is huge and thy take a little something from it and that is cool. The chargers are really a role model for all sports teams in general – I know that they do a lot of other community events other than team smiles and I am just really happy to be a part of this and I am just happy to share the WaterLase, the message minimally invasive laser dentistry. It is just having the opportunity – and making the time to have the opportunity to serve. I think a lot of players on the team like to do that to help out and you know boost moral on the team – show that the chargers care about more than football.

Sarah – 5 more minutes before we go to the dentist. But 0 it’s the dentist. And the needles, the drilling, the pain, and what about the drama – there is always so much drama! *gasps* it is okay – we have a WaterLase appointment – there are no needles no pain no drilling, just some water. Yeah it is easy – what’s their information? Visit waterlase.com to find a WaterLase dentist near you.