By Dr Hisham

Extensive scientific research and hundreds of studies over the last 20 years have proven the links between gum and bone disease (Periodontitis) and the resulting systemic problems, which range from heart disease to premature babies. In short, poor oral health will lead to poor general health and will reduce your life expectancy. Treating the disease and maintaining your oral and general health will increase your life expectancy by years.

Whoopi Goldberg recently spoke candidly and passionately about her serious gum disease on the TV show, The View. She risked humiliation in front of millions, and blamed herself for neglecting her mouth and health. She acted bravely for the greater good of her fans and said: “if you’re not taking care of your mouth, then you’re not taking care of your whole body and it will kill you.”

So why is it such a problem?

• It is one of the two most common infections of human beings worldwide (the other one is tooth decay). Although they don’t cause direct mortality, they induce a lot of other reactions in the body, over time, that increase risks for other disease. For example, an abscessed tooth can infect the brain, through the sinuses, and cause death. Other risks include dissolving jawbone, sepsis (blood infection), endocarditis (heart valve infections) and stroke.

• Chronic heart disease is the number one killer of people in the western world. Gum disease is a major risk factor for chronic heart disease, along with diabetes, smoking, alcohol and poor diet. If you have gum disease, you are twice as likely to die from a heart attack and three times as likely to die from a stroke.

• Diabetes is a major problem in the world today. It is directly linked with gum disease (each one causing a higher risk and aggravation of the other, plus sharing the same risk factors). If you have bleeding gums and diabetes, your chances of dying increase by 400 per cent to 700 per cent.

• Long term inflammation in the body increases proteins (Like C-reactive protein, CRP) that spread throughout the blood and keep the whole immune system in constant “fighting” state. This drains energy, opens you to other infections and deteriorates other vital organs in the body. It also puts babies at risk while the mother is pregnant, if she has gum disease.

Why aren’t dentists and doctors doing enough about it? Well some are, but it is not an exciting subject to talk about, and many patients don’t like to be “lectured” during their visits. Many professionals just avoid the conversation and treat the most urgent issue at hand. Also many times the treatment is uncomfortable (or really painful) and can take many visits and cost a lot. The follow ups and follow through with active home care and regular professional care is critical. Many patients just don’t want to deal with it, and many dentists don’t know what to do about that so they let it go.

Well, that isn’t good enough anymore, is it? People want to understand their risks, have treatment (or prevention) early and as comfortably as possible. The ultimate treatment for gum disease is long term management of bad “Biofilms”, a good diet, immune system enhancement and managing other risks like smoking and diabetes. This, by default, means a better state of wellbeing. Always work on the whole person, and one thing will improve another, naturally.

Current state of the art diagnostic tools for gum disease include Digital X-rays, digital mouth probes, oral “dip stick” cultures for bacteria, health risk analysis and more. State of the art treatment includes Ultrasonic, Ozone, and Laser gum disease treatment. It is more comfortable, painless and cost and time efficient to have such high tech and laser treatment than to have surgery, with faster healing and quick recovery. Long term proper active care is critical to maintain the success of treatment.

Here are 10 signs you have gum disease, or are at risk of getting it:

1 Your gums bleed at any time (or all the time) while brushing, eating, flossing or sleeping.

2 You have chronic bad breath, loose teeth or large old fillings.

3 You have diabetes, osteoporosis or any other chronic illness.

4 You are on long-term medication or drugs.

5 You smoke and/or drink alcohol regularly.

6 You have long periods of severe stress in your life.

7 You don’t brush for two minutes twice a day, and floss every night.

8 Your family has gum disease.

9 You don’t have a regular and thorough oral cleaning for one hour with a hygienist every four to six months, and a good dentist to examine your oral health yearly.

10 Your partner doesn’t have a healthy, fresh mouth and regular care, as this is an infection that can be passed on.

For more information you can ask questions here on my blog, or go to www.lasersmile.co.nz.

Most people over 35 have some (or many) black metal fillings. Most of us hate them and many believe they are dangerous for their health. Many authorities [like the American, Australian and New Zealand dental Associations] and dentists tell us they are safe and good for fixing teeth. Who is right? Here are a few facts and conclusions based on my long research and experience, to help you make up your own mind about amalgam fillings.

•    Dental Amalgam (silver mercury) fillings have been used for over 150 years now and the debate about their safety has been going on for 100 years!

•    Mercury is a toxic heavy metal, like lead (which was banned from petrol and paint due to its serious toxicity to humans).

•    Mercury batteries are being phased out worldwide due to their environmental toxicity.

•    Mercury in large fish is a serious hazard to people eating that kind of fish regularly.

•    Dentistry is estimated to contribute up to 70% of the total mercury load entering wastewater treatment facilities. Many dentists let out amalgam debris through suction into the sewage pipes without special separators to filter the mercury amalgam.

•    Mercury that is changed into methylmercury by bacteria is more dangerous to humans. Breathing mercury vapour is also very dangerous.

•    Amalgam fillings are 50 per cent mercury and release different amounts of mercury vapor and interact with bacteria in the mouth all the time. They corrode over time (they turn black from silver) as they are soaked in saliva and worsen when there are other metals in the mouth (like stainless steels pins, gold crowns, cheap metal alloy crowns and others). The amount of mercury released is variable and its effects are even more variable and difficult to measure.

•    Authorities consider amalgam that is removed from the mouth as hazardous. They advise dentists should keep this toxic waste in sealed containers under a fixer liquid to limit vapours, until professionally collected and recycled. It is not to be thrown into the normal rubbish.

•    An individual’s susceptibility to mercury toxicity is as variable as other health risks facing a population. Most people will not know about a health risk until they get sick! For example, it is well publicised that lead in petrol and paint is banned, as well as the use of asbestos products in the building industry. Most people who are exposed to these toxins are still alive and well, but enough people in the population have fallen sick or died from exposure to lead or asbestos to prompt a ban on these products for everyone’s safety.

Recently the FDA in the United States released a final rule classifying dental mercury amalgam as a class II device (more risk). They regulated that dentists should inform patients that mercury is present and there is a possibility of harm. It should not be used in people with metal allergies to mercury, silver, copper or tin. It is not to touch other metals in the mouth. The American Dental Association and New Zealand Dental associations released statements that they still consider it safe for general use. Sweden, Denmark and Norway have banned amalgam fillings totally and some other European countries are restricting its use (mainly in children, pregnant women and chronically ill patients). The rest of the world is still endorsing amalgam use, and a lot of universities still train students to use amalgam fillings, which they continue to practice after graduation.

I have not placed an amalgam filling in a human’s mouth since I graduated as a dentist. I ceased doing so when I finished my compulsory quota of amalgam fillings that had to be done in a dental faculty. I had my own amalgam fillings safely removed and replaced with Porcelain (Cerec) restorations and did the same for my family. These decisions were made based on my understanding that anything with such a toxicity risk should be avoided, especially when there are better alternatives.

Admittedly amalgam is the easiest dental filling material to use with low skill and it is very cheap. It also lasts a long time in the mouth, until, typically, the tooth cracks and breaks around it. Better options came about with the invention of bonding, and include composites and porcelain restorations. That said these are more expensive and difficult to work with (hence the need for advanced training and skills). Dentists and patients both have to make a choice, and sometimes reality overpowers the ideal scenario. That does not mean we shouldn’t have an ideal to work toward; otherwise we will never make progress.

My ideal is to help people become aware of all health risks and how to manage them, in order to avoid disease and illness. However, when people do suffer a dental problem, the best and least hazardous materials and techniques should be used to help them back into health and normal function.

Remember, always seek health rather than fight disease.

Have a lovely day and enjoy your health with passion.

lasersmile.co.nz

This topic struck me while I was watching Avatar in 3D. Amazing movie, isn’t it? Makes one wonder how beautiful our world would be, both physically and emotionally, without the greed and hostility towards others that seem rampant in the world today.

So I’ve thought of what health care professionals can do for our environment, and what am I already doing?

Dental practitioners and other health care professionals recognise that many of the materials and procedures we use to provide services present challenges to the environment. We should take measures to minimise the production of these wastes and limit their environmental effects. Reducing the carbon and environmental footprint of our profession should be every practitioner’s duty. Simultaneously, it should improve the quality of service we provide to our patients.

Here are some of the serious environmental concerns that face dental clinics, and how we have dealt with them in our dental institute. The benefits go to the patients, the clinic, the environment and, subsequently, the world.

1. MERCURY:

There are more than 20 studies from Europe, Canada and the US that identify the dental industry as the leading source of mercury to sewer systems. Dentistry is estimated to contribute up to 70 per cent of the total mercury load entering wastewater treatment facilities.

Amalgam fillings are made up of 50 per cent mercury, plus silver, copper, zinc and various other metals. It is a common, easy-to-use and cheap method to fill cavities in teeth. Amalgam corrosion and bacteria present in the mouth release methyl-mercury in the human body. This can pose health risks to some individuals.

The placement and removal of dental amalgam fillings generate solid and dust wastes that can enter the environment if they are not properly captured and managed. Once in the environment, changes in pH, oxygen and temperature can allow the mercury to be used by bacteria, which convert it to toxic organic methyl-mercury. In a bio-available form, it enters the food cycle and accumulates in higher organisms, particularly game fish and birds. This has led to restrictions on human consumption of many big fish species to minimise the potential adverse health effects.

The best way to control dental mercury amalgam contamination is to stop using it for fillings, be very careful when removing them and make sure the amalgam is not let out into the environment.

Safe removal is done under rubber dam with high volume suction so nothing goes down the patient’s throat or gets inhaled. The pieces that come out should not be thrown in the rubbish but sealed in airtight containers under fluid until they are recycled. The dust and small particles that go into the suction should never be let out into the water pipes.

Our system separates 99.5 per cent of the amalgam before letting the water out into the pipes. The sediment goes back to Austria in sealed containers, marked toxic waste, for recycling.

2. LEAD

Lead, like mercury, is highly toxic and persists in the environment. Even at low levels of exposure, lead produces adverse health effects on humans. It is a byproduct of traditional X-rays, the lead shields contained in each film packet. Dentists all over the world use thousands of films daily, and should collect this lead and send it for recycling. Unfortunately, manufacturers report that only about 5 per cent of products sold are returned for recycling.

The use of digital X-rays which don’t use film, lead shields or chemical processing are becoming more popular. They need lower radiation than normal X-rays, which is safer for the patient. Digital X-rays can be viewed on large computer screens, are easier to see and diagnose from, and do not need space or plastic holders to store. I have been using digital X-rays for over 11 years now, and have never looked back.

3. SILVER

Silver is another heavy metal that can enter our water system via improper disposal of dental clinic waste. Although silver is a component of amalgam, the silver thiosulfate in the fixer (a solution used in the processing of photographic film and dental X-rays) presents a greater environmental concern. Used fixer solution should never be let down the drain, instead it should be collected in sealed containers and sent for recycling. The best way to get rid of the whole problem and cost of compliance is to go with digital X-rays and photography, eliminating the use of fixers.

4. BIOMEDICAL WASTE AND SHARPS

Potentially infected items and used sharp needles and scalpels should also be disposed off in the appropriate containers and collected by designated agencies.

5. GENERAL WASTE

Like any other office/business, dental clinics can significantly contribute to reducing their carbon and environmental footprint by following general recommendations like purchasing products with minimal packaging and using reusable plastic containers (e.g. for cleaning and disinfecting solutions). Products, such as paper towels, made from recycled or partially-recycled materials should also be used.

Energy-efficient lighting and temperature regulation can limit office energy use. Recycling paper and digitising the office decreases the amount of paper used and the trees that need to be cut down. Recycling printer cartridges, unused furniture and IT equipment all help, too.

Have a lovely day and enjoy our beautiful world with passion.

TO WIN ORAL B’s most technologically advanced toothbrush with Bluetooth, the TRUIMPH 5000 (worth $209) answer this questions: How much of the total mercury contamination in water management centres is attributed to dentists worldwide?

Email your correct answer with your name, contact number and city to: jill@lasersmile.co.nz

www.lasersmile.co.nz in association with Oral B.

By Dr Hisham

Happy New Year and decade everyone. Have you made any personal health resolutions this new year? Remember, it is much better to have goals, no matter how big or small, than to not have anything to strive for.

Here are tips that will help guide you to make better health (and of course oral health) decisions in 2010:

1. MODERATION

The most important factor in maintaining balance in your life and health is moderation. A balanced body is generally a healthier body. The only things that are safe in excess are love, laughter, white fish, green vegetables and water. Everything else that we do or consume, has limits.

2. EAT SENSIBLY

The amount and type of food we eat is one of the most important health considerations we have in the Western world. Shortage of food is not our problem; excess of it is.

Excessive processing and chemical degradation of our food have created new health risks that our bodies have not adapted to dealing with. Eat more unprocessed food and vegetables, and reduce your consumption of fatty meats (pork is the worst) and processed food.

Eat three balanced meals a day, just enough to satisfy your hunger and reduce snacking to once a day.

3. REDUCE ALCOHOL

Alcohol is one of the most widely consumed addictive substances in the Western world. Many people drink too much alcohol and do not think they have a problem, as they don’t fit the ‘alcoholic’ stereotype we see on TV. You can learn more about alcohol overuse in this mindfood magazine article.

My point is, if you enjoy something, have it; but just in moderation. Know the limits of what is risky to your health. Alcohol is a risk factor for liver cirrhosis, cancer, heart disease, stroke and fetal deformation.

4. REDUCE OR STOP

Nicotine is another widely consumed addictive substance. We all know the health risks of smoking range from mouth, throat and lung cancer to heart disease and stroke. Smoking pure tobacco in a social gathering occasionally is how it all started with indigenous people in different parts of the world. That was healthy smoking! The daily abuse of chemical-laden cigarettes that is endemic of today’s society is not healthy smoking. Take care of yourself.

5. LIMIT YOUR SUGAR INTAKE

Sugar is a contributor to so many pleasures in life (cake anyone?) and so many health problems at the same time.

The problem lies in the excessive amounts people consume – particularly of the highly-processed kind. Excess fruit and honey is still risky, even though it is natural sugar, so always eat these foods in moderation.

We can’t avoid sugar – nor do we want to – but let’s make a conscious decision about how much we eat, what kind we eat (and give to our children) and what other options we have (xylitol, erythritol and inulin).

Excessive sugar consumption leads to tooth decay that could become a life threatening gangrene in the head; diabetes; obesity; and a range of serious health risks associated with these endemic problems.

6. BRUSH AND FLOSS PROPERLY AND USE ALKALINE DENTAL PRODUCTS

Gum disease (being a chronic infection) is a direct risk factor for heart disease, stroke and premature babies. It is also the leading cause of bad breath, an unattractive smile and tooth loss.

Cavities in teeth are the result of acids dissolving the outer shell of the teeth, then bacteria rotting away the inside when they get in. So cutting down on sugars that feed the bad bacteria and acids that dissolve teeth and bones are very important for your oral and general health.

Using alkaline products and eat more alkaline-rich foods to prevent dental problems. Seeing a good hygienist regularly will help you get rid of bacterial build up in your mouth that you cannot clean by yourself. Save your health, time and money and enjoy that great smile.

7. LOOK AFTER YOUR SOUL

Spiritual wellbeing is just as critical for health and longevity as any other physical aspect. Pray, meditate, take up yoga or tai chi. Be happy now and don’t wait for something outside of yourself to make you happy. Enjoy the everyday blessings of life, for they are too many to count.

8. EXERCISE

Also in moderation. Excessive exercise without proper rest and nutrition can cause more damage than good. Do some physical exercise daily, even if just a little. Going at it hard once and then nothing for a while is not a good way to keep healthy, and going hard all the time will wear your body out. Do it and enjoy it in moderation according to your body needs, your health, age and goals.

Following my motto “Let’s seek health rather than fight disease” I urge you to take a conscious step towards improving your quality of life by actively seeking health and avoiding excessive risks. Don’t just play the victim and constantly fight disease once it has occurred. You are on a journey, so decide where you want to go. Even if you take some detours along the way, you’d still get back on track to where you’re going. Otherwise life takes you anywhere it wants, and you may not like it there!

Have a lovely day and enjoy life with passion.

For more on oral health visit the Laser LifeCare Institute website.

Dr Hisham Abdalla

I envisage a world full of healthy, happy people. I see people empowered with health, properly applied knowledge and enduring experiences. Happy, healthy and prosperous societies only come about through education, passion and sharing inspiration.

Isn’t it by time we figured out what is really our focus; health or disease? In a world full of repeated ailments and increasing physical and fiscal costs of treatment one has to wonder why we’re constantly fighting the symptoms rather than dealing with the cause of disease.

The law of attraction dictates that whatever we focus on, we attract. So why is our “health-care” system so focused on disease? We’re looking for it fighting it, seeking magic bullets and quick fixes. Is it “disease-care” then? It’s time we focus on health, research it, understand it, teach it and live it. Let’s empower ourselves with knowledge & skills to achieve and maintain health. Let’s take responsibility rather than blame and complain.

Through my teachings I hope to help as many people understand the core of health, with a specific focus on oral health, my specialty, and its relationship to the rest of your wellbeing. This first blog is an introduction to the paradigm of thinking Health (positive) rather than Disease (negative). In following blogs we ‘ll discuss specific aspects of oral health, risk factors and what you can do to help yourself and your family improve your wellbeing. You’ll save yourself time, money, disappointment and enjoy feeling better, looking better and BEING BETTER.

Disease by definition is a state of dis-ease. It’s an imbalance, overburden and breakdown of what was once a well functioning “healthy” system, balanced and at-ease. The innate knowledge of how to maintain our body at Homeostasis (a state of balance and equilibrium- dynamic and flowing, yet at ease) is imprinted within our genes, in every living cell. We’re built to last, be healthy and avoid disease. So what goes wrong then? Dis-order attacks.

Risk factors affect us. Things like stress, toxins, pollution, bacteria, viruses, poor diet, alcohol, drugs, radiation, sugar and other factors that attack us constantly trying to tip our balance and get us into dis-ease and dis-order. The more risk factors we get hit by, for a long enough period of time, the more we’re at risk of getting sick. Whether it’s a cavity in your tooth or terminal cancer of your colon, the process is exactly the same. Something attacked you long enough, your body was unable to fight back any more (despite its built in know-how) and you went into dis-ease. Sometimes we have acute (short lasting) states of dis-ease, sometimes they are chronic (long lasting). Nevertheless, it’s always a PROCESS not an accident whether we’re healthy or not at any point in time.

So whose responsibility is it to understand the process of health and the process of breakdown of health? EVERYBODY’s! Healthcare professionals are responsible to teach their communities and people are responsible for themselves and their families.

“A true healthcare professional is one who empowers others to take care of themselves”.   Dr H Abdalla

Is oral health any different to general health? Well that’s possible if your mouth lived by itself. It doesn’t. You are one, and what happens in or to your mouth, what goes through your mouth and what you do with your mouth directly affect everything else about you. The way you look and feel, how well your other organs function and how balanced your system is, are all related to your mouth and each other. It applies the other way too. How you are mentally, physically and physiologically will always affect your oral health. Oral health is affected directly by things like diet, depression, diabetes, infections, drugs (legal or illegal), alcohol, metabolic problems, pregnancy, body pH balance and much more. Let’s tackle these risk factors one blog at a time.

Watch this space and keep well.

Yours in health