Here at FocusedCareDental.com, we take a comprehensive approach to oral health. We care about family dental care, and we care about delivering the best that cosmetic dentistry has to offer.

“What sets Dr. Allan Melnick apart,” you ask?

Well, as a proud University of Southern California graduate and former UCLA professor, I’d have to say that my ongoing attention to the latest research findings is the differentiating factor. I am PASSIONATE about research – not just because it is fascinating, but because it allows me – and my stellar staff – to deliver the very best to our patients.

Part of that “VIP dental care” that we tout includes educating our patients…and, not just about toothbrushes and dental floss. We talk about the tough stuff – like the link between oral cancer and a sexually transmitted virus. The human papillomavirus now is considered the “fastest growing risk factor for oral cancer.”

Oral cancer kills about one person every hour, 24 hours a day. Its death rate is higher than that of Hodgkin’s lymphoma, cervical and testicular cancers, and thyroid and skin cancers. Startling, isn’t it? About 40,000 Americans will be diagnosed with oral or pharyngeal cancer this year, says the Oral Cancer Foundation (OCF), costing the U.S. $3.2 billion a year. Only about half of these oral cancer patients will be alive in 2017!

These statistics are both scary and sad. They’re sad because the prognosis and treatment don’t have to be so dire.

Typically oral cancer is not that hard for a medical professional to diagnose intra-orally, but historically it’s been a cancer that gets discovered late – usually after it has metastasized in the lymph nodes or elsewhere in the body. By then, it’s much harder to take care of, and treatment is usually both disfiguring and debilitating.

The majority of Americans are ignorant about the risk factors for oral cancer. In fact, fewer than 30 percent of men and women know that the human papillomavirus, a sexually transmitted disease, is among the causative factors for oral cancer, according to an OCF national survey conducted recently. Many people think, “Oh, I don’t use tobacco, so I am in the clear. Or, I don’t drink alcohol, so I’m OK.” That’s just not true. Oral cancer can result from a physical relationship with the wrong person. HPV variants also cause genital warts and other cancers of the reproductive organs.

Oral Cancer Risk Factors

• Smoking tobacco
• Using “snuff,” or chewing tobacco
• Being sexually active
• Drinking alcohol

At our Encino dental office, we include a visual and digital oral cancer screening as part of our comprehensive dental exam. We added this service to save lives and to prevent a lifetime of disfigurement for survivors. Unless caught early, oral cancer treatment may require drastic surgical intervention, radiation and some very strong medicines. We hope to help our patients skip that kind of drama. Delivering peace of mind is so much nicer.

To schedule a dental consultation, please call the office of Dr. Allen Melnick, DDS, at (818) 385-3681.

Best regards, Dr. Melnick

Tip of the Day: Oral cancer isn’t painful in its earliest stages and often isn’t visually or physically apparent until it’s quite advanced. Oral cancer screenings should be part of routine dental checkups every year. Exams are quick, painless and non-invasive. Other precautions include sexual abstinence, vaccinations with Gardasil, use of condoms, and limiting alcohol and tobacco use.

Although this is 2012, the state of dental health care in the United States is still quite alarming. Let me paint you a picture, a paint-by-number portrait of just how many people lack this cornerstone to good health.

Dental Care by the Numbers

1. 16 million low-income kids did not see a dentist last year
2. 25 percent of seniors (65 and up) have lost all their teeth
3. 130 million Americans lack dental insurance
4. 55% of Americans (2 and up) didn’t see a dentist in the last year
5. 830,000 hospital ER visits in 2009 were linked to preventable dental conditions – a 16% increase in three years
6. 27% fewer people enrolled in dental school in 2003 than in 1980.
7. Insurance is expected to cover only about 48 percent of all dental expenditures by 2013, predicts the U.S. Centers for Medicare and Medicaid Services. Eight percent ($10 billion) of all dental expenditures will be covered by government aid. The other 44 percent will be out-of-pocket expenses.

We live in difficult times. While some are quick to propose solutions, the truth is that there are no easy answers. Quality dental care for every American would be wonderful, but “wonderful” takes money, infrastructure and people who see the big picture. Politicians need to do more than just paint pretty pictures to get re-elected.

We have made lots of medical strides in the last few decades. The medical profession needs to keep this trend going and set its goals even higher. Money for ongoing research is vital. We have learned so much about the effects of oral health on overall vitality, and I firmly believe dentistry will play an even greater role in fighting disease in the future. We need the financial support of private donors and national backing.

We’ll need to increase dental manpower too. In the last five years, there have been more retiring dentists than first-year dental students, so we need some bright young adults to step up to the plate. Hopefully these young men and women will set their ideals high. I hope dentistry will be their calling and not just an occupation of mediocrity. As American scholar Warren Bennis said:

“The lessons of the ordinary are everywhere. Truly profound and original insights are to be found only in studying the exemplary.”

Of course, there is a place for prudent social services to alleviate immediate suffering; that’s part of being a humane culture. But, to really put an end to the cycle of poor oral health and government aid, we need to do an even better job of educating the public about the importance of good dental hygiene starting in early childhood. Prevention is the strongest ally we have to ensure wellness. If we can get the parents’ attention – regardless of their socioeconomic standing – and teach their children young, I think we’ll be able to cut this dental crisis off at the legs. In the long run, I think it’ll serve the American people better and cost a fraction of the funds some politicians are proposing that we toss into the dental care reform money pit.

Education is something we take seriously at our Encino dental office. My hygienists offer excellent advice about gum and tooth care, and this blog has many articles about the latest findings in dentistry. If your questions are not addressed on this website, we would love to talk to you.

To schedule a dental consultation, please call the office of Dr. Allen Melnick, DDS, at (818) 385-3681.

Best regards, Dr. Melnick

Tip of the Day: Prolonged exposure to chlorine and other pool chemicals can soften teeth, erode enamel and cause staining. If swimming in a chlorinated pool, ask aquatic directors to keep pool pH between 7.2 and 7.6. It’s less corrosive on teeth. When possible, choose pools that use an alternative sanitation method.

On the social front, there’s only one way to look at bad breath. It smells! Chronic halitosis affects more than half of Americans – and yet it’s still often taboo to discuss the problem openly. Some dentists even hesitate to bring up the topic if patients don’t initiate the conversation.

So, let’s be honest. Offensive breath can wilt conversation faster than just about anything.  It’s an age-old problem, mentioned in numerous ancient writings. Currently, Americans spend billions of dollars each year on mints, mouthwash, toothpaste and breath sprays to freshen their breaths and boost self-confidence.

While breath-masking products help, I think a more effective approach is to identify the root of the problem! Is the odor’s source simply your penchant for foods with garlic, onion and other strong spices, or are you lax on your oral hygiene habits? Nine times out of 10, poor oral hygiene is the main problem.

If you aren’t brushing, flossing and using mouth wash on a daily basis, you will have offensive breath. The long-term consequences of bad dental care habits also will lead to puffy and bleeding gums, decay and tooth loss. It’s just a matter of time. Systemic illnesses such as diabetes, heart disease and cancer are linked to poor dental health, as well.

What Causes Bad Breath? Additional Reasons

• Gum infection
• A smelly coating on the tongue
• Smoking, coffee and alcohol
• Acid reflux
• Medication
• Disease
• Dry mouth (“xerostomia”)
• Infected sinuses
• Tonsil “stones”
• Poorly fitted dental appliances
• Extremely low-carb diets

The good news is that bad breath is highly treatable. Eating a healthful diet, breaking a tobacco habit and treating disease are a start. Regular dental checkups every six month and practicing a sound oral hygiene regimen at home are a must, if you want to conquer dragon breath.

Teeth should be brushed a minimum of twice a day, preferably after meals. Use dental floss to remove plaque from below the gum line and rinse with antiseptic alcohol-free mouthwash daily. Brushing the tongue and the palate should be routine. There are even tongue scrapers that help remove the tongue coating that harbors odor-causing bacteria. Be sure to gargle daily to loosen any plaque-like material from tonsil pockets.

Sip plenty of water throughout the day to keep the mouth moist and to rinse away food particles and bacteria. If the mouth is dry, the pH level changes, promoting an acidic environment in which bacteria thrive. Some anti-anxiety, anti-depressant and anti-histamine meds reduce salivation. So do certain medical conditions. Those with allergies and asthma often have to resort to mouth breathing and suffer from dryness. In some cases of “dry mouth,” artificial saliva may be required to protect the teeth and improve breath.

If you live in the Encino, Sherman Oaks, Woodland Hills, Van Nuys or Tarzana areas in California and suffer from chronic bad breath, let’s check things out. Just call my awesome FocusedCareDental staff and ask for an appointment with Dr. Allen Melnick. Ninety percent of the time we can correct things in our office, but I’d be happy to refer you to another physician if your case is more complex.

Best Regards, AM

Tip of the Day: Did you know eating mozzarella and other cheeses helps neutralize oral acidity? If you are on the go, include a dairy product with your restaurant meal, and actually use the parsley on the side of the plate! Chewing this garnish will fight odor-producing bacteria. Drink water at the end of the meal to rinse away food, and pop in a stick of xylitol-sweetened gum such as Spry, Vitacare or Ice Cubes.

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I think laughter does a body good. We do a lot of it in our Encino dental office. We provide the utmost in cosmetic and general dentistry care, but we think friendliness and humor complement the professionalism. So, here’s a joke that’s made the rounds for years. It’s an oldie, but a goodie.

One day, a woman walked into a dental office and asked how much it would cost to extract wisdom teeth.

“A bag of gold,” the dentist replied.

“That’s ridiculous,” the woman said. “Isn’t there a cheaper way?”

“Well,” the dentist said, “if you don’t use an anesthetic, I will charge you only half a bag of gold.”

“That’s still too expensive,” the woman huffed.

“OK,” responded the dentist. “If we forgo the anesthesia and simply pull the teeth with pliers, I can knock the price to a quarter pound of gold.”

“No-o-o,” groaned the woman. “It’s still too much.”

“Well,” said the dentist, scratching his head, “I could find a dental student to do it for 15 bucks.”

“Awesome!” said the woman. “Book my husband for next Friday.”

This joke is light-hearted, but it brings up a serious topic. Wisdom teeth.

Wisdom Teeth: A Third Set of Molars

Wisdom teeth are third molars that start to form around your 10th birthday. They are the last set of teeth to come in – usually making their debut between 17 and 25 years of age. Because this is the age when most young people are gaining knowledge at a rapid pace, these extra molars have been dubbed “wisdom teeth.” A misnomer? Perhaps, but that’s a topic for another time!

Evolutionary biologists classify these third molars as vestigial organs, kind of like the appendix. Perhaps they were useful in grinding raw food and roughage at one time, but in this modern day and age, they tend to be more trouble than they are worth and are the source of many dental problems.

Wisdom teeth typically cause grief when they begin to emerge from the gums, because our jaws are too small to accommodate extra teeth. Some lucky souls have no problems or very mild symptoms. Others get hit with severe – even life-threatening – complications when impacted wisdom teeth cause an avalanche of side effects.

Good oral hygiene is hard to maintain when erupting wisdom teeth cause pain in the back regions of your mouth. People tend to slack off on the brushing to avoid discomfort. Germs and bits of food accumulate under the gums, compounding the problem. Bad breath and gingivitis ensue as infection spreads. Opening your mouth and chewing becomes a chore too, so nutrition may suffer. It’s a vicious cycle.

Here at FocusedCareDental.com, we’ve compiled a list of problems that can occur with troublesome wisdom teeth. If you experience any of these, seek medical treatment. I’d be happy to take a look and make an assessment. I promise that I won’t charge a bag of gold or use tool shed pliers!

Signs of Erupting or Impacted Wisdom Teeth

• Bad breath
• Pain and infection
• Fever and lethargy
• Redness and bleeding gums
• Ear aches and headaches
• Swelling of gums and jawline
• Tooth decay and loss of bone
• A funny taste in your mouth
• Difficulty chewing and painful swallowing
• Overcrowding of neighboring teeth

These symptoms should never be ignored. In severe cases infection can spread, putting oral health and even one’s life in danger.

Wisdom Teeth and Braces

Orthodontic treatment also can fail if wisdom teeth are not considered. If you plan to go through the expense of getting braces, be sure you discuss your wisdom teeth and jaw size with your dentist/orthodontist. Complications can be avoided if wisdom teeth are removed before roots get too long or teeth tilt at crazy angles and cause overcrowding.

With medical advances, dentists and oral surgeons are able to remove third molars with much less pain, trauma and down time than when our forefathers went to a blacksmith to get teeth pulled. Now, oral sedation dentistry is offered for peace of mind, and medications are prescribed to manage pain. Size, shape, root length and physical orientation affect the ease with which wisdom teeth are removed. Some cases are complex, and some are easy. Healing time varies, but ice-packs, antibiotics and specific post-op guidelines speed recovery.

Best regards, AM

Tip of the Day: Follow post-operative guidelines religiously after wisdom tooth extraction. (Remember no straws, no spitting and only soft food.) Plan to take a few days off to rest and promote healing. This is no time to play volleyball or go jogging. You don’t want to disturb healthy clotting, break stitches or cause extra swelling. You’ll have gauze in your mouth anyway, so it’s best to stay home, nap and watch a few movies.

Last month a young Cincinnati father died as the result of a tooth infection. It made the national news. Although this 24-year-old had been advised to have oral surgery on his painful wisdom tooth, he was unemployed and uninsured. He decided to wait it out.

When his whole face began to swell, he went to the emergency room. He was prescribed pain medication and antibiotics, but decided to treat only the pain because of expenses. He did not get his antibiotic prescription filled. The infection spread to his brain and his life was cut short.

These are desperate times and it saddens me to know that this young man lost his life because of his decision, which was influenced by his joblessness and lack of health insurance. Unfortunately, he is not alone. Others are making similar choices, putting their health at risk too.

The 2011 Survey of Dental Care Affordability and Accessibility says:

• 50% of Americans lack dental insurance.
• 77% of those without dental insurance delay regular dental care.
• 74% of the noninsured only see a dentist when there’s a perceived problem.
• On average, the uninsured go to the dentist only once every three years.
• One-third of uninsured seniors say that it’s unlikely they will be seen by a dentist in the next five years – due to cost.
• About half of uninsured parents report delaying children’s regular check-ups because of financial burdens.

Suffer the Children

Let me be frank. These are horrific statistics. They affect not only adults, but also the health of tomorrow’s generation. The Centers for Disease Control in Atlanta report that cavity rates are up 15 percent in children ages 2 to 5 in the last decade. The U.S. Surgeon General’s office notes that an estimated 51 million school hours are lost each year because of children’s dental-related illnesses.

Dental problems are not just cosmetic. Neglecting preventive dental care has a snowball effect. Over time, health is impacted, as well as our kids’ education. (It’s hard to pay attention to the teacher or be nice to your classmates when your tooth hurts!)

Fallout of Dental Neglect

Gum and tooth infections are linked to diabetes, heart disease, tooth loss, cancer and other diseases. So skipping your children’s dental appointments not only sends them the wrong message about the value of good oral hygiene, but it also sets them up for health problems down the road.

I understand that times are hard. That’s why my FocusedCareDental office is committed to working with each patient to ensure that policy benefits are maximized. Our office manager has more than 30 years of experience in dealing with insurance companies, and she is very good at it. We know that dental insurance policies can be confusing and complex – maybe purposefully so. Every company differs. Some are easy to work with, while others are difficult.

We promise to do our best in estimating what is covered by insurance and to be transparent about out-of-pocket expenses. It’s our goal to serve families in Encino, Tarzana, Woodlands Hills and Sherman Oaks, as well as the San Fernando Valley and greater Los Angeles. We are more than happy to set up reasonable payment plans that can be worked into your personal budgets. You may have to skip a few spiced pumpkin lattes at Starbucks, but we’ll find a way to make it work for everyone involved.

Affordable First Dental Checkup

As a matter of fact, if you are new to my FocusedCareDental.com blog, we are offering a new patient introductory checkup for only $99! This budget-friendly dental deal includes teeth cleaning with our dental hygienist, a complete exam, X-rays and a fluoride treatment. Normally, these services would cost $249. To take advantage of this offer, call (818) 385-3681 to make an appointment, mentioning this Internet special to my office staff. I hope to see you soon.

Best regards,     AM

Tip of the Day: Get your baby used to dental care early. After meals, gently swab your infant’s gums with a clean, damp washcloth or cotton ball dipped in water. Once his teeth erupt, switch to a soft-bristled baby brush and water. Do not use toothpaste until the child can spit – usually after age 2. Avoid using baby bottles and sippy cups as pacifiers. Prolonged exposure to sugars in milk and juice will lead to “bottle mouth” decay.

The Little Details…like Spit!

The late John Wooden, UCLA’s legendary basketball coach, was wise both on the court and off. After his coaching career, he was a coveted guest speaker around the country and is often quoted. One bit of advice attributed to Coach Wooden is this nugget of truth:

“It’s the little details that are vital. Little things make big things happen.”

I know it’s a simple statement, but it is really so true! That’s why it popped into my mind while I was catching up recently on some dental research.

For most people the term “dentistry” brings to mind the mouth, teeth and gums. The term “saliva” or “spit” is not typically our first thought. I suppose the general population is kind of squeamish about that sort of thing, but as a family dentist, I had to get over that reaction long ago!

The salivary system is actually a complex environment and crucial to our oral and digestive health. It maintains the health of the soft and hard tissues in our mouths and assists our speech. It contains antioxidants and many disease fighting substances that repair cell damage, control microbe levels, and help inhibit the development of dental cavities. It’s an integral part of our digestive system, lubricating the mouth and throat so we can chew and swallow foods.

Did You Know…?

• The body produces between one and two pints of saliva per day.
• Spit buffers oral acid to keep the mouth at a pH of 7.0-7.5.
• Asthmatics have more cavities than non-asthmatics, studies show. Dry mouths may be the reason.
• Stress and depression can reduce saliva levels.
• Saliva flow is higher when sitting and standing than when lying on a bed.
• The three primary sources of saliva include the parotid, submandibular and sublingual glands, plus the uvula, and more than 600 other minor glands that contribute to salivation.
• Saliva is 98 percent water. Enzymes, mucus, antioxidants, proteins, electrolytes and other important substances comprise the other 2 percent.
• Being overly excited or angry can increase salivation.
• Saliva washes away debris and baths the enamel with calcium, urea, bicarbonate and phosphate ions, which help repair teeth.
• The submandibular glands produce 70 percent of the mouth’s saliva.
• Elevated cortisol levels in saliva have been used to detect stress in newborns and have been linked to compromised cognitive function (memory issues), according to a Maryland study reported in General Psychiatry (July 2007).
• Chewing gum (preferably sugarless gum containing xylitol) activates saliva flow and can increase output by 1000 percent.
• Saliva output increases before vomiting, and the bicarbonate it contains acts as an acid-buffering agent, which protects tooth enamel.
• If lost in a cave without any light, you would produce up to 40 percent less saliva. Wearing a blind fold would elicit the same response, studies show.
• According to the Academy of General Dentistry, nine out of 10 systemic diseases produce oral signs and symptoms.
• Enamel gets harder as we age, thanks to its constant saliva bath.
• Chewing gum or sucking on hard candy may help surgery patients recover normal bowel function faster – thanks in part to increased salivation, some doctors have noted.
• Pregnant women may drool more during their pregnancies.
• Strong smells cause a short-term increase in salivation.
• One in five adults will experience acute or long-term “dry mouth.”
• Researchers have found that saliva is a good diagnostic tool. For example, scientists have identified more than four dozen proteins in saliva that distinguish healthy women from those with an elevated breast cancer risk.
• A simple saliva test can detect HIV, illegal drugs and other environmental toxins.
• Radiation, chemotherapy and autoimmune diseases reduce salivary flow – as can hundreds of prescription drugs.
• UCLA has developed a saliva test that is able to predict head and neck cancer patients with 82 percent accuracy. Additional research is ongoing to find identifying biomarkers for other diseases as well.

I hope you found this information interesting. The human body is truly a wonder.

Best regards,     AM

Tip of the Day: After brushing your teeth, rinse your brush thoroughly under water. Then soak your brush in mouthwash while flossing. Tap off the excess mouthwash before putting your brush away. It will taste nice and fresh in the morning and have less bacteria on it.

Antioxidant Foods

Oral Antioxidants

I love to read the latest medical research findings. When I happen upon something that’s relevant to my patients and the general public, I like to pass it on. I recently learned some things about dental stem cell research and baby teeth and wrote about it in my FocusedCareDental.com blog. Well, I guess the media found it interesting too, because the topic got picked up on numerous online news sites.

While “oral antioxidants” may not be the media darlings that “stem cells” are, these molecules play a role in everyone’s health. Researchers have been studying salivary antioxidant activity and its relationship to oral inflammation, healing of mouth wounds and systemic disease. Links have been found between oral inflammation and diabetes, cardiovascular disease and rheumatoid arthritis, as well as conditions ranging from obesity to diminished fertility and premature birth.

The Saliva Defense System

Naturally occurring antioxidants in the saliva are part of the body’s defense system.  They protect your cells from damage caused by an overabundance of free radicals. Free radicals are produced in the body after exposure to things like radiation,  environmental pollutants and certain foods all leading to illness and aging.

Researchers have been studying the role of oxidation in oral health – particularly as it relates to periodontitis, chronic dry mouth, oral cancer, and malfunction of the jaw joint (TMJ). Smokers, patients under stress and those with these diseases have been found to have reduced antioxidant activity in their saliva. Oxidation in the oral cavity is thought to lead to mouth inflammation, so I think increasing antioxidant levels in the mouth is a valid component of a comprehensive oral hygiene program – especially if patients have had mouth surgery, teeth extractions or oral ulcers or lesions and need extra healing.

In fact, there is a topical oral antioxidant gel that has been available since 2010 called AO ProVantage. It contains ferulic acid and phloretin, two antioxidants that counteract free radical activity in skin cells. Researchers at Baylor College of Dentistry’s Department of Biomedical Sciences in Dallas, Texas, also recently linked these two substances to oral cell regeneration, according to a study released this month at the US National Library of Medicine National Institutes of Health. (Note: Currently, AO ProVantage is available only through a dentist or other health care professional.)

I think amping up the antioxidant levels in the mouth is a valid approach to promote healing of oral wounds and inflammation. When teamed with a nutritious chemical-free diet, brushing, flossing, professional dental cleanings, moderate exercise, stress reduction and good sleep on a consistent basis, I think we might see “spit therapy” play a role in the measurable reduction of disease. It’s a tall order, but we dentists can dream can’t we?

If you have oral inflammation or it’s been a while since you’ve been in for a checkup, call our Encino dental office to schedule an appointment at (818) 385-3681 or email us.

Best Regards, AM

Tip of the Day:

Eat foods high in beta-carotene, lycopene, lutein and Vitamins A, C and E and you’ll be well on your way to an antioxidant-rich diet: carrots, blueberries, beans, mangos, spinach, apricots, squash, watermelon, pumpkin, tomatoes, sweet potatoes, nuts, grains, cantaloupe, asparagus, papaya, eggs, collard greens, kale, broccoli, red wine, grape juice, figs, raisins, strawberries, peppers, avocados, spices, fresh herbs and cocoa. (I saved the best for last!)