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Thursday, November 8, 2012

Oral Cancer - Important Facts You Need To KNow

About 100 people are diagnosed with oral cancer every day in the United States. Oral cancer often is not discovered until it has reached later stages. As a result, the death rate of oral cancer is higher than many other cancers found in the body. Human papilloma virus number 16 (HPV16)-related oral cancer has become part of cause to this statistical rise. Oral Cancer is found most frequently in the rearward areas of the mouth, at the base of the tongue, the border of the lips, and the tonsils. The physical indentifiers of these lesions make them difficult to distinguish from healthy oral tissues. This is alarming because HPV16 related Oral Cancers have reached epidemic levels in the United States. According to the American Cancer Society, of the 37,000 incidences of oral cancer, about 200,000 (up to 60%) yearly cases can be linked to HPV. There are several other factors contributing to these high numbers. Public awareness about oral cancer, its early signs and symptoms, and its changing etiology, is low. Oral cancer has historically been linked to long-term tobacco use and high alcohol consumption (or a combination of both). Most of these lesions are usually seen in the anterior areas of the oral cavity. Now there is an increased prevalence of HPV16-related oral cancer and a decline in tobacco-related cancers, making it more critical to be screened by a dental and professional. The public needs to be informed and reminded about these current risk factors and the need for an bi-annual professional screening. There seems to be a similar model occurring in oral cancer as with genital/cervical cancers. Sexual transmission seems to be the likely source in both cases. Other than abstinence, a vaccine has been in place for pre-sexually active teens. These are the only a preventive treatments at this time. This is important information to share with patients,because 50%-80% of Americans will have HPV in their lifetime according to the Center for Disease Control and Prevention (CDC). About half of all men and more than 3 out of 4 women will be diagnosed with it at some point. The signs and symptoms of oral cancer range from a sore area that bleeds easily, a lump or thickening of tissues in the mouth, lips or neck, which may be a colored red or white patch or ulceration that does not resolve within 2 weeks. If any of these are evident, the patient should return within 7-14 days to confirm either persistence or resolution. The early stages of these sites, which may not be readily evident during a routine exam, usually are asymptomatic and often mimic other conditions. Dentists are the first line of defense because most patients are seen twice a year. The American Cancer Society estimated in 2009 that almost 90% of oral cancers are squamous cell carcinomas, and more than 97% of these cancers occur in adults 35 years and older. People ranging in age from 25-50 who never smoked are the fastest growing group being diagnosed with oral cancer. It is the HPV which seems cause the growth of the squamous cell type of oral cancer. In addition, these Virus have many variants. The number associated with HPV is a unique classification based on microscopic evaluation. HPV-16 seems to be the most common variant found in Oral Cancer, but not the only one unfortunately. Standard treatment usually involves surgical removal. Some treatments may also involve radiation and/or chemotherapy. The relative survival rates vary depended on its stage. About 83% survived 1 year after diagnosis, 60% 5 years after diagnosis, and 49% after 10 years. The 5-year, staged combined survival rate is only about 57% . This high death rate is directly tied to late discovery. As with all disease, early detection and education is the best way to reduce risk. Your Dental Professional should be doing biannual oral cancer screenings.

Wednesday, September 5, 2012

Car Air Conditioning-A Blessing or a Hazard, You Decide

Your car air conditioner is a blessing during the dog days of summer, but studies indicate that the toxin ‘Benzene,’ a toxic chemical is being emitted from your air conditioner during the first few minutes after you turn it on. There are conflicting blogs and reports on the Internet about the hazards of car air conditioners. If you are savvy enough to understand the OSHA, NIOSH and EPA standards citing the benzene acceptable exposure standards for consumers and employees in the increments of ppm (parts per million), then you are equipped to assess this potential hazard. For the rest of us we need to use common sense and err on the side of caution. If the reports are true, it would be beneficial to open your windows and even step out of your car for these first few minutes while your air conditioner is initially turned on. This would allow any toxins that are potentially released from the air vents to make their way out before you breath that air in. There is no debate about the hazards of Benzene, it is also important to know that Benzene is present in our air both indoors and outdoors and Benzene does exist in car door panels, seats and interior car components. Wherever there are plastics, synthetic fabrics and glues, there is Benzene and the hot weather conditions will ‘off-gas’ trace amounts. The operative question is ‘how much?’ Well, it depends on whose documents you read. For all of us who drive our vehicles in the summer airing out your car is a smart habit, and should be added to other smart habits like cleaning your fruits and veggies thoroughly, avoiding the microwave when food is in plastic containers, and jogging on a track instead of the roads to avoid exhaust fumes just to name a few.

Wednesday, January 18, 2012

Cavity Prevention: A Huge Return On A Small Investment

Here’s an interesting fact: according to the CDC, the most common chronic disease in children ages 5 – 17 is tooth decay! Why hasn’t a modern, technologically advanced country such as ours combat this age-old problem? In fact, we have! The better question is why don’t parents take advantage of a readily available procedure known as SEALANTS?

My dental training was in the most economically diverse community in the world, New York City. Like all dental schools in 1985, children’s clinical approach was simple, aggressive prevention. Sealants and fluoride-containing vitamins were the thrust then. Although Fluoride is one of the most studied elements on the planet and subject to much debate, the Sealant procedure is today’s greatest tool used to combat tooth decay in children.

Here are the facts: food that has not been brushed, rinsed, or flossed away turns into acid. The acid and bacteria along with the remaining food and saliva will form plaque, a sticky substance that will start the process of tooth decay. It takes only 20 minutes for plaque to develop after your food is chewed. Acids in the plaque dissolve your teeth's protective coating of enamel, creating holes—or cavities. A Sealant application to the tooth surface will protect the cracks and craters of the biting surface thus providing a physical and chemical barrier from the food acids that eat away at the most vulnerable part of the tooth. The cost? Minimal. Almost laughable when you consider the cost of fillings, caps, crowns as well as other invasive procedures needed to fix cavities. A 20 minute visit for a typical sealant session will cost between $15 – $60, (Pedodontist/child dental specialist may charge more). Unfortunately, many families don’t have dental insurance, and those who do, sadly learn that their policy doesn’t cover the sealant procedure. 96% of all dentists offer it, 66% of the dental insurance companies don’t cover sealants, 40% of parents who are offered the procedure turn it down because they would be paying out-of-pocket. A National Health and Nutrition Examination Survey revealed only 30% of children ages 6 to 11 had dental sealants. It also found only 38% of children 12 to 19 had them. These are disturbing statistics for a disease so preventable.

Bridging the gap of value and cavity reduction is a personal one. As a dental clinician, the facts are clear. We need to educate the value and role of the sealant to parents and children. Investing at a child’s young age greatly reduces the need for active dental treatment later in their lives. As parents, this is our goal, to provide them with all the advantages we available today.

Michael J. Gulotta, DDS - Family Dentistry
1150 Portion Road
Holtsville, NY 11742

Wednesday, December 7, 2011

Holiday Chit Chat

I enjoy conversing with my patients before starting their treatment. This can cause havoc with my schedule flow, but its my trademark. Yes, I can yap with the best of them.
Sal was the last patient of the day. I greeted him, hoping he and his family had a nice Thanksgiving. Before two sentences passed by, we were talking about food. This subject matter is so universal, no one alive has nothing to say about it. Well it took 20 minutes before I started Sal's dental procedure.
I usually make an off-the-cuff statement to keep the verbiage rolling. I bragged about not having the traditional turkey dinner for Thanksgiving. My son and my mom both suggested flounder. So we had flounder. Not too long after, the conversation when into Christmas dishes. With the traditional Italian Christmas Eve dishes being fish related, Sal, my assistant Eileen, and I went off on all the bizarre dishes we ever had.
The three of us are of Italian decent, but not from the same region. As each country has its own dialect, the style of cooking can be quite different. We brought up cooking Calamari, Scungilli, and the dreaded Eels. Then we all recalled this fried vegetable stalk called Cardoone. Actually spelled Cardoon. We had NO clue what it really was. Every ethnic cuisine has "that" unknown stuff. Don't know what it is, but tastes great.
We were thinking it was an artichoke stem, celery stalk, or even a fennel stem. After finishing Sal's dental procedure (successfully), we were not satisfied ending the visit until finding out this mysterious food item. Well, when in doubt, Ask Mom!! I called her up. She thought the worst; someone got sick, a patient bit my finger off or the fish died! I calmed her down, and plainly asked her what is the Cardoon dish? Mom stated, "Cardoon is a plant all its own." Related to both the Aster and the Artichoke.
Yes I could have "Googled" it, but the validation from a loved one is priceless. As was the time spent with Sal and Eileen enjoying some truly fond memories. I hope we can all enjoy the fond memories this Holiday season. Try to bring back the little family treasures and traditions that seem have been pushed to the side. Lets bring back these special times for the next generations to come.

Michael J. Gulotta, DDS - Family Dentistry
1150 Portion Road
Holtsville, NY 11742

Friday, November 11, 2011

The True Colors of Teeth Whitening Techniques

Having a great smile is one of the nicest compliments you can get. People see bright, pearly whites as a sign of confidence and good health. But what if you’re teeth are dull and stained? At Michael J. Gulotta DDS, we’ve taken a close look at what causes poor health and dull teeth color and the effective methods available to reverse poor teeth appearance.
What ‘s the cause of poor teeth color?
Our teeth are absorbent. Cola, coffee, teas and red wine as well as tobacco are the common culprits that stain our teeth. Our aging plays a part as well. Our tooth enamel becomes thinner in time and subsequently more transparent causing the inner layer, the dentin to appear darker.
What works?

The primary ingredient in most all teeth whitening procedures is Peroxide. It is safe and effective, but will, in some cases can cause temporary tooth sensitivity when the peroxide molecules make their way to the tooth nerve passageways.
Who Can Consider Teeth Whitening?
It’s important to see your Dentist prior to beginning any teeth whitening regiment. It is not recommended for people with extreme sensitivity to cold, anyone with crowns or fillings on their front teeth, or those patients with grey discoloration (rather than yellowing) due to early antibiotic use. In this case, the color is deeper in the tooth and will not react to any topical teeth whitening procedures.
The Methods
There are many products available but the most effective method is the ‘Barrier Method’, this is when trays or strips are used whereby the solution is against the teeth for the longest time. You will see dramatic results after using for thirty minutes a day in just a full week. Over-the-counter trays or test strips are fine however they sometimes are ill fitting which causes the solution to cause gum irritation. It is recommended to avoid brushing your teeth an hour prior to using any teeth whitening methods, the detergents in the toothpaste causes the gums to become further irritated. A custom fit tray from your dentist is the most effective way to get the perfect tray that has been molded to the shape of your teeth and bite.

Another method available is a paint-on whitener. Common sense will tell you that your saliva will quickly dilute and wash away anything you’ve applied and would not give you good results.
It’s important to note that simply brushing your teeth is another method in teeth whitening. Toothbrushes with an oscillating motion will give you better results than a manual tooth brush, and devoting a full two minutes is also very important. As for toothpaste, look for products that prevent new stains from sticking to your teeth.
Your dentist has all the tools and resources to provide you with the perfect fit for teeth whitening. They have gum-protecting masking gels to protect the gums during stronger, in-office treatments, and can also provide accelerating bleach options that get teeth up to 10 shades lighter in a single visit. This method uses light to increase the effectiveness of a standard application. The inpatient bleaching treatment, also known as the ‘ZOOM’ bleaching system is recommended for patients with more intrinsic staining. At Michael J Gulotta DDS, we use the Opalescence System that has less post treatment sensitivity.
With teeth whitening procedures so readily available today, there’s really no excuse for ignoring your teeth color. Speak to your dentist upon your next visit about the way in which you can get back the bright smile you used to have. It’ll give you loads of self confidence and a youthful, healthy appearance that we all work so hard to achieve.

Easy, on-the-go Teeth Whitening Care
•Eat crunchy fruits and vegetables such as apple slices, carrots, and celery sticks for snacks. They actually will help clean your teeth while you chew.
•After lunch. If you’re unable to brush, chew sugar-free gum that will absorb some of the new surface-staining food you may have eaten.
• When your out for dinner, be sure to rinse your mouth out by swishing water for 30 seconds if you’re unable to brush.
•Multitask in the morning by using teeth whitening strips. Use these strips when taking your five minute shower.

Michael J. Gulotta, DDS - Family Dentistry
1150 Portion Road
Holtsville, NY 11742

Important New Facts about Mouth Wash

It has always been understood that Oral Rinses (mouth washes) will give your mouth a clean, fresh feeling with great, minty breath. Now there’s new data that shines new light on potential dangers when certain oral rinses are used on a regular basis.
The key ingredient that is the greatest concern is alcohol.
Recent studies have shown sufficient evidence that the use of oral rinse with a high content of alcohol can increase the risk of developing oral cancer, and the Dental Profession is being advised to warn their patients about the oral rinse products on the market whose ingredients include alcohol.
The surface of the mouth is very absorbent.
Understanding the anatomy of the mouth can help to better understand the dangers when alcohol is exposed to the mouth. Our gums, teeth and tongue are coated with saliva and mucus. This coating protects us from a range of bacteria and germs. Without this protection, we run the risk of diseases including dysplasia (pre cancerous cell growth) and cancer. Just 15% alcohol can permeate the protective coating on the tongue and this exposure when long term can lead to tissue damage and precancerous basal cells.
Our mouths are constantly exposed to germs and bacteria from the foods we eat, from the smoke and air we inhale as well as the incidental microscopic organisms we inadvertently put in our mouths with our own hands. It is critical that we retain the moisture our mouths require to fend off the diseases we could encounter. We should therefore limit the alcohol from our diet and eliminate it altogether from our mouth washes. It is our first defense in good oral and overall health.
Drinking alcohol.
It is also important to note that oral cancer along with throat and neck cancers are found amongst heavy drinkers and most especially amongst drinkers who smoke. Like alcoholic rinses, heavy drinking will break down the natural protective barrier weaken your natural shield and will expose your mouth to unhealthy pathogens.
Healthy Oral Rinses.
Be diligent when purchasing mouth washes. Check the ingredients and be sure to avoid any rinses with alcohol. Our first defense to good health is information.
Here’s a list of the oral rinses on the market today and their alcohol content:
Listerine Antiseptic: 26%
Listerine Teeth Defence: 22%
Listerine Cool Mint 22%
ListerineTarter Control 22%
Listerine Citric Fresh 22%
Listerine Smooth mint 21.6%
Cepacol Mint 15%
Cepacol 14%
Savacol Original 11.5%
Listerine Whitening 8%
Difflam Solution 7.5%
Difflam-C Solution 7%
Neutraflour 220 7%
Plax 6%
Peroxyl 5.5%
Neuraflour 900 5%
Curasept 0%
Dentyl 0%
Biotene 0%
Oral B 0%
Amosan 0%
Neutraflour 220 Ethanol Free 0%
Flourocare 200 0%

Michael J. Gulotta, DDS - Family Dentistry
1150 Portion Road
Holtsville, NY 11742

Sunday, July 17, 2011

Choosing A New Dental Provider

Many factors go into determining a person’s choice when it comes to a new healthcare provider, but the first impression is the most important component. At Michael J. Gulotta, DDS, you will find our receptionist considerate and mindful of any apprehension. We promote happiness, comfort and relaxation for each client who walks through our door. These are the merits you should expect and the qualities we strive for knowing full well how stressful a dentist visit can be.

When visiting a provider for the first time, come prepared with questions. Do the attendants care about what they are doing? Will the dentist listen to my history and understand my needs? What about comfort? Are they gentle? Is the office clean? Do you know what your current dental needs are? What are all your options? What are your financial obligations to the treatment and are there payment options? Decisions should be made as collaboration between you and your dentist, you want the best treatment necessary and Michael J. Gulotta DDS can help you meet these health-minded goals.

Being heard is the foundation to a solid relationship between you and your dentist; we understand your concerns and will work with you to satisfy any apprehension. As a practicing dentist for 26 years, (and a patient for 50!) I know how I like to be treated and that is the attitude and sentiment I bring to my practice every day.