2020 is an impressive year. It marks the 50th Anniversary of Earth Day , a world-wide civic celebration recognizing the importance of taking care of the environment. It is also the 75th anniversary of community water fluoridation. In 1945 Grand Rapids Michigan became the first community to fluoridate their drinking water (not to be confused with Flint, MI which had lead in their water- different mineral). Despite current skepticism over whether communities should continue to add fluoride to public drinking water, there are some positive statistics that stand today with years of research backing them. Here are some myths that have been busted.

1) People get fluorosis from drinking fluoridated water. Fluorosis happens when children with developing teeth consume too much fluoride from any source, and those teeth erupt with white lines or streaks. The ADA notes that “The type of fluorosis found in the United States has no effect on tooth function and may make the teeth more resistant to decay.” Once teeth erupt you cannot develop fluorosis. To prevent fluorosis, you may want to use baby formula mixed with non-fluoridated water, watch younger children so that they do not swallow toothpaste, and make sure your dentist and pediatrician know if your water is fluoridated before taking fluoride tablets.
2) Fluoride causes cancer: In 2015, the U.S. Public Health Service lowered the recommended level of fluoride in water from 1.0 (in Massachusetts) to .7 parts per million. This was in response to the availability and use of other fluoride rinses, toothpastes and fluoride supplements that people may take to reduce the build up of fluoride in the body. Shown in animal testing, excessive fluoride can build up in the bones and in growth plates, especially in male rats, causing osteosarcoma. The American Cancer Society has collected studies over the last 25 years, and has not identified any direct correlation between communities with drinking water and an increase in cancer or cancer risk in humans. This is not to say that consumption of high levels of fluoride from other sources combined does not cause an increased risk.
3) Why fluoridate water in communities if adults do not need it? A big debate is whether the risk of fluoride in drinking water out weighs the benefits to children with developing teeth. A report by Medical News Today in 2019 looked at an Alaskan community that decided to eliminate fluoride in its drinking water and study what happened over time. Backing up findings by the ADA, in a 9 year period, they found that there was a 25.2% increase in cavities in this community, despite the availability of fluoridated rinses, toothpastes and supplements. They also noted that the cost to families for cavity treatment rose by 73%. The benefit of fluoride to strengthen the enamel in unerupted teeth, and to remineralize the enamel in erupted teeth creates healthy teeth that last a lifetime.

https://www.mouthhealthy.org/en/az-topics/f/fluorosis 2/27/20

https://www.hsph.harvard.edu/news/features/a-call-for-reducing-fluoride-levels-in-drinking-water/ 2/27/20

https://www.cancer.org/cancer/cancer-causes/water-fluoridation-and-cancer-risk.html 2/27/20

https://www.medicalnewstoday.com/articles/324086 2/27/20

In the orthodontic office, it isn’t always front and center the things we are thankful for, and what a better time than the present to share some of our favorites.

1) We are thankful when someone is referred by friend. It is true that many dentists are the first in line to suggest that you or your child see an orthodontist, but we are truly humbled when someone puts a friend as the person who recommended us.
2) We are thankful to have opportunities to help in our community. While much of what a business does seems to focus internally, our office is blessed to be able to support fundraisers and other benefits in our area. One of our biggest outreaches is in February during National Dental Health Month. Our multitalented, does-everything employee, and former pediatric nurse, Lisa Masciadrelli, will go to countless 2nd grades in two states to visit over 1,500 students with a unique dental program every year. The children get to interact, ask questions, and be candid about their dental knowledge. We are thankful that we can provide supplies and dental goodies for every child, so they can go home and share their story with their parents.
3) We are thankful for our fellow orthodontists. What may not be known is that orthodontics is not a dog-eat-dog field. Many of our local orthodontists work with us in different capacities to support each other. Our office is part of a network of orthodontists who communicate with each other directly. This circle of doctors will cover for each other when one is away. They also discuss patient cases that are unusual. These doctors will also look to each other for guidance in current issues, such as insurance regulations, or transitioning to new technology. We are thankful to have a wonderful treasure of orthodontists who support each other.

October is National Orthodontic Month

What better time to discuss smiles than the month where we carve groovy grins into our gourds. To help celebrate, here are a few of the top advances in orthodontics over the years that make our patients scream for joy.

1) Bandsylvania no more!  Until the 1970’s, every tooth had to be wrapped with a band to create the force needed to move teeth. For those of us horrified by the thought of separators, this is indeed an orthodontic nightmare! Now we bond a small bracket to the front of the tooth with an adhesive similar to what is used for a tooth colored filling.

2) The wrong impression:  One of our patients’ favorite upgrades to taking records or appliance fits in our office is that we no longer have to go through the impression process with “molds”. Nothing says “We Care” like getting rid of something that not only sounds legitimately gross, but is a gag for many patients as well. Paired with our 3D printer by Formlabs, we can use 3D scanner and re-create any mouth without the mold.

3) Invisable by Invisalign: The clear aligner technology with patient case videos has to be the most remarkable upgrade to orthodontia yet. Unlike “mail-order” aligners which have proven to have serious consequences for self-referred users, Invisalign has a tested, orthodontist-approved method of safely moving teeth in specific increments in the minimum amount of time possible. No bracket, no wires, no problem eating that candy!

In our office, it is important to remind our orthodontic patients about protection and wearing a mouthguard. While it may be common sense that wearing a mouthguard while playing sports is a good idea to avoid dental trauma, it may be also helpful to know a few interesting facts about them.

1) Give me the numbers: According to recent research, the following facts are true:
• Every year, there are about 15 million dental injuries, 5 million involved an avulsed tooth (knocked out) and a median of 26% were sports related.
• Males are twice as likely to be traumatized by a dental injury
• Children ages 7-10 are most likely to be injured.
• The National Federation of State High School Associations mandates mouthguards for only four sports: football, ice hockey, lacrosse, and field hockey. Wrestlers are mandated if they have fixed orthodontic appliances.

2) Those must be the sports with the most injuries, right? While these organized sports are top contenders for oral injury, they are not the worst contenders:
• In a study of 3,411 athletes, basketball was a top sport for orofacial injury for both males and females. In that study, none injured were wearing a mouthguard. Personally speaking, in the 20+ years I have been in practice, I have never had a patient with a dental injury from playing football, ice hockey or lacrosse. Those leagues mandate mouthguards for their players. The one sport that I see dental injuries in my patients every year is basketball. It is usually the same story: both team’s players are down at one end of the court trying to get the ball as it comes off the backboard and someone gets an elbow to the mouth. When I ask if the player was wearing a mouthguard, the answer has always been “No.”  Parents – please have your child wear a mouthguard for basketball, especially if they are in braces.
• For those younger children, baseball has the top incidence of trauma.
• Many dental injuries happen with non-contact, non-organized sports where people would not wear a mouthguard. We can vouch for the top recreational bicycle vs. pavement finding. Although not listed in this study, our office has a high incidence rate of “sibling-caused” dental injury.

3) Does it matter what type of mouthguard is worn with braces? Good question. There are several opinions on the boil-and-bite vs. stock-type mouthguard during orthodontic treatment.
• Stock-type mouthguards:
– Pros: fit over braces for the duration of the sport season without refitting. Allow for tooth movement during treatment time. These are the types of mouthguards we have in our office for patients.
– Cons: Must be held in place by biting, inhibiting speech. Due to their one-size-fits-most limitation, they can be more bulky and ill-fitting, causing the patient to not wear the mouthguard.
• Boil and Bite mouthguards:
– Pros: Better fitting for increased compliance, recommended by the Academy of Sports Dentistry.
– Cons: For patients in braces, as teeth move during treatment, the mouthguard needs to be frequently refit. We note an increase in breakage of braces due to forced fitting and removal of this type of mouthguard. These types can get stuck on the braces and break the braces off the teeth.
Source: www.dentalcare.com/en-us/professional-education/ce-courses/ce127/stock-mouthguards Accessed September, 5, 2019

Welcome to the first Blog for our new website. We hope to provide user-fed, question-based information on this page that you may not be able to find on a general search. For our first Blog, it may make the most sense to give you an idea why having a current web site is important to us.

1) Who are these people?

Unlike shopping online, in the orthodontic field, you want to know a little bit about the doctor and staff with whom you might be spending a decent portion of your time. On average, including pre-exam and retention, you could be in the practice for 4 years or more. People going to an orthodontic site want to know what qualifications the doctor has, what is the staff like, what technology they use and what the hours are.

2) We are referral based.

Unlike searching online for a recipe, approximately 85% of people in our practice were specifically referred to us by a dentist, friends, or a combination of both. Only about 10% of people are insurance-referred, and only 5% or so decide they do not like the smile they see in the mirror and Google us. When people get referrals, the first place they go to is the web site to get our phone number and address. Our web site also has a great “contact us” section, by location, so people can shoot a message to us at any hour that is convenient or request an appointment.

3) Information, please.

We will have personalized “how-to” videos uploaded this fall based off of patient/parent frequently asked questions. We want to highlight information, not opinion.

Stayed tuned for our upcoming blogs as we discuss fall sports, injuries, and the need for special types of mouthguards with braces.

Several weeks ago, we launched our new website and hope you like it. It is now more interactive and mobile device friendly. As part of the redesign of the site, we have now added a blog section. From time to time, we will be posting helpful information about orthodontic treatment and who knows what else!