Issue #22, August 2008

JoAnne’s Motivational Minute: Choosing Joy

By JoAnne Boettcher-Verigin

Joy is what happens to us when we allow ourselves to recognize how good things really are. – Marianne Williamson

Sometimes I consider not watching the daily news or reading the newspaper. We are confronted continually with negatives: the economy is falling apart; we’re running out of energy; violence is everywhere. Yet it’s because of this that I find it more important than ever to expose ourselves to the positive – and there’s plenty of it out there if we just stop and look for it. After all, we have the choice of how we respond to life.

So maybe we can use the negativity around us to focus more fully on how we react to it, making it a positive force.

If we have to change our spending habits through watching our food budget, for instance, why not see it as an opportunity to explore exciting new ways to cook – more economical, and maybe more nutritional, as well? Perhaps you could plant a garden, getting family, friends or neighbors involved in planning, planting, nurturing, harvesting and sharing the bounty. What a valuable experience that could be – to understand just where our food comes from! And if we plant a few flowers along with our vegetables, we experience even more of the beauty and plenty of our environment. Even if you live in the city, you can put plants on a balcony, deck, rooftop or just a window sill.

With the cost of gasoline so high now, maybe it’s time to forego the long road trip. Instead of being disappointed, perhaps we can look at vacations in a different way. We can take the opportunity to look around just where we are and enjoy our homes, our neighbors and the many fascinating sites that are close to home and so often overlooked. We can spend quality time with our families instead of subjecting ourselves to the very real stress of planning, traveling, doing-doing-doing, and then experiencing the “re-entry” as we arrive home again.

In this election year, we are bombarded with political information – much more than many of us might want to hear. And yet, despite the negatives we often see, I still feel joy to live in this country and have the freedoms it provides. When I think about that, I am reminded that I need to always take my small part in the voting process and in my local community. I need to be involved with my neighbors and family. I need to help spread joy instead of complaints.

I choose joy. How about you?

Source: Scott Ableman/Flickr, CC

More ideas for finding joy

It is better by noble boldness to run the risk of being subject to half the evils we anticipate than to remain in cowardly listlessness for fear of what might happen. – Herodotus

Dr. Verigin’s Comment:
10 Reasons Why Your Teeth Might Hurt – and 7 Things You Can Do about It

By Gary M. Verigin, DDS, CTN

When people contact our office about tooth pain, they usually have just one idea about the cause: a cavity. If they’ve seen another dentist about the problem, they often say they were told to have a root canal. Not wanting to go that route, they opted for a second opinion. And we’re glad they did, because there are many more reasons a tooth can hurt after a dental procedure, as well as before.

So I’d like to spend some time telling you about ten of the most common causes of dental pain and what you can do about them. For the answers get to the heart of important issues such as biocompatibility and minimizing dental stress.

1. Every time a tooth is worked on, it undergoes a variety of insults, especially mechanical or frictional heat from the dentist’s handpiece (a/k/a the “drill”) and water and air spray from both the drill and the assistant’s water/air syringe. The cumulative effect is reduction of the dental pulp’s responsiveness in healing and a triggering of inflammation, which causes pain. The inflammation also makes it harder for the pulp to receive adequate nutrients via the capillary system, as the pulp is one of the few terminal circulation points in the body. At the same time, intrapulpal pressure is increased due to swelling in the connective tissues. Repeated insults make the pulpal tissue more fibrotic – just as sun exposure makes an adult’s skin harder and drier than that of a newborn child. Thus, we do all we can to minimize the trauma when performing necessary restorative procedures, as well as the number of procedures that need to be done.

2. Most often, the need for restorative dentistry is due to tooth decay. Bacterial toxins filter through the dentinal tubules – the miles of tiny tubes coiled within the dentin of every tooth.

Source: Oral & Craniofacial Histology

Normally, these tubules circulate nutrients via the dentinal fluid. But when toxins flow through and make contact with the pulp, the pulp protects itself by initiating an inflammatory response. If the toxins are given the opportunity to bathe the delicate tissues of the pulpal complex for a long time, those tissues become necrotic. The blood supply is lessened. The tissues decompose.

3. Another sort of trauma that can occur during dental procedures is slangily referred to as “twisters.” When the drill cuts into the dentinal tubules, the friction – along with high and low pressure areas created by the turbulence – can literally suck out the protein processes in them, just like a tornado (i.e., a twister) sucks up and displaces all that lies within its path. The tubules are now “dead tracts,” devoid of once viable protein processes and, thus, cells.

4. Dentin is the second hardest substance in the body – harder than bone but not as hard as enamel. When first cut, though, its condition is like that of any fresh wound, save the lack of blood. This makes it vulnerable to contaminants. When dental materials such as acid etching and chemical bonding agents or acetone primers are used, the exposed tubules soak up these materials like a sponge. Accordingly, the underlying pulpal tissue responds with an inflammatory reaction. The thinner the dentin in relation to the pulp, the more acute the reaction and, thus, the pain.

5. Microleakage in dental restorations – gaps between the restorations and the walls of the prepared teeth – can also lead to pain.

Source: Geneva Smile Center

It is believed that microbes growing in these gaps spew off toxins that diffuse through the dentinal tubules and irritate the pulpal tissue. These gaps aren’t necessarily the result of bad dental work. Over the long term, many well placed materials may allow these gaps to form. We most often see it with respect to composite resins, followed closely by mercury amalgam, especially when placed in the back teeth. After years of being under the stress of chewing – and sometimes grinding and bruxing – such fillings can leak. Further, microleakage can also occur with composites if the light curing is incomplete. This is because the mateiral shrinks away from the walls of the tooth preparation during polymerization (the hardening process).

6. It is crucial that any restorations placed in the mouth fit well. If the provisionals don’t fit properly, cement wash-out can occur, leading to microleakage and bacterial proliferation. The temporary cements don’t have antimicrobial qualities and are highly acid soluble (saliva is slightly acidic). If they break down, oral microbes can become rampant, becoming another source of inflammation and pain. Thus, we do our best to insure proper fit – as well as making sure you have enough time between placement of the temporaries and that of the permanent restorations to give the pulp plenty of time to heal.

7. Occlusion – how the teeth come together – is similarly important. If the restoration is left high, the client may complain of cold sensitivity and pain upon chewing. They may not even be able to bring their teeth together evenly. Thus, an even bite is key when placing restorations, both temporary and permanent. With your help, telling us as specifically as possible how your bite feels, we can usually get it right the first time. Sometimes, though, later adjustments must be done, either in the most closed position or perhaps in one of the functional movements of the lower jaw.

8. Yet another cause of post-treatment pain comes from bond-failure. Saliva, blood, serum, water and oil all have the potential to interfere with bonding the restoration to the prepared tooth. During the procedure, isolation of the tooth being worked on is needed, to keep it dry and bacteria-free. Otherwise, the porous dentinal tubules will absorb microbes from the saliva, and these can become trapped and possibly irremovable.

9. As noted, acetone is an ingredient in many primers and bonding agents that are used on the freshly cut dentin before composite placement. But research has shown that not all primers harden completely. Thus, uncured primer can still be present in the dentinal tubules. For how long? No one yet knows.

10. Finally, there’s the matter of post-treatment hygiene. If the provisionals are connected – as in a fixed bridge – then a perio-aid should be used, as well. At cementation, the tissues need to be free of most inflammation so that successful cementation into a dry field can occur.

Knowing all this, we can hone in on seven steps for minimizing tooth sensitivity and pain:

  1. Minimize new tooth decay by maintaining excellent home hygiene, disturbing the biofilm daily by brushing, flossing, irrigating and otherwise cleaning the teeth and oral tissues.
  2. Eat a nutrient-rich diet based on whole foods, with minimal intake of refined carbohydrates (e.g., products made with white flour and sugars).
  3. Choose the longest-lasting dental materials possible, to minimize the need for frequent future replacement.
  4. Choose only biocompatible materials, verified through proper evaluation.
  5. Use the proper homeopathics after dental work to support the healing process.
  6. Avoid using aspirin and other anti-inflammatories that do nothing but mask pain.
  7. Above all, check the pulpal health of the teeth thoroughly before proceeding with any dental work.

And what if pain should arise anyway? There are a number of steps we can take, including the use of homeopathics, repolarization of the intraoral acupuncture points associated with the painful tooth, cold laser therapy and adjustment of the bite. But the main thing is that you let us know what’s going on – as specifically and soon as possible – so we can help you through the healing process.

If thorough and proper pretreatment evaluations are done and an adequate amount of time is spent obtaining a thorough history of the teeth to be worked upon before actual treatment is started, the number of future endodontic or extraction procedures will be dramatically decreased.

If you can find a path with no obstacles, it probably doesn’t lead anywhere. – Frank A. Clark

From Our Blog:

Autoimmune Disorders and Environmental (and Dental) Toxins

Many new clients who contact our office have been diagnosed with autoimmune disorders – from allergies and asthma to Crohn’s and celiac diseases to fibromyalgia, rheumatoid arthritis and MS…just to name a few. Often, they have bounced from health care provider to health care provider in search of healing. Sometimes they have experienced brief respites from their symptoms only to fall sick again. This vicious cycle usually inspires them to learn as much as they can about their conditions and available options, and in doing so, they discover the possibility that dental conditions or oral pathologies could be at the root of their problems. After all, though more and more practitioners are coming to appreciate the relationship between the mouth and the rest of the body, relatively few consider it as a factor in the patient’s current illness.

In general, the number of people with autoimmune disorders has skyrocketed. According to Donna Jackson Nakazawa’s The Autoimmune Epidemic, 23.5 million Americans – or 1 out of every 12 – currently has at least one of almost 100 known autoimmune diseases. This is more than the number of people with cancer or heart disease.

Consequently, we were excited to see this book come into print, especially due to its focus on the role of environment in the etiology of autoimmune disorders. For indeed, as the author – who, herself, has Guillain-Barré – writes, “We are our environment. What we put into it, we also put into ourselves. What we do to it, we also do to ourselves.” In fact, as she writes elsewhere, “two-thirds of the risk of developing autoimmune disease is acquired through some environmental trigger, genetic risk being the smaller part of the equation.” Or put even more bluntly, “While genetics may load the gun, it’s environment that pulls the trigger.”

Nakazawa is at her best here when telling the stories of those who developed autoimmune disorders, how their conditions developed and the process of attempting to heal – especially in her chapter-long chronicle of the lupus clusters that arose in Buffalo in the mid-1980s due to unacknowledged toxic sites in the area. Indeed, she powerfully explains and illustrates the role of the envirotoxins that infiltrate our lives even if we are careful:

You can green your home as best you can, eat organic, avoid dry cleaning the clothes, throw out the solvents, and buy bedding sansflame retardants, but can you find that hallowed ground far from the chemical-driven American industrial machine?

There is, of course, plenty of proof for the impact of envirotoxins on the human body. For instance, in a 2004 CDC study cited by Nakazawa, researchers found traces all all 116 chemicals they looked for in every single one of 2500 Americans from across the country. The following year, a different team of scientists detected 287 different toxins in the fetal cord blood of ten newborns – findings that continue to be replicated elsewhere.

One important and potent source of toxicity, however, gets the short shrift: the mercury people are chronically exposed to via amalgam fillings. This source is barely mentioned, garnering one paragraph about halfway through the book and a few isolated sentences elsewhere. And yet many times, it is arguably the greatest source of toxic exposure for the person with such fillings. They are there in the mouth, mere centimeters from the brain, 24 hours a day, seven days a week, constantly releasing mercury vapor. And with any stimulation – through chewing, temperature changes or other event – even more vapor is released. It circulates through the body. It is absorbed into the body’s tissues. There is no let-up. Ever.

Along with root canals and cavitations – two other persistent dental/oral sources of disease – mercury fillings poison the body, giving rise to a whole range of diseases, disorders and dysfunction.

In a way, Nakazawa’s apparent lack of appreciation of this point may well stem from the sense that she largely keeps within the industrial medicine paradigm. Throughout the book, she points to drugs used to “manage” the symptoms of autoimmune disorders and research into new ones that may do the job better. (Indeed, this is the heart of industrial medicine: you never cure a disease, only “manage” it.) She explores the latest research into therapies within this paradigm – some of which are exciting and fascinating (Regrowing myelin sheaths and axonal nerves? Cool!) but neglect the problem that the drugs themselves are yet another contributor to the toxic dumps our bodies can become, polluting the terrain and interfering with the body’s own processes of healing.

That said, the book is of value in exposing the relationship between disease and environment – the focus of just about half of the book. And the case histories are informative in illustrating this, as well as helping us understand what it’s like to develop and cope with such an illness.

Amazon page for The Autoimmune Epidemic

For more articles like this, as well as news and comment, video, recommended sites and more, visit our blog, Know Thy Health.

When the Japanese mend broken objects, they aggrandize the damage by filling the cracks with gold. They believe that when something’s suffered damage and has a history it becomes more beautiful. – Barbara Bloom

Copyright ©. Gary M. Verigin, D.D.S., inc. All Rights Reserved. California State Licensed General Dentist.
Disclaimer: We make no claim of providing superior services, nor do we guarantee any specific outcomes from the services we provide.