TMJ & Posture Videos

Here are links to two great uTube videos, put together by my colleague Dr. Scott Tamura.. The first, TMJ for Dummies nicely explains the role of the jaw and bite in head, neck and facial pain disorders. The second is great at explaining how a bite disorder can cause all sorts of other structural problems. Enjoy and contact us if you have questions.

Crooked Teeth in Children

This YouTube video is for all those parents whose children I have seen recently and who are wondering why their children have crowded teeth. This video explains one of the causes of crowding, that being poor breathing patterns or habits. If these patterns are not addressed before correction of the crooked teeth, the result may not be stable and relapse will occur. Enjoy another YouTube video from my colleague Dr. Scott Tamara.

Exposed Metal on Dental Crown

Recently had a query as to whether the exposed metal on a dental crown constitutes a health risk. The short answer is that probably does not, at least no more so than if it was not exposed.You see a common dental crown has a metal substructure that covers over the remaining tooth. That metal substructure is then covered with porcelain to look like a tooth. However, whether or not the metal is totally covered makes no difference, it is still exposed either from inside or outside of the tooth. Also a porcelain-fused-to-metal crown (PFM for short) can have up to 6 different metals to create an alloy that enables the porcelain to stick to it. The photo attached shows a typical PFM crown (second tooth in from the right – the PFM crown has exposed metal on the inside near the gum area at the top of the photo. The photo also shows badly broken down mercury and plastic fillings on the other teeth).

Biological Periodontal Therapy

Our office recently had Dr. Oksana Sawiak in office to help implement our biological periodontal therapy protocols including our phase contrast microscopy skills.

Identification and treatment of pathogenic bacteria, parasites and protozoa is fundamental to the improvement of health of the ‘gums’ or periodontal tissues. Recent tests that examine the nature of the microflora of the mouth seek to identify and provide solutions to eliminate periodontal disease, which is linked to many systemic diseases.

Testing of saliva and scrapings of plaque from areas of the mouth are the basis of two laboratory tests, OralDNA and OraVital. These can confirm the chairside evaluation of plaque using a phase contrast microscope, which is an immediate and visual representation of the patient’s oral microbiology, which can include parasites (amoebae, Trichanomas Tenax), fungi, spirochetes and much more. For an eye opening discussion of Biological Periodontal therapy have a look at the following interview with Dr. Lyons.`

What Materials Are Used to Fix MY Teeth?

Excellent article on how we determine what materials to fix teeth with. We get asked a lot about this subject and this article can help those navigate all the information on this subject. We use materials that are bio-compatible for most folks meaning metal free ceramics, zirconium and resins. We still use titanium implants but are trained to place zirconium implants also. For those who really want to know what is best for them the tests mentioned are available through our office.

Allergy to Titanium?

Titanium has been used in dentistry as a restorative material for decades now. Most associate its use with frameworks for partial dentures and dental implants that replace roots. Now it is also being used to restore teeth as a material used in the fabrication of crowns.

The following is taken from a recent publication, the Journal of Prosthodontics, a peer reviewed scientific dental journal. For those with pre-existing sensitivities to metals, including nickle, and auto immune disorders Dr. Valentine-Thon suggests avoiding titanium implants. Testing, as mentioned in the article, is available for those considering titanium implants and restorations. Always discuss material selection with your dentist. Non-metal solutions are now available including ceramic implants. Also, as noted in the following article, if you have titanium implants fluoride should NOT be used.

Titanium and Allergic reactions

New research puts a question mark on conventional thinking that titanium (Ti) is unlikely to cause allergic reactions because of its superior corrosion resistance.

The incidence of allergic reactions attributed to titanium sensitization may increase with its overall medical use, research published in the Feb. 4, 2014 online edition of the Journal of Prosthodontics reported.

The incidence of allergic reactions attributed to titanium sensitization may increase with its overall medical use, research published in the Feb. 4, 2014 online edition of the Journal of Prosthodontics reported.

Scientists in Japan described the case of a 33-year-old woman referred for treatment following a 10-year history of eczema and itchy redness on her fingers. An allergy clinic conducted lymphocyte stimulation testing (LST), which has been demonstrated in the literature to be a reliable method for detecting metal sensitivity. The patient showed a rare, specific reaction to mercury, nickel and silver, but no reaction to other tested metals, including titanium.

After checking the composition of the patient’s 17 metal restorations, researchers removed all of those containing mercury or silver. The patient’s pruritus improved within two months. After waiting an additional month, researchers replaced the restorations with new ones made of titanium.

Nine months after placement of the Ti restorations, the patient developed cervical eczema. The condition gradually worsened. LST testing revealed a specific reaction to titanium, so the authors removed all titanium containing restorations and replaced them with auto-polymerizing poly (methyl methacrylate) resin. The patient’s eczema resolved within three months and didn’t reoccur over more than five years of observation.

Earlier research uncovered Ti allergy because dermal inflammatory conditions ceased after removal of titanium. This current study, however, described a case of dermatitis associated with a positive LST reaction to titanium after insertion of titanium dental restorations.

In discussion, the authors noted that Ti ions dissolve in artificial bio-liquids more than expected when the surface film is destroyed, and topical fluoride solutions can cause stress corrosion cracking.

“The present findings suggest that the patient had become sensitized by nine months after insertion of Ti, and the fact that complete remission was achieved after removal of the Ti strongly suggests that the cervical eczema was caused by an allergy to intraoral Ti,” the authors said.

They speculated that titanium restorations are likely to increase in frequency as a substitute for precious metal due to the belief that titanium is very stable.

“It seems likely that the incidence of allergic reactions caused by sensitization to titanium will increase in the future as use of medical titanium increases,” authors said. “The rare occurrence of such a response to titanium materials in clinical dentistry should therefore be further discussed and investigated.”

Why Does My Child Still Have Cavities?

I have had several parents over the last couple of years express the same frustration. Essentially they are frustrated by the fact that their children continue to get cavities despite their best efforts at prevention. Basically, decay is a nutritional disorder. One of the best articles describing the process was published in the Journal of General Dentistry by Dr. Ken Southward in the September/October 2011 issue, titled: The Systemic Theory of Dental Caries (Citation in the Document Library under Nutrition in Dentistry). It basically confirmed the findings of Dr. Weston Price and chronicled in his classic text Nutrition and Physical Degeneration first published in 1943 and in continuous print ever since. One of the frustrations of many parents is that their children continue to get cavities despite following what they feel is the Weston Price diet. The solution to the decay problem lies with diet and nutrition. Diet is a complex topic. Under ideal dietary conditions we get the nutrients we need to grow healthy tissues. Sadly, today’s food choices are difficult. A factory farm raised chicken does not nearly have the nutritional value as a free range ones we pick up at Sonset Farms, a small producer close to where we live. The chickens we get there are excellent and make a high quality broth. Sue even throws in the feet. The same can be said for every food choice, like eggs. You need to educate yourself on the quality of food you are buying. Your local Weston A. Price Chapter can help with helping you to source local foods. Look for a local chapter on line and get involved. The knowledge base in the membership of these organizations is truly amazing and you can usually connect with folks who are having similar issues. As a biological dentist I feel that the best dentistry is no dentistry. If I can educate patients or provide the resources to help them prevent dental problems that is the way to go.The benefits extend beyond preventing cavities to proper development of the the face and jaws, preventing orthodontic problems among many others.

So what do you do if your child is diagnosed with cavities? Well, it obviously is a wake up call to examine your child’s diet. Decay is a process. It can be active or inactive. To determine whether it is active or inactive you need reliable records that measure what is going on at two points in time. Xrays have been the traditional methods of assessment but a new technology using a non-invasive laser called the Canary System ( has been shown to be more accurate than Xrays in detecting and monitoring decay. If early decay is detected preventative methods can be used to help reverse the process. Ideally, following many of the dietary principles of Weston Price is best but there are oral hygiene methods and topical solutions that can help. We like SHEC’s cavity guard ( that contains iodine versus fluoride. If teeth need to be restored with fillings we use a very non-invasive laser ( to remove just the damaged tooth structure. Often the use of ‘freezing’ or local anesthetic is unnecessary. Other advantages of the laser is disinfection of the cavity and micro-etching of the tooth structure so the filling sticks really well. We will often use ozone to disinfect the cavity as well (

Diet is only part of the story. A factor commonly overlooked is frequency of eating. Every time you consume something it creates an environment that makes teeth more susceptible to decay, especially simple carbohydrates which negatively impact the ability of the tooth to self clean as per the mechanism described by Dr Southward. I commonly see children be given snacks frequently throughout the day which shuts down this mechanism and coupled with not cleaning the teeth and mouth creates an ideal environment for dental decay. So the message is to choose appropriate snacks and drinks and minimize or eliminate snacks between meals.

An excellent reference text is The Dental Diet by Dr. Steven Lin which can be found at:

In any event, the best dentistry is no dentistry. Our knowledgeable team is always available to answer any questions you have.