Feeling sick?

Well just about everyone in the neighborhood is sick. If I remember correctly then it was about this time last year that we all got sick also. It seems to happen right after all of our many family & friend gatherings around Christmas time. I did get my flu shot which was said to be effective this year but I think I just have a common cold. In case anyone else is suffering from a cold here is an excellent website with good supporting research: http://www.commoncold.org/ another great website that has some conflicting views with the previous website but also provides a good evidence based and concise review of treating the common cold is: http://www.mayoclinic.com/health/cold-remedies/ID00036

I hope everyone has a great new year!

How to Prevent Tooth Decay Re-Visited

In a previous article I wrote on ideas for preventing tooth decay. I would like to re-visit this topic because despite the fact that we have the means available to completely prevent this disease it is still very rampant in our society. Take a look at this well-written article on WEBMD:

http://www.webmd.com/oral-health/guide/tooth-decay-prevention

I liked this article and thought it was a good practical summary of prevention ideas similar to my article on prevention. However, cavity prevention cannot be achieved simply by reading a list of instructions in every case. There is a reason why less educated and people with lower socioecconomic status have a much higher rate of tooth decay: more than likely they were never taught the habbits that lead to oral health and they probably don't understand how this disease process works. I would like to expound on this article and the one I wrote previously. Tooth decay is a multifactorial disease meaning there are a lot of causes. However, Understanding a few basic ideas of how tooth decay works can help you change your daily habits and prevent new cavities from forming.

We were taught in dental school that 3 conditions must exist for a cavity to form:
#1 an agent: bacteria
#2 a succeptible host: you
#3 an environment that supports the agent or reduces hosts defenses.

#1 Tooth decay is the result of a bacterial infection. Your mouth is chuck-full (yes this is a very scientific term) of bacteria! The specific types of bacteria that cause cavities like Streptococcus Mutans are passed from mother to child. Cavity causing bacteria eat and digest sugar and other easly broken down carbohydrates then they produce acid. This acid is what starts to brake down your tooth structure forming a cavity. The bacteria cannot be eliminated completely with our current treatments. Even after rinsing with Listerine (which does kill them) they will re-bound, antibiotics would have a similar effect except with more negative side effects.

#2 Tooth decay is the result of a succeptible host: you! These bacteria need a hard surface to attach to: your teeth! Newborn babies that do not have teeth yet have very low numbers of these cavity causing germs. As soon as infants get some teeth especially molars with grooves in them the levels of cavity causing bacteria go up exponentially. Part of your succeptibility to decay may be genetic. Some people may have natural cavity protection in the form of good anti-cavity saliva and less succeptible tooth anatomy. However there are aspects of you that you can change. "Soft teeth" is usually not the reason for your decay. There are very rare disorders where the dentin or enamel on your teeth does not form properly thus this person would truely have soft teeth.

#3 Cavities are the result of an environment conducive to the growth of specific bacteria. If I were a cavity causing bacteria I would love the following environment: a dry mouth and plenty of carbohydrates frequently placed in the mouth of my host throughout the day and especially right before bed. The frequency of carbohydrate or sugar consumption throughout the day is a risk factor for tooth decay.

We learned about something in dental school called the Stephen's curve which describes the pH or acidity of your mouth immediately after eating a sugary or carbohydrate rich food. In some people who have poor quality or low quantity of saliva it takes a long time (more than 30 minutes) for the acid to be neutralized or brought above the critical pH of 5.5 (the critical pH is the acidity level at which your enamel begins to dissolve or de-mineralize). If this type of person is snacking on crackers, sipping soda, eating bread, or cookies 5-6 times throughout the day then there teeth may be in an acidic environment all day long. People with very dry mouths may have an oral environment which is constantly below the critical pH of 5.5. However in someone with normal salivary function the acid is neutralized within 20 minutes but even in this case the person could spend a significant portion of the day with their teeth being dissolved!

Now a few things you can do about it: You can't completely eliminate the bacteria or change your genetics but you can drastically change the environment that the bacteria live in.

#1: Chew a piece of sugar free gum or suck on a sugar free mint after meals and snacks. The main goal here is saliva stimulation immediately following a meal... Why? Because saliva in most cases is very effective at neutralizing the acid produced by the bacteria and washing away excess bacteria and food debris. Unfortunately a great deal of our modern medicines have the side effect of inhibiting the production of saliva causing dry mouth. This is why people can go their whole life without having much decay then all of the sudden when they start taking medicines which cause dry mouth (Xerostomia) they get a lot of cavities. If you have a dry mouth then you need to see your dentist and ask him or her about how to prevent decay with aggressive high strength fluoride therapy and saliva substitutes.

For everyone with normal saliva flow the sooner you can stimulate saliva following a meal, snack or drink of soda the faster you will reduce the acid levels in your mouth to normal and thus prevent decay. So chew some xylitol sweetened gum! If you don't have any gum then buy some, if you can't buy some then get a drink of water after a snack or meal.

#2 Don't rinse with anything including water for at least 30 minutes after you brush your teeth (with ADA approved fluoride toothpaste). Fluoride has the opposite affect from sugar on your teeth, it re-mineralizes rather than dissolves the tooth structure. The problem with fluoride is that it has poor substantivity meaning it does not stick to your teeth very well. After brushing your teeth you should spit the remaining paste out THEN DO NOT RINSE WITH WATER! If you rinse after brushing you are washing away most of the protective fluoride. Fluoride needs contact time with your teeth and in your saliva to help repair the damage done by the acid producing bacteria. It is especially important if you have a high risk for cavities to expose your teeth to fluoride right before bed as the fluoride can remain in your mouth uninterrupted for 7-8 hours. If you don't brush and floss your teeth before you go to bed then you are letting the bacteria dissolve your teeth for 7-8 hours!

In short your teeth are constantly in a flux of either being re-mineralized or de-mineralized. Tooth decay depends on how well you keep your teeth in the re-mineralized category. Your job is to stop the teeth from dissolving by stimulating saliva with a sugar free gum or sugar free candy and help the teeth re-mineralize or solidify by allowing your fluoride toothpaste to sit on your teeth uninterrupted for as long as possible.

Or if you want it in even simpler terms... For cavities: Fluoride & Saliva GOOD, frequent sugar exposure without anything to neutralize the acid BAD!

I'm glad I don't have to go to school tomorrow it's getting late!

Here are some other suggestions for preventing cavities:

7 Ways to Prevent Cavities
http://dentistry.about.com/od/dentalhealth/tp/preventing_cavities.htm

Going the Distance

Last weekend I ran the Richmond Suntrust Marathon. I was standing back with the 3:40 pace team when the marathon started.

I stayed with the 3:40 pace team running an 8:30 mile for 13 miles...

Then I hit the wall...

I was still able to walk, then jog, then walk, then run until I finished the 26.2 miles with a time of 4 hours 36 minutes or a (10:35 per mile pace).

Running the marathon was probably the hardest thing I have ever done, I ran 745 miles in training and although I did not get a sub 4 hour time like I wanted, I was happy that I was able to finish. Out of the nearly 4,000 runners who signed up about 3,000 finished and I finished in 1,686th place.

Exercise, its good for you!

Due to the fact that I don't have nearly as much homework now as a 4th year dental student, I have had a little extra time to dedicate to training for the Richmond Suntrust Marathon coming up in November. Here is my training schedule:I have never run a marathon before so my goal is to just finish it and hopefully do it in under 4 hours. I have spent my Saturday mornings doing long jogs. Last Saturday I was able to beat my previous personal distance record of 16 miles by running a full 17 miles.

This episode of NOVA on PBS inspired me because there were people with some serious health problems who were able to finish the Boston marathon so I figured if they could do it so could I. I watched this episode for the second time about six months ago around the time when I started to seriously train for the marathon. I began my training around May as you can see on my training schedule the numbers highlighted in yellow are the runs I have completed. Thus far I have been doing intensive training for nearly 4 months and have run a total of nearly 500 miles.

Running and exercise in general is much easier to do with a friend. My buddy Jonathan has helped out quite a bit because he has gone with me on nearly every one of my training runs. He has run in a few marathons already so he has some experience I can learn from. There are actually a lot of very talented runners at my dental school. One of the 2nd year dental students finished 7th at the last Boston marathon and another friend of mine, Jake ran in college and has gone on some of the longer runs with Jonathan and I.

One tip we have learned for anyone who is an endurance athlete is that low fat chocolate milk is an excellent recovery drink after doing a long run because it has the correct protein: carbohydrate ratio and it just tastes good.

Another tip I have for runners is to buy shoes frequently and if you can afford it get them from a running store where they can match your running style to your shoe. I broke both my feet with stress fractures in high school running cross country due to over training and not replacing my shoes frequently enough. I went through months of recovery and physical therapy and after all of it was over I had some custom orthotics made by my podiatrist which I still wear all day every day some 10 years later. Once I get a job I think I will have a podiatrist make me a new set of orthotics.

Other lessons learned from breaking my feet: eat a good diet with calcium and vitamin D. (I eat a good diet and I take a multivitamin daily). AND build up your endurance and fitness slowly! Your bones need time to get stronger, your muscles and tendons need time to rebuild and re-tool themselves to be able to withstand the intense pounding of a long run.

While intense exercise like marathon training is rewarding and challenging, exercise in general is essential to good health. We were not built to sit around. Diet is more important for weight loss than exercise (probably because as you exercise a lot you need to eat more). However, exercise is very beneficial for maintaining a healthy weight along with prevention of cardiovascular disease which is the leading cause of death in the USA.

Check out this Wikipedia article on exercise and this article on MayoClinic.com and finally this concise list of the benefits of exercise from Georgia State University.

Exercise will improve your ability to learn, prevent disease, and improve your mood. Just Do It!

Second Hand Smoke Causes Asthma

On Friday afternoon I got home from school and my wife told me that our son had been diagnosed with asthma. (If you scroll down you will notice my article on second hand smoke—is there a correlation? OF COURSE!!!) Our son had been throwing up almost every night starting about a month ago (shortly after our new smoking neighbors moved in) but when we visited family out of state for two weeks he had relatively no problems at all. We thought at first that the problem was acid reflux. The doctor listened to his lungs and checked his Oxygen saturation and diagnosed him with infantile asthma. My initial reaction was anger at the fact that I knew something like this was coming. I have been spending every free moment trying to seal our apartment to keep the smoke out. We were given a nebulizer to give him some medication but he screams and screams until he throws up making the whole medication idea pointless. So now we just have to focus on creating a healthy environment.

Here is what we have done so far:

1. Purchased a new vacuum with a true HEPA filter for $140
   
2. Purchased 2 Honeywell True HEPA air filters from Wal-Mart and left them running on full power while we cleaned the house the larger air filter/purifier was about $130 and the smaller one was $85. In addition to the HEPA filter they have an activated carbon pre-filter to help with the smoke. These filters have made a significant difference in the smoke smell in our home. There are better air filters/purifiers on the market which implement the same basic technology of a true HEPA filter with an activated carbon pre-filter but they cost nearly $600 and are not found in your basic Home Depot or Walmart. See the photo below...
3. Vacuumed the entire house with the new vacuum including the sofas
4. Removed most of the dust in the house
5. Washed all the sheets, blankets, washable pillows, drapes, and rugs in HOT water and dried them In the dryer on HOT to kill/remove any dust mite colonies
6. Sealed off some suspected remaining entry points of smoke into the house
7. Placed a top of the line furnace air filter with an activated carbon layer to absorb smoke and chemicals.

What I plan on doing:

1. Finish Cleaning: I still have to clean the kitchen floor and do more dusting.
2. Purchasing a Dehumidifier: Humidity should be low to reduce the incidence of dust mites which are a very significant allergen and contributor to asthma; chances are you have dust mites in your pillows, sofas, mattresses, and elsewhere. I take back my comment on the last post where I say you should open your windows. It is good to open your windows assuming it is not too humid outside and the air quality outside is good. Centralized air conditioning is good in that it reduces humidity.
3. Purchasing dust mite proof encasings for our mattresses and pillows.
4. Eventually I will purchase leather sofas to prevent dust mite infiltration
5. Someday I will find that last little spot where the smoke is getting in... you would not believe how many hours I have spent on sealing little air leaks probably near 40 hours so far at least. (in addition to being a full time dental student, dad, etc) This little area above the furnace closet was a highway of air coming from our neighbors apartment, whenever our AC would run it would suck the smoky air from their apartment into ours. Solution: stuff it with insulation and cover with plastic and duct tape, in addition to keeping the furnace closet door open to prevent the "suction effect":
   

My theory is that my son developed asthma when the cigarette smoke in combination with the dust mites and other irritants overwhelmed his lungs. It probably does not help that we have smokers next door, live in 30-40 year old apartments, and live in a very humid part of the country.

For information on second hand smoke see my last post.

For more information on dust mites see the following:

http://healthandenergy.com/dust_mites.htm

http://www.ehso.com/ehshome/dustmites.php

http://www.mayoclinic.com/health/dust-mites/DS00842\

One recent systematic review in the Cochrane Database suggests that efforts to reduce dust mites do not have any clinical affects at reducing asthma: I still think it is worth trying to reduce dust mites in combination with avoidance of cigarette smoke and other potential triggers.

http://health.usnews.com/articles/health/2008/04/18/got-dust-mites-just-live-with-them.html

However this study shows that overall reduction in multiple allergens can help reduce symptoms of asthma.

http://www.nih.gov/news/health/feb2008/niehs-29.htm

I figure it is still worth the effort of trying to prevent and control the problem rather than medicate it. It just breaks my heart that my poor son has to suffer due to the inability of his parents to afford a nicer place to live and the poor choice of our neighbors nicotine addiction. At least all this effort makes me not feel so guilty so I can sleep at night knowing I have done everything possible to prevent/treat his condition. Good news is that we will be moving in less than a year following my graduation from dental school and hopefully be able to afford a clean place to live in the future.

All I need is the air that I breathe: The importance of good indoor air quality

Last weekend on Saturday a new family moved in the apartment next door. Unfortunately our neighbors are heavy smokers and the smoke started pouring into our apartment through the poorly sealed adjoining walls. Tobacco smoke can cause/aggravate: cancer, heart disease, bronchitis, asthma, emphysema, periodontal disease (loose your teeth), to name a few. I have a one and a half year old son not to mention my wife and I to protect from breathing in the cancer causing chemicals every day and night. This would be a big deal to almost any non-smoker but especially for me because I am obsessive compulsive about clean air anyway. I have spent a long time doing research on how to maintain clean air. There is some good information on the air quality tips blog and the EPA website dedicated to indoor air quality.

We found that most of the smoke smell was coming from our downstairs bathroom. I decided to try to seal off the source of the airflow between the two apartments. I used cardboard, tinfoil, duct-tape, and plastic to secure our bathroom fan which we can no longer use. I bought caulking and sealed any open cracks between the walls, light fixtures, electrical outlets, pipes, etc. I found a major source of airflow was underneath the bathroom cabinets there was smoky air coming in and where the pipes came out of the wall. I used caulking where I could to seal it off. Over the next few days the smoke smell greatly diminished. I learned a few tips for any of you who may be facing this problem.

Tips on sealing off an apartment from smokers:

• Use your nose to find where the smoke is coming from
• Use non-odor acrylic based caulk; don’t just replace one toxic odor with another: the 100% silicone has a strong odor which can’t be healthy.
• Do not rely on candles or any other form of air freshener to “hide” or “cover-up” the smoke smell. God gave us a nose for a reason: to enjoy good smells and to know when to get away from bad smells. Eliminate the source of the bad smell don’t just cover it up. Candles and air fresheners also have risks of toxicity; not only does the smoke from a candle flame produce carbon-monoxide and carbon dioxide but it also can have lead in the wicks which is carried into the air when a candle burns.
• Be careful when applying caulking or the foam stuff. It sticks to your arm hair and hurts to remove so wear an old long sleeve shirt, gloves (I prefer disposables), N95 respirator, and eye protection. Also the foam sealer is flammable, sticky, and does not defy gravity.

General tips on improving indoor air quality:

• Check online if the air quality is good/moderate outside and the weather is nice then open your windows! This is the best way to quickly and effectively improve indoor air quality.
• Purchase a good air filter for your furnace/ Air conditioner and change it regularly: The filters rated MERV 12 are the best currently on the market; make sure you get a good tight fit to avoid air leaking around the filter.
• They do have good indoor air purifiers with HEPA filters that supposedly work well but they are a very expensive proposition. I think as long as you are not sensitive to minor air impurities then you can get along just fine with less expensive methods.
• Ventilate your house well when painting or using any type of cleaner with volatile substances
• Have your home tested for Radon: the 2^nd leading cause of lung cancer in the USA after smoking.
• Some houseplants are good at removing toxins but one study showed that the soil that the plant is in and the microorganisms in the soil that live with certain species of plants are also beneficial. The study also mentions having activated carbon mixed in the soil to absorb toxic chemicals. While the benefit of houseplants is controversial because the benefit may be negligible or very slight; it still may be a good idea if done properly especially when outdoor air quality is bad making it unwise to ventilate with the outside world or it is too hot or cold to open a window.

This is what I would use as a recipe for a houseplant “air purifier”:

• Use the Janet Craig Dracaena plant for its various qualities: good at removing toxins, low maintenance, low light needed, non-toxic (or less toxic than other houseplants for pets & kids)
• Add carbon, Perlite, and Shultz’s Soil Conditioner to the soil
• Trim the lower branches to avoid covering the soil
• Use a pond basket, or strainer type of pot to allow a lot of air flow to the soil and roots
• Use a tray to catch the excess water
• Place several of these plants throughout the house; the more the better.
• Make sure to not over-water the plant to avoid mold
• Place a fan behind or near the plants and blow air on them to facilitate faster air exchange.\

This weekend when I posted this article the strong smoke smell came back again and we realized that our neighbors probably smoke more at home during the weekends. So I started looking for air leaks and found a major one in the kitchen where the wires and pipes come through the wall. I just have to move the dishwasher to get to it. For additional air quality tips take a look at the air quality tips blog: http://www.airqualitytips.com/97/9-ways-to-keep-your-indoor-air-healthy/

Health care workers are at high risk for developing irritation contact dermatitis

As I said in a previous blog post, I have had an annoying, painful, red, and itchy rash on my right hand for over a year since I started doing full time clinical dentistry. I ruled out latex allergy, poison ivy, and 3^rd year dental student syndrome. I finally got an appointment with my dermatologist who called the problem hand eczema. I have made some important changes by being much more selective about the products I buy that come in contact with my skin but the problem still has not gone away. Yesterday I realized why...

I was studying the Dental Decks for part II of the National Board Dental Exam, when I read a card that hit me like a Mack Truck on its way to a NASCAR race:

“The most common form of an adverse epithelial reaction noted for health-care professionals is: Irritation dermatitis. A number of published reports have cited data suggesting that between 20-30% of health care workers suffer from occasional or chronic dermatitis on their hands. The most common manifestation of the condition is irritation dermatitis, a non-specific immune reaction often caused by contact with a substance that physically or chemically damages the skin. The condition can be aggravated by frequent hand washing, residual glove powder left on hands, and the harshness of repeated use of some antiseptic hand wash agents. Health care workers located in colder climates may also experience chapping during the winter months.”

Wow! Finally after a year of searching, something tells me what the specific name of my problem is! I have had this problem for more than a year! All my dermatologist did was prescribe a topical steroid, say it was eczema, and throw a pamphlet about “Hand Eczema” at me as I was kicked out the door. “That will be $80 please.”

Irritant contact dermatitis is a form of eczema that occurs from frequent irritation by harsh chemicals, water, dry air, or chronic physical trauma. I googled “Irritation Contact Dermatitis and Health Care” and found the following article on the American Academy of Dermatology Website.

I don’t know but Dr. Nedorost may be getting some of her information from this article on Pub Med:

Prevention of irritant contact dermatitis among health care workers by using evidence-based hand hygiene practices: a review.

Dr. Nedorost explained that irritant contact dermatitis is more highly associated with the number of times you wash your hands every day than any other factor; the best way to prevent it is to reduce the amount of times you wash your hands. Does this mean that we should stop washing our hands? Absolutely Not! Clean hands are essential for preventing the spread of infection from patient to patient and to you and your family. However, we can take the following precautions while still maintaining very clean hands as health care providers:

• Use a good alcohol hand sanitizer rather than soap and water whenever possible. (If you have visibly soiled hands then soap and water is necessary.) A great hand sanitizer that is fragrance free and includes moisturizers is Nexcare 3M Moisturizing Hand Sanitizer or the EO brand hand sanitizers.Don’t use the cheap stuff from the Dollar store or Wal-Mart!
• Use good quality, fragrance free moisturizers/emollients right after hand-washing
• Irritant contact dermatitis is a form of eczema that occurs from frequent irritation by harsh chemicals, water, dry air, or chronic physical trauma.
• Topical steroids may provide temporary relief of the symptoms but will not likely solve the problem. Long term use of topical steroids may actually weaken the skin making it more susceptible to further damage.
• Use cotton under gloves if possible; this may not be feasible in dentistry due to the fine amount of tactile sense required but if you have a bad case it may be helpful.
• Look up your hand soaps, moisturizers, and other cosmetic products that come in contact with your skin on http://www.cosmeticsdatabase.com and try to choose those products that have less harsh chemicals for your skin

I encourage anyone who has to wash their hands frequently to be aware of the damage it can cause to your hands. Even if you use the best hypoallergenic, mild soaps available, the water and drying effect on your hands can cause dermatitis. Especially those of us who work in health care, we need to use a good hand sanitizer as the rule not the exception. When your hands are visibly dirty then wash with soap and water, if not then use the hand sanitizer. Our dental school needs to improve by having hand sanitizer available to our students and to educate them on this topic; for now, I am going to bring my own Nexcare hand sanitizer from home.

Public Service Announcement #2: Replace Your Worn Out Tires!

This sounds obvious but I have friends whose family members were killed because they had tires that exploded. We recently replaced our tires on our one car that had very worn out tire treads. I watched this video on the Tirerack.com website that scared me quite a bit because I have almost crashed a few times on wet roads. Watch this video on the testing they did as to how long it takes you to stop with worn tires on a wet road you will be amazed! http://www.tirerack.com/videos/index.jsp?video=5

I know its biased propaganda from a tire company trying to scare you into buying new tires but why take the risk? The old rule: “replace your tires when the tread does not pass Lincoln's head on a penny” is just not safe at all. Even tires which only have tread as deep as Washington’s head on a quarter are not as safe. Rule: If the tire tread does not pass Washington’s head on a quarter you need new tires yesterday!

Even new tires vary as to their stopping ability. Some tires stop faster than others which may be the difference between life and death or an expensive crash and a close call. The Tirerack.com website has excellent reviews and ratings and fairly good prices. I ended up buying my tires from a local tire company but you can order through tirerack.com and they will send the tires to the auto shop where they install your tires.

Another good resource for information on tires in consumersearch.com which gives you a good review of the reviews and details on why performance tires are good for heat dissipation and handling which may be good when you are in a potentially scary situation on the highway. http://www.consumersearch.com/www/automotive/tires/

Again having a baby inspired me to do all this research too. I come from a long line of people who worry about things, just ask my mom.

Today's Public Service Announcement: Eat More Fruit

I was very long winded on the last post so this will be short and sweet. Fruit helps prevent various types of cancer including oral cancer and provides essential nutrients. I took this photo of a strawberry I picked from a local farm where they let you pick (and pay for) your own fresh, organic strawberries. Fruit is good for you and tastes good too!

Even if it's not organic fruit is still good, and we should all eat more of it. A multivitamin can never take the place of a healthy diet. While studies show that fruit helps prevent cancer, studies also show that you do not get the same benefit from taking a multivitamin. That's all I have to say; just eat more fruit!

How to protect your skin from toxic chemicals

This topic really chaps my hide. About a year ago when I first started treating patients in the clinic I noticed a red, painful, itchy sore on my right hand. I originally thought it was from Poison Ivy which is plentiful where I live. It does not look like much but it is annoyingly itchy to the point of being painful.

The differential diagnosis

When it still had not gone away about 4 months later I realized something else was wrong. To give you some background, at the same time I had been using the cheapest shampoo available in a huge container from the dollar store, the cheap antibacterial soap from Wal-Mart, the cheap dollar store hand sanitizer, dental student budget, you get the idea. I was also wearing latex gloves all day at school and washing my hands a lot, and using gallons of hand sanitizer because I was covering the emergency oral surgery (extractions) clinic for people who came in off the street with toothaches. I was not sure if it was a latex allergy or just dried out and chronically irritated skin. I decided to try to see a dermatologist. It’s now nearly 10 months later and I still have not been able to get an appointment because of my hectic schedule and the lack of available dermatologists.

I started to realize that the soap, hand sanitizer, shampoo, lotion, cavicide used to clean the clinic, and other chemicals may have caused an allergic or other type of inflammatory reaction. The problem does not get worse when wearing latex and it is isolated to one spot on my right hand so I don’t think it is a latex allergy.

I stumbled upon this awesome website called Environmental Working Group which collects a lot of research about chemicals, the environment, and practical advice on how to protect your family from these harmful substances.

Check out there Every Day Pollution Solutions for basic ways to de-toxify your life. You can also look at the Skin Safety Database of cosmetic products and what they contain. The database ranks the products from the best (least amount of cancer causing and allergenic substances) to the worst and even gives you a level of evidence for being toxic in the form of a percent data gap. You can then choose to show 500 results and you can click control-F to “Find” your product. I discovered that I was dumping all kinds of cancer causing and allergenic chemicals on my skin every day without even knowing it. The government does a poor job regulating the safety of cosmetics while these companies make a lot of money poisoning the public.

One quick tangent: Are all chemicals bad?

Just to clarify, I am not an extremest or an alarmist when it comes to “toxins” that people blame for everything like vaccinations or amalgam fillings and Autism. Many good studies have shown no association of Autism with vaccinations or Amalgam fillings. Vaccinations serve a very useful purpose protecting you, your children, and society from lethal and debilitating diseases.

Amalgam fillings also do not pose any danger other than the danger of uglyness. Sometimes amalgam serves better as a restorative material in situations where composite would not work well. I personally would rather use composite (the tooth colored filling material) in most situations if the area where the filling is being done can be kept dry enough to make a suitable, long-lasting filling but my reason for using composite is because it looks better not because it is less toxic. Some studies have shown amalgam fillings to last longer than composite fillings and even composite has some minor toxicity concerns.

Fluoride in drinking water is one of the safest and most effective and economical ways to prevent tooth decay. Many activists would have no fluoride in drinking water or toothpaste which would then lead to a huge increase in tooth decay. Untreated tooth decay is the number one chronic illness in children. Parents who constantly feed their children soda or even juice place their kids at a high risk of developing cavities. Please give young children mostly water to drink with the occasional juice or milk at meal times. Children who then develop severe tooth decay do not gain weight like they should, may have social problems, pain, and sometimes require extensive treatment under general anesthesia which carries the risk of death. So in the name of safety, fluoride in the water is the safe alternative. And fluoride in toothpaste does not pose any problems and unless ingested in large quantities. Just keep the toothpaste locked up so your kids don't eat it. Fluoride serves the practical purpose of preventing cavities which people can actually die from or at the very least have to pay to have it restored or the tooth extracted. A cavity can be deadly if it develops into an abscess which infects their brain or closes off the airway due to swelling. I have seen someone in the hospital operating room who was near death because she started out with a simple cavity which was never treated leading to a deep space infection which nearly closed off her airway. There was also a young boy in Maryland who died about a year ago due to a brain infection he developed as a result of a cavity not being treated.

There are many chemicals that serve a genuine and useful purpose that should not be omitted from our daily lives just because they contain a small and often unfounded concern of toxicity that is not substantiated by any good science. While some substances do both good and bad, sometimes if the good outweighs the bad you have to take that chance. The antibacterial triclosan in Colgate Total toothpaste helps prevent gingivitis although I think it is unnecessary if you already have very good oral hygiene and is also unnecessary in hand soaps.

Along this same line of thinking is the whole concept of “antibacterial” soap. My good friend’s dad is a microbiologist who laughs at the idea of an “antibacterial” soap. He says it is completely unnecessarily except in hospitals or in the homes of people who are immunocompromized because soap without the triclosan antibacterial will wash away all of the bacteria without the need for any “antibacterial” substances which are nothing more than a sales gimmick and an extra irritant to your skin. Here is a good article on antibacterial soap. Some chemicals are fine to use even if there is some slight toxicity concern but if you can get something that works equally well with less harsh chemicals than why not do it.

Another important concept to understand it that fetuses and young children are more susceptible to toxins than adults are which is my whole reason for doing all of this research; to protect my son.

How to eliminate hazardous chemicals from your daily life

The EWG cosmetic safety website also has a tips section and suggestions of specific chemicals to avoid such as “fragrance” when you are at the store but in my experience it is impossible to remember the complex chemical names while shopping on a busy Saturday with a stressed out wife and a one year old son screaming to be able to accomplish anything this way. I would do your research ahead of time and buy online even if it means paying a shipping fee. However some of these things are readily available as you will see below.

The skin safety database has thousands of products which work as good or better than the cheap ones you can buy at Wal-Mart or the dollar store or it can help you know which products at Wal-Mart are less toxic. I have found that these safer products are usually more expensive with a few exceptions. I have a few recommendations of products I have tried. Again, I am not being paid by any of these companies although they should pay me for telling you about these things on my blog.

Mother always knows best

After doing hours and hours of searching the database on the environmental working group website and then checking the prices and availability of the products nearly every product that had a very good (low toxin) score was made of pure saponified olive oil or something to that affect and was very expensive. Then I realized that my mother has had the solution all worked out for years without doing any Internet research or getting a doctorate level degree in biochemistry. She had been using pure olive oil as a lotion and even told me about it but I had never tried it. Now I only use two skin "lotions" olive oil and 100% pure petroleum jelly. I guess I need to listen to her more; some things it takes years to learn. In short, using pure olive oil accomplishes two goals:

1) a safe, effective, and inexpensive lotion or makeup remover

2) a good way to stick it to the MAN who in this case happens to be the cosmetics industry. They don’t make a dime from my olive oil purchases.

So here is a list of products that are not too expensive but are also safe and effective alternatives to the toxic cosmetics we usually use: If you have a whole household of bad chemicals you want to replace with “healthy alternatives” start with the chemicals your children are exposed too. Babies are much more sensitive to chemicals than adults are. I would also start with what you use the most of. Here are a few suggestions:

A few suggestions of safe alternatives

Lotion:

Use 100% pure olive oil (Much cheaper and much safer than the normal lotions; use it for my one year old after he takes a bath; dermatologists recommend moisturizing your skin within 3 minutes after bathing)

OR

Use 100% pure petroleum jelly with no fragrance (equate at Wal-Mart or Vaseline; also very safe and effective; more viscous than olive oil too) Also works well for chap stick.

Makeup remover:

Use pure olive oil (according to my wife and my mom this is the best way to do it) (very inexpensive and moisturizes your skin at the same time)

Bar hand soap:

Try Kiss My Face 100% pure saponified olive oil fragrance free. (It’s a green bar of olive oil soap; works great; I bought it on Amazon.com)

Shampoo:

I am still working on finding a good, inexpensive alternative for me. For my 1 year old son I use California Baby brand shampoo and body wash which you can purchase at Target, healthfood stores or online.

Liquid Soap:

I have tried a few alternatives but most of them are very watery and can work fine but you have a compromise as to ease of use. I am still working on this one too.

Deodorant:

This is a tricky one because you will likely want to use something that actually works. I have found the Tom's of Maine fragrance free deodorant to work well.

Baby wipes:

I had to make a compromise as to what was affordable and what actually worked while factoring in the chemicals also. I would just see what you have at your local stores and buy the least toxic one according to the database.

Hand sanitizer:

Nexcare 3M Moisturizing Hand Sanitizer or any of the other least toxic sanitizers on the list at ewg.org.

Sunscreen:

Plain old Rite Aid Zinc Oxide Ointment can be used as a very effective sunscreen! The active ingredient in one of the most effective broad spectrum sunscreens is Zinc Oxide. There are some good "natural" sunscreens that are safe and effective but they are also very expensive! The top ones on the list on the EWG website will cost about $16 for 2 oz. or you can buy the Rite Aid Zinc Oxide Ointment for $5.

The sunscreen section is an excellent part of the database because it not only rates its effectiveness against blocking UVA and UVB rays but also its chemical safety. Here is the EWG guide to sunscreens. I recently purchased California Baby’s SPF 30+ fragrance free sunblock stick which was #1 on the list. I was really concerned with getting the best stuff for my 1.5 year old who will be spending some time in the sun this summer.

While I am on this topic of skin protection a few other notes/ tips to be aware of:

Wear an effective sunscreen, sun proof shirts, and broad rimmed hats that cover your ears, a good way to prevent melanoma, squamous cell carcinoma of the lip, basal cell carcinoma on the ears and face, etc. They sell cool sun proof swim shirts for kids/babies or adults which I highly recommend along with a good hat that covers your child's ears, face and neck. You don’t need to sunbathe for vitamin D; Take a multivitamin!

Wear gloves when dealing with chemicals used for automotive, gardening, construction, health care, etc. Motor oil is a carcinogen, most chemicals are not good for you or your skin. Buy a cheap pair of rubber coated gloves or latex exam gloves at the very least when doing these things. I would also wear gloves when doing housework with chemicals. There are also good alternatives to some chemicals used around the house for cleaners but I don’t feel like writing an article about that topic just Google it.

Use a safe moisturizer following your shower such as olive oil or petroleum jelly (Vaseline).

These are only a few examples but you get the idea; when I have time to finish this project, I want to replace all of my household cosmetics with a healthy alternative that is affordable and effective thus reducing my family’s exposure to these chemicals. I think as time goes on and this subject gets more attention, companies will realize it is not profitable to put crap in cosmetics that have questionable safety and the safe alternatives will become more readily available and less expensive.

Is Cancer Preventable?

One end note on cancer. Cancer is the 2^nd leading cause of death in the USA after heart disease. When I tell people about things I have learned on how to prevent cancer they usually say something like “Everything causes cancer!” which to some extent is true but that just reflects peoples frustration as to the overwhelming amount of information and studies which show a lot of things to be cancer causing. I hope this blog will show you that there are some specific, simple things you can do to prevent cancer. Don’t get overwhelmed and don’t be careless either. Not everything causes cancer. Just because there are a lot of ways to get cancer does not mean you can’t make a few changes in your life to do something about it.

Check out this quote from Wikipedia on cancer prevention: (I know there are better sources than this but they quoted a study by Danaei G, Vander Hoorn S, Lopez AD, Murray CJ, Ezzati M (2005). "Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors". Lancet 366 (9499): 1784–93. doi:10.1016/S0140-6736(05)67725-2. PMID 16298215.)

“About a third of the twelve most common cancers worldwide are due to nine potentially modifiable risk factors. Men with cancer are twice as likely as women to have a modifiable risk factor for their disease. The nine risk factors are tobacco smoking, excessive alcohol use, diet low in fruit and vegetables, limited physical exercise, human papillomavirus infection (unsafe sex), urban air pollution, domestic use of solid fuels, and contaminated injections (hepatitis B and C).^”

So there you have it 9 things that can be “modified” to prevent cancer. I hope you find this information interesting and helpful. I still don't quite know what the problem is with my hand but I plan on going to the dermatologist soon; hopefully I will get some answers. For now I am self medicating it with over the counter topical hydrocortizone cream which does provide some relief. It may just be eczema but its still a good excuse to use less harsh chemicals that could potentially endanger my family.

How to prevent cavities and gum disease while saving yourself a bundle of money when you go to the dentist

Several years ago as a college student I ended up needing a root canal and crown on one of my teeth which ended up costing me a little over $1,500 even with a student discount. If I had known better how to prevent cavities I may have been able to avoid that cost, especially at a time when I had such a tight budget. Also, if I had been going to the dentist more regularly I maybe could have gotten away with just a filling rather than a root canal which would have saved me around $1,250.

Cavities are caused by 1) an infection by acid producing bacteria such as streptococcus mutans. 2) carbohydrate or sugary food for the bacteria. 3) a bacteria friendly environment: your teeth. While part of your susceptibility to decay is genetic, most tooth decay is preventable! Many dentists say the same thing: “Brush twice per day and floss daily to prevent tooth decay” which is essential for optimal oral health but there is more that can be done!

If you want to prevent tooth decay or periodontal disease here are a few suggestions:

1. Brush at least twice daily after meals. I brush after breakfast and after dinner. Use ADA approved fluoridated toothpaste, such as Colgate Total which has Fluoride and Triclosan to decrease tooth decay and gum disease. Studies have shown that toothpaste with Triclosan provides some protection against gum disease. Gum disease includes gingivitis and periodontitis which is a major cause of tooth loss. People who smoke or have diabetes are at a higher risk of developing gum disease. If you have excellent oral hygiene habits and go to the dentist regularly then you may not need to use toothpaste with triclosan. However if you are at a higher risk of developing gum disease, Colgate Total with triclosan may be a good choice of toothpaste to use. I would avoid triclosan for pregnant or nursing women and just be extra diligent with tooth brushing and flossing during that time to prevent pregnancy associated gingivitis. Don’t forget to brush your tongue! After brushing do not rinse, eat, or drink for 30 minutes to let the fluoride remineralize your teeth. Brush the right way.
2. Floss every day after dinner or before bed; make sure you floss the right way.
   
3. Chew Xylitol sweetened gum immediately after eating snacks and after lunch if you cannot brush. Try to use 100% Xylitol sweetened gum which includes: Spry, Xlear, Epic, Zapp, Xylichew and others which are available for sale at the dental school, health food stores, and online. If you cannot readily find 100% Xylitol gum then use gum which has Xylitol as the first ingredient—a good example is Icebreakers gum. Some gum recently became ADA approved which does not contain Xylitol. This is because sugar free gum helps just because it stimulates saliva production. Xylitol gum goes beyond just saliva production to actually inhibit cavity causing bacteria. Xylitol gum is also good for people who are on medications which decrease saliva flow. Do not chew Xylitol gum if you have TMJ pain or if your chewing muscles and joints are sore or stiff. The only side affect of Xylitol is that it has a laxative affect if you consume too much of it but the amounts you would consume chewing a few pieces of gum per day should not cause a problem. Malitol and Sorbitol have the same affect just don't consume any of these sugar substitutes if you have diarrhea. Here is a paper I wrote my first year of dental school on Xylitol.
4. Buy a new toothbrush regularly this includes the brush head to electric brushes (replace every 2-3 months or more). Use a soft bristled toothbrush and don’t push too hard when brushing to avoid damaging your teeth and gums. It is more important how long you brush for and the technique you use rather than how hard you push. Brush for a full two minutes each time being sure to brush at or near the gum line on all sides of your teeth front and back.
5. Use a good electric toothbrush research has shown that an oscillating rotating toothbrush is more effective at reducing gingivitis than a traditional manual toothbrush long term. This may be because you are more likely to brush for a longer period of time with an electric toothbrush than with a manual brush; maybe because you will not get as tired, and some electric toothbrushes even have a timer on them.
6. Rinse with Listerine every other day if you have gum disease the equate brand is also ADA approved and is essentially the same thing. Listerine is also is an alternative to using toothpaste with Triclosan to prevent gingivitis. However each of these has their side effects. Listerine can dry out your mouth if used too much and Triclosan, while yet un-proven, may produce stronger bacteria that have become resistant to Triclosan after years of use. However, Listerine and Triclosan are the most effective (over the counter) chemical means we have available of reducing the bacteria in your mouth that cause gum disease. When using Listerine, follow the directions and rinse for 1 minute. Listerine is the most effective over-the-counter mouthwash at decreasing the amount of bacteria in your mouth which cause cavities and periodontal disease. Do not use Listerine if you have a history of alcoholism—using too much Listerine can also dry out your mouth if used excessively. If you have a problem with dry mouth or alcoholism then use Crest Pro-Health mouth rinse. Recently there have been complaints of the blue Crest Pro-Health rinse staining teeth. You can purchase the clear version to avoid this problem.
   
7. Rinse every day with fluoride mouth rinse. ACT brand fluoride mouth rinse, and the Wal-Mart Equate brand fluoride mouth rinses are both ADA approved, over-the-counter fluoride mouth rinses. Rinse for one minute and spit it out without rinsing with water; also do not eat or drink for at least 30 minutes to let the fluoride remineralize your teeth. I recommend you rinse just before going to bed unless you brush your teeth before going to bed. If you brush your teeth following dinnertime then you can wait until bedtime to rinse with ACT. Toothpaste actually has more fluoride in it than the mouth rinse so if you would rather just brush your teeth again you can do that instead just do not rinse your mouth with water after brushing your teeth. Spit out the toothpaste and don’t eat or drink for at least 30 minutes.
8. Avoid drinking large amounts of soda! Fruit juice, sugared coffee, sugary sports drinks, and other sugary or acidic drinks can cause uncontrollable cavities especially in someone who has a dry mouth. If you do drink sugary or acidic beverages, then don’t sip it all day long. Chew Xylitol gum or rinse your mouth with fluoridated water right after a sugary snack or drink. If you drink bottled water, make sure it has fluoride in it or use filtered tap water that still has fluoride in it. Some fruits such as lemons, limes, grapefruits, grapes and others are very acidic and can erode away your teeth just make sure you rinse with water after eating your fruit. Fruit is actually good for preventing oral cancer. Use calcium fortified fruit juices if you drink fruit juice to reduce erosion of your teeth.

9. Eat more fruits and vegetables vegetables do not contain carbohydrates which can be used by cavity causing bacteria in the mouth, and fruits while they do contain some sugar have a fast oral clearance rate due to their stimulation of saliva not to mention they can help prevent cancer, heart disease, and the common fat.
   
10. Eat less sugary foods sugar containing foods have been found to increase cavities especially with people who do not have adequate fluoride exposure. The frequency of using these sugary or carbohydrate rich foods throughout the day is more important thus...
    
11. Snack less frequently
    
12. Don’t Smoke! Smoking is the #1 cause of preventable death in the USA. Smoking increases your risk for lung cancer, oral cancer, emphysema, dry mouth, and periodontal disease which can make you loose all of your teeth.
13. Be aware of Dry mouth. Most medications can cause you to produce less saliva called xerostomia. If you are taking any medications and even some herbal supplements you may have a dryer than normal mouth which drastically increases your chances for developing cavities and other oral problems. This is also why it is so important not to go to bed with a dirty mouth. You do not produce very much saliva at all while you lie down or sleep. I have seen too many cases of patients who have dry mouth combined with consumption of a lot of soda all day long who have cavities on nearly every tooth! If you have dry mouth do not drink soda! Drink water!
14. Ask your dentist about preventative measures… if you have severe tooth decay your dentist can prescribe prescription strength toothpaste, chlorhexidine mouth rinse, do a bacterial test to determine the type and amount of bacteria present and give you specific advice about how to prevent future problems. Sometimes you may have a very small cavity (incipient) that can be reversed with aggressive fluoride treatment. Fluoride varnish or prescription strength fluoride toothpaste along with the suggestions on this blog may help you re-mineralize an incipient cavity without treatment. If you show a little initiative and do your part, your dentist will be more willing to help you win the war on tooth decay rather than just drill, fill, and bill. The responsibility for prevention lies with both the patient and the dentist.
15. Visit your Dentist Regularly I can’t stress this enough! If you want to make your dentist rich then just go once in a while or go all the time but don’t take care of your mouth. Some people don’t go to the dentist because they cannot afford to or they say they want to save money which does not make sense. I have seen time and time again what happens when someone does not go to the dentist on a regular basis. They end up with severe periodontal disease and need their remaining teeth extracted and replaced with a denture because they have not received a professional cleaning in 10-15 years OR they end up with rampant tooth decay which costs a fortune to restore properly with root canals and crowns. If you go to the dentist on a regular basis and take care of your mouth every day you can save yourself a lot of pain and money. You may need some minor preventative procedures, a few small fillings, fluoride varnish, cleanings, etc but it will save you from the really expensive procedures. Also, in most cases, nothing functions or looks better than your own natural teeth!

*These suggestions are intended for people who are adults and teenagers. Ask your dentist about your specific situation and how to prevent tooth decay in infants, toddlers, and young children. I recommend some specific products based on sound research. I am not being paid by any of these companies. For more suggestions go to http://www.adha.org/oralhealth/index.html or http://www.ada.org/public/topics/decay_faq.asp