Ebola Update

Ebola is a potentially deadly viral disease which is not treatable by medications.  Estimates range from 50-90% mortality rate.  Infection is believed to be possible through direct contact, and is currently not considered an airborne disease. A person is considered infectious and should be quarantined when a fever is above 101.5 F, assuming that person’s fever is related to travel to, or contact with, any of the hotspots or persons who have been to or come from the hotspots in Africa.  

It is believed if a person has not exhibited any signs or symptoms after 21 days, there is no risk.

Given the nature of some of the cases around the globe, clearly not all the information is consistent.  More alarming are the cases of Ebola infection in which people who are unknowingly infected may have had multiple contacts with persons who may also become infected.  This seems to be the case of the emergency room doctor in Spain, who just quarantined himself. How many patients did he contact before this self imposed quarantine. In theory, if he was afebrile it should not be a concern. However, if any one of these people become infectious, the virus spread will literally “go viral.” 

We are screening all patients for fever using a non-contact infrared thermometer  in the interest of protecting all our patients. Even though the likelihood of contagion is very small at present, we want to be very proactive in what could prove to be a serious problem.  We request any patient who has  a non-allergic cough or fever to please reschedule their appointment.  For now, everyone should observe simple precautions: wash hands thoroughly after contact with strangers or foreign objects.  Avoid high risk persons, e.g. people who have just come back from one of the African hotspots (after 21 days such persons are thought to be noninfected).  But, if you have reason to suspect you have been infected, seek immediate Hospital care!

Dr. Schonberg honored as new Essex County Dental Society President

Award_RCS_NJDA_edited-1On Monday night, Dr. Schonberg was one of several people honored by the New Jersey Dental Association. Installed as the new president of the Essex County, he was presented with a plaque by the current NJDA president, Dr. Byron Roshong. Also present was Dr. Greg LaMorte, President-elect of the NJDA and the Executive Director, Art Meisel, Esq.

ADA on Micorobeads in Crest Toothpaste

From the Amereican Dental Association ( ADA):

Good Morning America Segment on Microbeads in Toothpaste

ABC’s Good Morning America (GMA) contacted the ADA for a segment that aired today on microbeads (polyethylene) in toothpaste. All of the varieties of Crest ProHealth® toothpaste which have earned the ADA Seal of Acceptance contain microbeads.

The ADA provided a press statement to the GMA producer indicating, “According to the American Dental Association, clinically relevant dental health studies do not indicate that the ADA Seal should be removed from toothpastes that contain polyethylene microbeads. Products with the ADA Seal have been independently evaluated for safety and effectiveness by the ADA Council on Scientific Affairs.”

Local news stations, including ABC 7 Chicago, have previously reported on microbeads from health and environmental angles. Procter & Gamble (P&G), the manufacturer of Crest ProHealth®, includes information for the public on their website and has indicated they plan to remove microbeads from toothpaste.

According to P&G, “While the ingredient in question is completely safe, approved for use in foods by the FDA and part of an enjoyable brushing experience for millions of consumers with no issues, we understand there is a growing preference for us to remove this ingredient. So we will. Crest will continue to provide consumers with effective and enjoyable products which are designed to their preferences.”

The following suggested talking points may help you discuss the issue with your patients should they ask you about microbeads in toothpaste:

  • Microbeads have been in the news lately. You may have heard about it in connection with toothpaste.
  • Microbeads are most often used as scrubbing beads in exfoliating skin care products.
  • The FDA has approved microbeads as a food additive, and small quantities, which appear as colored specks, are in some of Crest’s toothpastes, including Crest Pro Health, which has the American Dental Association Seal of Acceptance.
  • According to the ADA, clinically relevant dental health studies do not indicate that the ADA Seal should be removed from toothpastes that contain microbeads.
  • Products with the ADA Seal have been independently evaluated for safety and effectiveness by the ADA Council on Scientific Affairs.
  • While there is no clinical evidence that microbeads in toothpaste are harmful to your dental health, Crest is voluntarily withdrawing the ingredient from toothpaste in response to growing consumer preference.
  • As your dentist, my goal is to help you achieve optimal dental oral health. Whenever you have questions about any dental care product, feel free to talk with me.
  • Brushing two minutes twice a day with fluoride toothpaste and flossing daily are important ways to take care of your dental health.

Colgate Triclosan Update

Some concerns have been raised about the safety of triclosan, an ingredient in Colgate Total toothpaste. At present it is believed to be safe in the amounts used, though the EPA is looking into data concerning the endocrine effects, developmental and reproductive toxicity, chronic toxicity and carcinogenicity. There are also concerns about the possibility of Triclosan contributing to making bacteria resistant to other bacteria.

Triclosan has been shown to be effective in preventing gingivitis.  Colgate’s website refutes some of the research claims about carcinogenicity and endocrine effects, and offers the extensive research which supports the use of Triclosan in toothpaste. It remains to be seen then, whether further research will continue to  vindicate its use in toothpaste.

This information comes from the United States Environmental Prtoection Agency factsheet on Triclosan,  the the U.S. Food and Drug Adminstration Factsheet, and Colgates’s website.

 

 

Fluoride Recommendations

Very few communities in New Jersey have water fluoridation.  As such, the benefits of fluoride for the prevention of tooth decay must be obtained through other means. For children, this is in the form of an ingestible source, typically a vitamin with fluoride added, or simple fluoride drops. To avoid excess fluoride consumption the following recommendations have been made. It breaks down into three columns of possible external sources of fluoride consumption, such as bottled water, or areas where fluoride occurs naturally in drinking water.

Age <0.3 ppm other sources of fluroide 0.3-0.6 ppm other sources of fluroide >0.6 ppm other source of fluoride
Birth to 6 Months None None None
6 months to 3 years 0.25 mg/day None None
3 to 6 years 0.50 mg/day 0.25 mg/day None
6 to 16 years 1.00 mg/day 0.50 mg/day None

It should be noted iingestible fluoride is only of benefit when the teeth are being formed and the fluoride can become incorporated within the enamel .  After teeth have erupted, ingestible fluoride is of no use, and only topical applications of fluoride are of benefit, such as toothpaste and/or fluoride applications or rinses.

Dr. Schonberg Selected as Top Dentist

Millburn ShortHills017crop

The May 2014 edition of the Millburn-Short Hills magazine featured Top Dentists, and Dr. Schonberg was honored to be included as one of the Top Dentists in the General Practice category. Selections were made by asking area dentists to nominate colleagues they would choose in seeking dental care. This was further refined by the Super Dentists research team, which further evaluated peer recognition, professional achievement and disciplinary history.Millburn ShortHills019RCS

Early Dentistry…Really Early!

caveman

Some time an estimated 7,500 to 9,000 years ago, early man is suspected of using flint tips to drill into the enamel of teeth.  Several skulls were found in Pakistan  which appear to have molars drilled with flints, as reported in Nature in 2006.  More recently though, a 6,500 year old tooth has been found in Slovenia  with what is now regarded as the earliest (to date) dental filling material: beeswax.  The early Neolithic inhabitants where the tooth was found engaged in farming, and used bees and wax.  Many times primitive remedies find modern uses.  Modern dentists use beeswax too, but not as a filling material!

Mercury Free

Back in 1992 I attended a lecture which convinced me to stop using amalgams, the mercury-silver fillings that look black in people’s mouths.  Besides the obvious concern of mercury toxicity to both patients and myself, was the fact amalgams weaken the tooth and set it up for fracture.  Tooth colored bondings, on the other hand, help hold the tooth together, and have the obvious esthetic advantage.  While the American Dental Association maintains dental amalgams are safe, several European countries have outlawed them.  It should be stressed however, there is no proof that having the amalgams removed will improve any ailments.  While it is true mercury is toxic, there are no conclusive studies that link the mercury in dental amalgams to any specific diseases.  That being said, we still chose to stop placing the silver-mercury fillings and offer the better alternatives instead. Our patients are happier, and so are we!

Clear Correct…an Invisalign Alternative

We now officer Clear Correct, an Invisalign alternative to clear tray orthodontics. Clear Correct offers a cost saving advantage.  For patients, this can be hundreds of dollars, depending on the type of case.  Like Invisalign, clear trays are generated by computer controlled, digitally scanned dental impressions of the teeth.  The trays are worn 24×7 except for eating.  The beauty and comfort of this systems becomes apparent once you take the trays out to brush your teeth: no wires to get tangled up on,  and no brackets to cut your lips and cheek.  Call today at 973-379-2730 to ask how Clear Correct can change your smile, and even your life!clearcorrect

Amalgam Free

We have been amalgam free for over twenty years now.  Ever since I attended a lecture given by John Kanca on bonding and avoidance of amalgam fractures back in 1992, I put my stock of mercury and silver on the shelf and used the composite resin: tooth colored, bonding materials.  With one exception, most of the different brands have held up very well. I dropped amalgam from use, not from any fear about toxicity or safety, but for biomechanical reasons.  I do believe amalgam is safe when properly placed by a clinician.  However, there is no question amalgams weaken teeth  and can set them up for fractures. Bonding composite  can be more conservative, and can help hold a tooth together better.  However, even bonding (resins/composites) have their limitations, and there is concern about bis-phenol A in the oral environment.  Gold still remains the most biocompatible  material, and has the longest longevity. Of course, not many people want to show off the “bling” in their mouths, and would rather show it off on their wrist, ears, lapels, etc.

The future of dental restorative materials may  fall by the wayside,  With stem cell harvesting, the future may bring the genetic manipulation to the forefront and relegate tooth repair to the rear.