2009 Newsletter
  1. Mall-Booth Bleaching
  2. Fluoride Supplement
  3. Getting Plaque Free
  4. Tooth Fairy Letter
  5. Baby Teeth on Board
  6. Chisako’s Corner
  7. Staff Personals

 

MALL-BOOTH BLEACHING

What is That About???

Everyone wants whiter teeth! It is safe and fairly easy to accomplish that today. Going to “single-session-in-the dental-office” or “Bleach Booth” solutions always sounds good. Patients think “one-hit, don’t have to keep fooling with it” and surmise it is worth the money. Please be advised of some facts about “one-hit” tooth bleaching, whether in a dental office or a “mall-booth”. YOU HAVE TO MAINTAIN YOUR SHADE! So there is no “one-hit” permanent solution. You will need bleach trays that you can pop in during shower/shave/hair time once or so each week to keep your color! Those “quicky” places DON’T MAKE YOU A TAKE HOME TRAY!

Also BEWARE that some color change from “one-hit” bleaching IS BECAUSE OF THE TEETH DRYING OUT AND ONLY LASTS 2 HOURS!

And BE AWARE that an article in the ADA NEWS by Jennifer Garvin expresses concerns over the safety of the solutions used and the sterile conditions at bleaching centers and booths that exist outside a professional dental office. Her article quotes Dr. Daniel M Meyer, ADA Senior Vice President, Science/Professional Relations as saying, concerning non-dental office bleaching centers, “The foremost concern is that there may be a chemical or ingredient being used that may be harmful to patients…especially if they are not applied carefully or are applied too long.

In addition, there are also concerns over infection control being used that may be harmful to patients…ampespecially if they are not applied carefully or are applied too long. In addition, there are also pconcerns over infection control and underlying conditions that may require the care of a dentist or physician prior to patients using these products.”

Sooo! You may as well come in to our office and get a tray made and get issued a kit WITH REAL bleach solution at PROPER concentrations that is SAFE. You will be able to control your own shade RIGHT AT HOME with daily use for a week or 2 to reach your desired shade, and weekly maintenance after that. This is the gentle, safest way to bleach. OR IF YOU ARE IN A HURRY or just want a jump start, we will do a “sit-down-in-the-chair” bleaching here, safely. YES WE HAVE THE LIGHT but most bleaches don’t require it. It is, in some cases just a “gimmick”!

So come in and get a consult AND LET REAL PROFESSIONALS HANDLE YOUR BLEACHING NEEDS! You can have white teeth for the New Year!

FLUORIDE SUPPLEMENT

By Kathleen O’Connor Hanley

The question of whether or not to supplement our children’s fluoride intake has been a source of disagreement among dental professionals for decades. The official ADA recommendation is still to provide fluoride supplementation to all children l6 years old or younger. This recommendation is different from both Australian and Canadian Dental Associations. Both have scaled back their recommendations with the Australians recommending no supplementation at all.

The big trade-off with fluoride supplementation is the risk of fluorosis. Fluorosis is the result of ingesting more than an optimum amount of fluoride and manifests as discoloration of the teeth. In mild cases, it appears as white freckling or a “snow capped” appearance of the teeth. In more severe cases, it can manifest as dark stains and a mottled appearance to the teeth. These teeth are very resistant to decay but often are not aesthetically appealing. The emphasis, by today’s society, on the perfect, bright, white smile makes fluorosis a concern. As dental professionals, we want our patient’s teeth as strong and healthy as possible but we also want them to be pleased and confident with their smiles.

Here in San Francisco, the water supply is fluoridated at an optimum level. If children were ingesting city water with their baby formula, juice or just alone, we could gauge a little better the amount of fluoride they ingest. Today’s trends, however, are more toward breast feeding and bottled water which are almost impossible to track for fluoride content because, with the bottled water, there are so many different brands and sources. Another challenge is that not every city in the Bay Area is fluoridated and children may attend day care or school in a city that is fluoridated even though their home water is not. These unpredictable outside sources of fluoride consumption make accurate prescriptions for fluoride difficult.

Many studies have been conducted on the subject and the Journal of the American Dental Association published a systematic review of these studies in the November 2008 issue (JADA, Vol. 139 Nov. 2008). They found limited evidence to support the effectiveness of fluoride supplements during the first three years of life. The evidence did, however, support the effectiveness of fluoride supplements when used by school age children to prevent caries. There was also consistent evidence that the use of the fluoride supplements in the first three years of life increased the risk of developing fluorosis with the first year of life being the most important period for development of this discoloration.

So what are dentists and pediatricians to do? The American Dental Association Council of Scientific Affairs is in the process of developing new clinical recommendations that are anticipated to be published in the summer of 2009. In the meantime, we should remember that patients can take advantage of the benefits of topical fluorides through dentifrice and rinses without developing fluorosis and without ingesting fluoride.

The ONLY automatic toothbrush we approve is the ROTODENT! It has the right size, shape, and type of bristle and motion! Available in dental offices only with a demonstration in proper, safe usage.

GETTING PLAQUE FREE

By Dr. Presley-Nelson

What really does “getting plaque free” mean?

Plaque is that furry film that coats the teeth daily. It feels like a rough “sweater” on each tooth. It is a colony of bacteria, not food. It will form whether you eat or not, just like mildew forms on the shower walls because of warm moist conditions. It is clear and invisible until it is 2-3 days old but dangerous after only 24 hours.

Before 24 hours the bacteria (it’s not plaque yet) is not strong and organized enough to make enough acid to do harm. So you don’t need to brush after every meal. You can do so for refreshment, but the only thing that matters is complete plaque removal once every 24 hours. Usually brush and floss are enough for this. Remember, food is not the culprit, that clingy film of bacterial plaque is. Brushing away food particles is different from disorganizing an adherent colony in a systematic order around the mouth. It will be back in 24 hours but we call it getting “plaque free” if you disorganize it once a day!
Ask for a plaque review in the office. And read the hand-out “Two-Way Toothbrushing” for further understanding. We have lots of tips and tricks to show you!

TOOTH FAIRY LETTER

Dear _______________

Thank you for leaving [ ] tooth(s) under your pillow last night. While we make every attempt to leave a monetary reward, we were unable to process your request for the following reason(s) indicated below:

( ) the tooth could not be found
( ) it was not a human tooth
( ) we do not think that pieces of chicken bone are very funny
( ) we were unable to approach the tooth due to excessive odor
( ) the tooth had previously been redeemed for cash
( ) the tooth did not originally belong to you
( ) you were overheard to state that you do not believe in the tooth fairy
( ) you were age 13 or older at the time your request was received
( ) the tooth is still in your mouth
( ) the tooth was guarded by a vicious fairy-eating dog at the time of our visit
( ) no nightlight was on at the time of our visit
( ) you were not really asleep, just pretending
( ) your bath/bedtime routine was late/incomplete
( ) room messy/unsafe to enter/looks unkempt and or scary
( ) the snacks provided for the tooth fairy were not satisfactory, or were missing
( ) teeth in mouth were not well brushed and flossed (oral hygiene black-list)
( ) evidence of unsafe tooth extraction was discovered, as follows:
[ ] string
[ ] pliers
[ ] gunpowder
[ ] part of skull attached to tooth
[ ] no dental care evident
[ ] Gummy Bear or Caramel involved

( ) other:

Thank you for your request, and we look forward to serving you in the future.

Sincerely,

The Tooth Fairy**

BABY TEETH ON BOARD

By Dr Wendy Fung

Now that I have a little one, dental care for baby teeth is on my mind more than ever!

Delay Decay

Studies show that children who had no decay before age 7 have fewer cavity-causing bacteria in their mouths, making them less susceptible to decay in the long term. The only way to ensure such a healthy dental future is for parents to be proactive in establishing proper diet and hygiene habits early. We are here to help guide and support parents in this role.

Control the Diet

The sweet tooth of a child who is not exposed to many sweets is more likely to be satisfied by something like a banana, while a child who has regular exposure to sweets is more likely to need something much sweeter to be satisfied. Obviously, frequent exposure to sweeter foods, especially those with refined sugars, increases susceptibility to decay because plaque can metabolize simple sugars quickly, increasing their acid output, resulting in cavities. So control those sweet exposures while you can!

Brush Early and Brush Often

As a parent, I know firsthand that establishing an oral hygiene routine for children is not easy, but consistency and adult supervision is crucial. Start brushing for your child as early as you can. It is recommended that parents help their children brush until the child has the dexterity and commitment and motivation needed to proceed competently on their own; this could be at age 8 or much older! At least, parents should regularly check to make sure that their children’s teeth are clean. And of course, parents need to be a good example!

Respect Those Baby Teeth

Although baby teeth will eventually fall out and be replaced, while they are in the mouth, they warrant as much care and attention as their permanent counterparts. Baby teeth are crucial in speech development, eating, and self-esteem. A baby tooth is in a child’s mouth between 5 to 8 years, which is plenty of time for it to become decayed, abscessed, and cause pain. In extreme cases, the permanent tooth can become damaged, and the child can have pain so severe that it leads to problems with eating and nutrition and the ability to concentrate on schoolwork. Also, baby teeth are good “practice teeth.” The only way a child will know how to take care of his permanent teeth is if he has been taught how to take care of his baby teeth.

The Dentist is FUN!

Our goal is to keep your mouth in top shape. Cavities usually don’t cause pain until they are deep enough to necessitate more extensive treatment than a routine filling. So a painless mouth isn’t necessarily a healthy mouth. This is why regular cleanings and exams are crucial parts of proper oral care. The American Dental Association recommends that a child’s first dental visit should coincide with the eruption of the first tooth or no later than 1 year of age. Generally, the earlier a child starts with regular dental visits, the less likely those visits will involve anything more than checkups and cleanings. With no reason to have fear or anxiety toward the dentist, the child can develop a positive attitude toward dental appointments. We will help you to reinforce the importance of good daily hygiene and diet. However, if there should ever be a need for treatment, the trust that we have already established can mean the difference between a pleasant experience and a traumatic one. Also, please keep a happy, non foreboding attitude about dentistry and health care in general around your child. It is hard for us to undo fears instilled by the parents! It is out job as parents and dentists to encourage and enforce habits that promote oral health. Here at the office, we welcome kids of all ages and are happy to answer any questions you or your children may have!

CHISAKO’S CORNER

Insurance and You. Please remember you, your employer and the insurance company agreed on your insurance coverage. You picked/agreed to your plan and have been paying premiums for what you agreed would be covered. Your booklet describes what is and isn’t covered and how often, and under what circumstances re-imbursement will occur. We are not in anyway connected to your plan. We are happy to send claims to your insurance and to help you as best we can. However, ultimately, your dental insurance contract is yours.

Keep an eye on your claims. Most dental claims must be processed within 1 year in order to be paid. A few cut off at 6 months. When the insurance has not paid for any claims within 2 months, please call your insurance company and inquire. They respond faster and better to the insured than they do to the dental office. Should they say they don’t have the claim in their system, call us to re-submit. If it is not followed up on, it may eventually be denied. There are many of you and a few of us. Thank you for your help and for knowing something about your insurance benefits.

Changes to your dental insurance, employer, phone numbers, and address? Inform us before your next visit.

Cancellation Policy

Please give us advance notice when rescheduling or canceling appointments. Notifying us less than 48 hours prior to the appointment will incur a charge of $30 per half hour scheduled.

This means if your appointment was one hour, there will be a lack of notification charge for $60. We are not trying to be mean, or non-lenient, but overhead continues with or without income. If Doc is paying everyone to be here to help you, she still has to pay everyone that hour that you don’t come. We’d rather charge only the patient of that hour, than raise everyone’s fees to cover the downtime. We are sure you understand, and of course occasionally there are extenuating circumstances, so please talk it over with us. We really want to see you come in so we can serve you and your oral health.

From My Heart to Yours

In this time of economic downturn, and worldwide woes, my heart goes out to all and any of you who are unemployed, or marginally employed, or are serving or have a loved one serving in any capacity of danger, at the border or in foreign lands. I especially reach out to all small business owners, for whom my hopes and prayers extend, that you may hang on and move forward to prosper once again in a brighter future. Don’t close, don’t give up if you can help it.

In taking the liberty of philosophizing, at this uncertain time, I dare to reminisce about the past when things seemed unsettled. I remember trying to start my practice in 1982 during what seemed like crushing economic difficulties, nation-wide. Then I remember the stock market crash in 1987 that took away much from all of us, and the ensuing downturn through ’89. And I can’t forget the real estate drop in the 90’s when the house we’d just purchased was suddenly worth a fraction of what we’d paid for it. No one can forget 9/11 and the following economic mayhem. All are boulders in a long path that we travel together.
Some of those times had only 3 news channels spilling the doom, and then only at 6 O’clock. Now we hear it roaring from a hundred lion’s mouths at all times, day and night. No doubt this time is worse, I would never minimize suffering. But I hope and pray that we can all look forward, work forward, but remember the lessons of the past. This too will become the past, perhaps not soon enough for some of us, but past it will become.

I know I am truly privileged to have you wonderful patients to care for and serve. I’m humbled and grateful every day by the trust you have bestowed on me. I and my staff will be here for you, looking forward, into the future.

The “Comes From Afar” Box

Often, when people move away, they still remain as patients in our practice and travel one or more times a year to receive their care from us. We so appreciate their efforts and their loyalty that we want to honor them here.

  • Arthur Sussman and Cheetah Llanes from Richmond
  • Bill Bender from Hayward
  • Carole and Gerald Leikam from north of Marin
  • Darwin Albers from Paradise, CA
  • Diane Mibach from Antarctica
  • Elisabeth O’Connell from London
  • Helena O’Connell from Ireland
  • Jennifer Ruzek from Oakland, CA
  • Lenore Cohen from Sunnyvale
  • Mary Johns from Piedmont
  • Mary Switzer from Mill Valley
  • Melanie Walas from Livermore
  • Molly Mundell Bass and John Bass from Marin
  • Pon Piamchon from Thailand
  • Paul Chamberlain from South Peninsula
  • Peter & Faaoso Vrana and family from Pittsburg, CA
  • Rex Golding from South Peninsula
  • Rob Waring from Palo Alto
  • Steve and Jo Moorehouse from north of Marin
  • Tanya Kauffman from Alameda
  • Theresa and Jeff Pabst from London
  • Theresa Lobre from Livermore

 

The “Comes From the Farthest” Award

This year goes to the Helmy Family
from Morocco, where they moved to start
a school for handicapped children.

Our Away at College Patients
Make time for teeth!

We enjoy, encourage, and appreciate all you college students who squeeze in a check up and cleaning while you are home on break! Summer, Spring and Winter breaks are when most of you drop in. We love to hear your stories and “catch up”! Call ahead to reserve your spot!

This year we enjoyed:
  • Tony Bader—UC Davis
  • Lauren Brown-Cornell—UC San Diego
  • Jay Giblin – New Mexico
  • Lillie Jeffries—Vassar in New York
  • Tracy Lee—UC Davis
  • Michael C Novak—Santa Barbara
  • Mari Novak—UC Santa Cruz
  • Gary C. Presley-Nelson—UOP Stockton
  • Lorenzo Robleto—San Diego
  • Aly Sneider—Reed, Portland
  • Anna Snyder—Duke, North Carolina
  • Simon Snyder—Emory Law, Atlanta Georgia
  • Hannah Yannow—University of Oregon

And more! Let us know who we missed!

Howdy Jokers!

We so appreciate all you humor mongers out there who come into the dental office and get us grinning!

Our “usuals” include Michael Novak, Walt Meservey, Bianca “Baked Goods” Hirsch, The Moorhouses, The Leikams, Steve Reidbord, Harold Yanow, Richard Jann, Tom Beeks, The Rucks, Marilyn Brown and Steve Cornell, Ski Tostanoski, Barry Hanson, and Joe Razon

This year we add jokers Kathy Trapani, Sharon Cassidy, Ruth Oates and Jimmy Johnston! Welcome aboard!

AND THE WINNING JOKE AWARD….(drum roll please….) GOES TO …..

SHARON CASSIDY!!!!

FOR:

1) WHAT DO YOU CALL A MIDGET PSYCHIC
THAT ESCAPED FROM JAIL?

A: “SMALL MEDIUM AT LARGE”

2) HOW DO YOU MAKE HOLY WATER?

A: BOIL THE HELL OUT OF IT! (Whoops!)

CONGRATULATIONS SHARON!!

STAFF PERSONALS

Dr. Presley-Nelson and husband, Gary, are experiencing the “half-empty nest”. Gary Clarke Presley-Nelson went off to college at University of the Pacific in Stockton, the mother campus of Doc’s Dental school. He is a business major, econ/pre-law minor and enjoys playing the cello in the UOP Orchestra. He has adapted well to college, and comes home once a month to play in the church praise band. The parents are also adapting well but missing him too. Son James is a junior at SF School of the Arts High School on Viola and was also away for a month this fall. He went as Student Ambassador to Israel, received training in Wash DC, and at the UN in New York City, and toured Israel, speaking at schools. He now has 3 months of speaking engagements here, starting in January. He traveled with a chaperone and a body guard with an M1-A1 at all times. Pretty exciting trip! The parents aged, though Dr. Presley-Nelson did not get any gray hairs at all…really! Last spring the boy’s Mock Trial Team went to “State” and competed with all the other counties in California. That was a thrill to watch. So was Gary Clarke’s graduation from SOTA High School! Husband Gary made the cut and still works for Hewlitt Packard after lay-offs, but now has more workload. We are grateful to have work and hold high hopes for this New Year.

2008 has been an incredible year for Dr. Fung and her husband, Steve. Their daughter, Nora, has been such a joy. She was born just before the New Year, so 2008 has been a year of firsts for all of them. Seeing her become a little person and discover the world around her has been fun and fascinating. Of course, Dr. Fung has enjoyed continuing to see patients at the office and feels so fortunate to be able to have the best of both personal and professional worlds. At the office, she hangs out with interesting, entertaining people, and then she goes home and hangs out with the cutest, brightest, sweetest little girl on the planet! (She’s a little biased, but definitely allowed to be!) Dr. Fung looks forward to a fun-filled 2009 and wishes everyone a terrific new year!

Kathleen O’Connor-Hanley and her husband Patrick have had a busy year. Unfortunately, Pat lost his job in April when ATA went out of business, quite unexpectedly. It was a rough few months but, thankfully, he was just hired on as a manager with Alaska Airlines. There is much to be thankful for this holiday season. The kids are doing well. Ryan is l3 and doing well in his new school. It is hard to believe that high school is right around the corner! He is still driving mom crazy with his drums but he is sounding better. Emily is 11 and a really good soccer and piano player. Kathleen turned the big 40 this year and that means she has spent more than half her life with the office. No wonder she says that the patients feel so much like family. The O’Connor-Hanleys send their heartfelt best wishes to everyone for 2009!

Chisako Tanaka, our office manager, is still keeping appointments, insurance, and all office employees on “the straight and narrow”. She also enjoys spending time with her nieces, learning what they like to do, and how easy is it to plan an outing with them. Chisako is rethinking ways to entertain a 9 year-old. Rather than walking around a museum, which is not interactive, she is considering, for her next excursion, taking a paddle boat around Stow Lake and feeding the turtles, gulls, and ducks.

Daneille Uttley, our main Chairside Assistant, heads our sterilization, assisting, and maintenance team. Danielle is the proud mother of her amazing 11 year old twins, Xianna and Andres. Andy studies the guitar while Xianna has become quite the young artist. This year the family took a trip to Disney World in Florida, with beloved Great Grandma. They also went again to Enchanted Hills Camp for Visually Impaired Children in Napa in the summer, where the twins learned more skills for “getting around” including some bike riding! The family’s most recent adventure was a trip to Las Vegas, where the twins cheered Mom on through the Las Vegas Half Marathon! Danielle is still active with the roller derby team, The Bay City Bombers, and she has been busy recruiting new patients at her weekend job, bartending at Grandma’s saloon on Taraval!

Daniel Gee came to our staff about a year or more ago from an ad placed at SF State University and has rapidly become indispensable. He learned chairside assisting and sterilization quickly. He then moved to all around organizer, computer expert and helper in all ways imaginable. He readily subs in when needed and is a competent asset to our practice. Daniel has been busy juggling school at SF State, and his hobby, martial arts, while working at the office. He recently took his black belt test in kenpo karate and expects to be promoted very soon. He is a biology major.

Now a sophomore at San Francisco State University, Tessa McGregor continues to pursue her Physiology major and Spanish minor and is now a new member of the Circle K International volunteer club at school. Aside from school, she still enjoys playing piano and learning new things at the dental office (in the spring, she received a certificate in radiation safety along with Liza and Daniel at the University of the Pacific). Tessa is also interested in surfing; while she has a board, she has yet to try it out, but hopes to do so soon.

New to the Healthy Tooth Team is college intern, Cipriano Gudoy, majoring in Physiology with Pre-Dental ambitions as a third-year at SFSU. He eagerly learned the many chair side assisting skills and is still learning so much more. When not at the office, you can find him studying for something or trying out the next great food find in the city.

Jennifer To is a senior at UC Davis this year and will be graduating this coming spring. She has been with us since she was a sophomore at Lowell High School. Even with her busy school schedule, she tries to come back every other weekend to work on mailers and other maintenance tasks. She still comes into assist during school breaks, so keep an eye out for her! Jen wishes all happy holidays and a great new year.
Linda Dang has graduated with a degree in Biology, concentrating in Physiology and is ready to join the workforce outside the dental office! She is excited and happy for this new change in her life and what it has in store. During her free time she enjoys traveling and discovering new restaurants in the city, as well as spending too much time with her boyfriend, Chris. Linda now acts as general substitute to keep the dental office moving along.

Denise Tong is now working full-time at UCSF Medical Center. She’s currently applying to dental school and will be flying around the country for interviews in the coming months. She still stops by the office to help wherever help is needed, including putting together this annual office newsletter.