The Tooth, Mouth & Jaw Corner.

Fluoride is a naturally occurring mineral in almost all water supplies. The fluoridation level in San Diego is at the minimal adjusted level of 0.7-0.8 mg/L which is just enough to prevent tooth decay. The recent concern surrounding community water fluoridation and its possible association with lower IQ in children, is based on a report that tested fluoride levels at twice the amount found in our community water supplies. Both research and real life examples of communities that removed fluoride from drinking water, have shown increases in tooth decay. Currently, states and local municipalities are the entities that will be deciding on the removal of fluoride in drinking water.

In addition, the FDA is aiming to remove the availability of ingestible prescription fluoride supplements from the market. These supplements (such as chewable tablets) are prescribed by general and pediatric dentists to children who live in low or non-fluoridated communities and who are deemed to be at high risk of developing tooth decay. Several other factors, such as a child's diet, are taken into account before prescribing them. These are not the same products that are available over the counter such as toothpastes or mouthwashes, nor are they are the same as the fluoride gel (varnish) that is placed over your teeth in the dental office.

The fluoride found in toothpastes and rinses protect against dental cavities and acid erosion of enamel. Toothpastes that are "fluoride free", may contain other cavity-reducing agents such as xylitol and hydroxyapatite, that work differently than fluoride. The amount of fluoride found in over the counter toothpastes and rinses is low (0.05-0.3% sodium fluoride), but still beneficial and is not harmful if used correctly with the guidance of a dental professional. Some toothpastes come in much higher amounts of fluoride (1.1 % sodium fluoride, such as the 3M Clinpro™). Clinpro™ is a combination of fluoride with hydroxyapatite. Those can be only be prescribed by a licensed dentist for patients with a high risk of enamel and root decay, or acid erosion due to certain diets, extent of dental work, medications, and medical conditions. Those toothpastes are prescribed with specific instructions for use.

No two patients carry the same risk of tooth decay so each patient will require different approaches to their cavity prevention. No two teeth even in the same mouth carry the same risk of cavities or erosion. Therefore, I make sure that each patient has an individualized prevention plan for their oral health specific to their dental condition. That means getting to know your habits, diet, medical conditions, and other risk factors such as orthodontic treatment, when deciding which anti- cavity product and in what format, is most appropriate. For example, in our practice, when a fluoride varnish treatment is applied to your teeth, it is placed at the areas most at risk, and we document those specific areas in your chart. While fluoride is undoubtedly a key component in any cavity prevention regimen, it will not stop tooth decay if used incorrectly. This is why we take time to explain how even the most basic over the counter toothpaste or mouthwash should be used, and in many cases, which ones to avoid.

It is important to obtain information on fluoride from credible sources, so if you have any questions about fluoride or any other product in general, please don't hesitate to contact us directly. 

Eating disorders are more common than we might think. Some 35 million men and women have an eating disorder, including athletes or those engaged in sports.  Dentists can detect eating disorders such as bulimia by spotting dental damage and symptoms they can cause. Parents of children with eating disorders may or may not recognize their child may be anorexic or bulimic but dentists can detect the oral consequences of such conditions, including mouth sores, tender glands, eroded enamel, bleeding gums and sensitive teeth.  So if you suspect your child to have an eating disorder, Dr. Barakat may be able to assist in recognizing the warning signs and guide you and your child to medical care, as well as help resolve the associated dental problems.

Fluoride is not just for just kids! As adults, our saliva changes as we age and becomes less protective against decay and enamel erosion. Those with periodontal disease are at higher risk of root cavities which are very challenging to control and restore unlike enamel cavities, and can develop on the exposed roots resulting from bone loss. Fluoride varnish treatments are part of the regimen Dr. Barakat recommends to help protect exposed roots from decay. We use gluten free fluoride varnishes with a great tasting berry flavor!

Sleep apnea machines have recently been under review for their safety and the FDA is still investigating the possibility that toxic chemicals could be emitted in the materials lining the devices. If you suffer from sleep apnea and use a cpap machine, check your model and discuss it with your primary care physician. Also know that there are alternatives such as oral appliances that can also manage obstructive sleep apnea without the involvement of positive air pressure masks. Those are typically made by dentists who have knowledge on sleep devices and who can help determine if you are a candidate. Dr Barakat can help guide sleep apnea patients with the appropriate referrals.