From the office of
                                                                                                            PRSRT STD
                                                                                                                                                                                                               Dr. Joseph Heher, D.D.S.
                                                                                                           U.S. Postage                                                                                        1301 Mt. Hermon Road,
                                                                                                               PAID                                                                                            Salisbury, MD
 Joseph M. Heher, D.D.S., 1301 Mt. Hermon Road, Salisbury, MD 21804                                       Salisbury, MD                                                                                        410.749.0320
                                                                                                          Permit No. 247

                                                                                                                                          HELPFUL HINTS, REMINDERS AND NEWS TO KEEP YOU IN SMILES • SPRING-SUMMER 2008

                                                                                                                               “I am still learning.” “Trifles make perfection, and perfection is no trifle.”
                                                                                                                                                                        Michelangelo di Lodovico Buonarroti Simoni (1475-1564)

                                                                                                                                                                 careful about taking                another pain medication, can
                                                                                                                                                                 Ibuprofen, as Ibuprofen will        be very dangerous when
                                                                                                                                                                 negate the effects of the           combined with alcohol. There
                                                                                                                                                                 aspirin. Aspirin should be          is a new anti-smoking drug on
                                                                                                                                                                 taken 1 hr. before taking an        the market, Chantix. The
                                                                                                                                                                 NSAID, or 8 hours after             pharmacology professor
                                                                                                                                                                 taking an NSAID. Next,              claimed it was better than
                                                                                                                                 DRUGS AND YOU
                                                                                                                               Recently, I attended a            taking over 1000 mg. of             Zyban, but should be used
                                                                                                                               continuing education program      Acetaminophen, (Tylenol) will       with caution on depressed
                                                                                                                           4   on drugs and pharmacology         not provide additional benefit.     people, as there have been           1
                                                                                                                               from a PhD/DDS professor          Effects max-out at that level.      reports of hallucinations.
                                                                            (apnea). Research indicates it                     from the U. of MD dental          Acetaminophen has been              (Some of my patients who
for years after cleaning my
                                                                            is a male dominated problem                        school and I’ll relay some        implicated causing liver            have taken Chantix report
teeth with the Perioaid (the
                                                                            until women reach                                  information he provided that      problems. 4000 mg./day in           very “vivid” dreams.) 10% of
tooth-pick instrument), and I
                                                                            menopause, and then the                            might be useful to you. The       people with a normal livers or      teens report using cough
tend to forget what it was like
                                                                            rates even out. Sleep apnea                        best medication for dental        2000 mg./day for those with         medicine to get high.
in the “old” days. Recently, I
                                                                            has been shown to have a                           pain is Ibuprofen (Advil,         liver problems will cause liver     Dextromorphan is the active
had to have some minor mouth                                                direct correlation to                              Nuprin, etc.). Most dental        toxicity. (Note: there is this      ingredient in Robotussin DM
surgery for an old high school                                              cardiovascular disease and                         pain is inflammatory in nature    mentality among some                and Coricidin. Keep watch on
accident that involved cutting                                              high blood pressure. Mild and
                                           SLEEP APNEA &                                                                       and NSAIDS (the drug              people that if one pill is good,    your medicine cabinet. In
my gum tissue and peeling it                                                some moderate levels of
                                              SNORING                                                                          category that Ibuprofen fits      two pills are better; thus if you   2005, according to a study,
back like a banana skin. I felt                                             sleep apnea can be treated                         into: N (non) S (steroidal) AI    really want results, take more      19% of teenagers reported
this was a good chance to see             I just returned from an
                                                                            with dental appliances. Some                       (anti-inflammatory) D (drug)      pills. Such thinking is             abusing prescription
                                         interesting course on sleep
just how long it would take me                                              moderate and most severe                           are best at reducing              dangerous.) Those people            medications from the
                                         apnea. Some points from the
to stop all bleeding and dis-                                               cases must be treated by
                                         program. When people                                                                  inflammation. Those who           taking albuterol aerosols           medicine cabinet. It is
comfort. I was meticulous and                                               other means. While snoring
                                         sleep, there is a “mute button”                                                       shouldn’t take Ibuprofen are      (Proventil) on a daily basis for    thought by the researchers
relentless with my home care                                                tends to be a “joke”, I had a
                                         that seems to go off in our                                                           people with stomach ulcers,       conditions such as asthma           conducting this study, that
efforts, once a day. The time:                                              neighbor with diagnosed
                                         heads; if you wake yourself                                                           on anti-coagulant therapy,        should avoid aspirin and            these numbers are
just over one year. So don’t                                                severe sleep apnea who died
                                         up while snoring, it is not from                                                      and/or allergic to the drug or    other NSAIDS (Celebrex,             “conservative”. Marijuana
give up if your gums hurt and                                               after falling asleep at the
                                         the snoring, but from a lack of                                                       aspirin. Those on daily           Ibuprofen). Same caution            causes spatial distortion—
bleed after cleaning—they will                                              wheel. I don’t find that to be
                                         oxygen due to temporary                                                               aspirin therapy to prevent        exists for those taking             objects look farther away than
get better if you keep at it.                                               a laughing matter.
                                         cessation of breathing                                                                heart problems have to be         Singulair. Darvon,                  they are. Many car accidents
    occurring at stop signs and       many years and you will find       amalgam fillings to mercury      miraculous cures once they         JOLLY RANCHERS                   for septic systems, as the floss
    traffic lights have a marijuana   her personality quite              poisoning in the body.           had their amalgam fillings                                          can clog and damage them as
                                                                                                                                             An interesting letter to the
    component. 38% of traffic         reassuring, pleasing and           Logically it makes no sense      removed cannot be                                                   well. The trashcan, while not
                                                                                                                                             editor of the ADA Journal
    accidents today involve           comforting. All of us in the       to me that something which is    substantiated in double blind                                       ideal, is probably the preferred
                                                                                                                                             warns of candies such as
    alcohol, down from 60% ten        office, who collectively have      labeled a poison before it       research studies (double                                            method of disposal.
                                                                                                                                             Jolly Ranchers, which are
    years ago (a result of MADD       spent well over 100 years in       goes into the body and a         blind means that neither the
                                                                                                                                             very sour. In addition to
    and raising awareness).           the medical/dental fields,         poison after it comes out of     researcher nor the patient
                                                                                                                                             sugar, the sourness comes
    Federal law limits caffeine       have commented on what a           the body wouldn’t be labeled     has any idea who is receiving
                                                                                                                                             from acid, which has a low
    levels to 72 mg. in a 12 oz.      great staff we have and I felt     toxic when it is inside the      the experimental protocol).
                                                                                                                                             enough pH to dissolve
    can of soda. So why does          you should know this too.          body. However, research          Double blind studies are
                                                                                                                                             enamel—in effect, a double
    Red Bull have 80 mg. of           Only when one works in other       seems to indicate the            considered the gold standard
                                                                                                                                             whammy for teeth. Similar
    caffeine in only 8.3 oz. of       offices can one appreciate         overwhelming majority of         in research, and reports of
                                                                                                                                             conditions exist for chewable
    water? It is listed with the      the good fortune of a staff        mercury in amalgam fillings is   reversal of various illness
                                                                                                                                             vitamin C tablets, which are

                                                                                                                                                                              IN AN EFFORT
    FDA as a nutritional              pulling together for the patient   bound in a slightly different    conditions are considered
                                                                                                                                             nothing more than Ascorbic

                                                                                                                                                                               TO KEEP OUR
    supplement rather than a soft     and the effect that can have       form than elemental mercury      placebo results. My own
                                                                                                                                             Acid. Use with caution!
    drink. Go figure!                 on a practice’s working            which is the concern to the      opinion on all this is mixed. I
                                      environment. We are blessed        environment; the mercury         don’t think the final epitaph on                                       PATIENTS
                                      in this respect!                   vapor generated from such        amalgam has reached
                                                                                                                                                                              REGARDING ALL
     ↓ Joanna            Bethany ↓
                                                                         mundane activities as            consensus. I see no reason

                                                                         chewing is not believed to       to remove amalgam

                                                                         produce a concentration          restorations unless you want
2                                                                        strong enough to cause           them removed. Finances can                                                                             3
                                                                         health problems. One of the      be a concern for many                                               Even the tooth fairy feels
                                                                         biggest sources of increased     people, and to remove all                                           inflation's bite. The price per
                                                                         blood levels of mercury          amalgam fillings costs. It is                                       baby tooth is 22% steeper
                                                                         occurs when old amalgams         undeniable that amalgam has
                                                                                                                                              DISPOSING OF
                                                                                                                                                                              today than it was a year ago.
      NEW STAFFING:                                                      are removed by drilling. The     saved many teeth over the           DENTAL FLOSS                    A poll of 647 parents shows
                                        MERCURY AND
    Sara has returned to her                                             particlization of the amalgam    years from extraction. The         Many types of floss,             that the tooth fairy pays $2.09
    homeland, Pennsylvania.                                              by drilling increases the        best restorations remain gold      especially the newer brands
                                                                                                                                                                              per baby tooth, on average,
    Her husband has taken a new           FILLINGS                       surface area available to        and porcelain, with fillings,      are shred-resistant, but this    up from $1.71 last year.
    job with a nice promotion and     You may or may not have            release mercury into the body    either tooth colored or            also makes them non-             Most said they pay $1 per
    it was an opportunity they        heard the nation of Norway         and transient increased          amalgam used as                    biodegradable. While this        tooth, with $5 coming in
    couldn’t pass up. Replacing       has banned mercury -               mercury levels are recorded,     compromises when gold or           might lead one to conclude       second place. Then there
    her is Joanna Masiello and I      containing amalgam fillings,       which return to normal after     porcelain would be the             that the best method for         were the outliers: from $.05 to
    think you will find her quite     more out of concern from           several days. This is another    treatment of choice.               disposal is via the toilet,      $50 per tooth. (from Web MD)
    personable and gentle—that’s      what I can read for the            BIG advantage to using the                                          recent studies have shown
    the feedback we have been         environment, than for health       rubber dam—it prevents                                              that once floss is flushed, it
    receiving. Also giving me a       reasons. The ADA and the           mercury from entering the                                           has the potential to create         HOW LONG
    hand chairside and                National Institutes of Dental      blood stream by keeping it                                          havoc in waste processing        BEFORE MY GUMS
    alternating with Karen is         and Craniofacial Research in       out of your mouth. The                                              stations, potentially causing     STOP BLEEDING?
    Bethany Given. Bethany has        Washington have been               anecdotal reports of people                                         jams and increased               One of my problems is that my
    been a dental assistant for       unable to objectively link         experiencing almost                                                 maintenance problems. Ditto      gums haven’t bled or hurt

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