Fluoride plays an essential role in dental health. Fluoride helps prevent tooth decay by stopping the acid from bacteria to erode enamel and by strengthening the enamel. It can also assist in reversing early tooth decay by remineralization. Since the addition of fluoride in the water system, tooth decay has been reduced by about 30%. Unfortunately, over 25% of toddlers still present with one or more cavities.
Water fluoridation became national policy in 1951. About 60% of the United States population receives fluoridated water. If you are unsure about your town's water system, contact the local health department. Below is the dosing for fluoride depending on the fluoridation of the town water.
Dosing Schedule for Children for Dental Caries prevention
Ages 3 months to 3 years old
1.Local Water Fluoride <0.3 ppm: Fluoride 0.25 mg daily
2.Local Water Fluoride 0.3-0.7 ppm: No Fluoride Supplement Necessary
3.Local Water Fluoride >0.7 ppm: No Fluoride Supplement Necessary
Ages 3 to 6 years old
1.Local Water Fluoride <0.3 ppm: Fluoride 0.50 mg daily
2.Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.25 mg daily
3.Local Water Fluoride >0.7 ppm: No Fluoride Supplement Necessary
Ages 6 to 16 years old
1.Local Water Fluoride <0.3 ppm: Fluoride 1.00 mg daily
2.Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.50 mg daily
3.Local Water Fluoride >0.7 ppm: No Fluoride Supplement Necessary
Fluoride supplements are typically prescribed. It comes in liquid and chewable tablet forms and may be combined with a multi-vitamin. Supplementation may begin at six months of age. As children get older, fluoride toothpastes are used to prevent tooth decay.
Children two years of age and younger should not use fluoride toothpaste but instead use a training toothpaste like Orajel Toddler. Children over two years of age should use an ADA approved fluoride toothpaste but with assistance from a parent. Kids should be taught not to swallow and use a "pea-size" amount. Also, children under six years of age should not use fluoride mouth rinses.
Excessive fluoride intake can cause a condition called enamel fluorosis (discoloration of the permanent teeth). Talk to your health care professional for more information.
Finally, dental visits should begin within six months of the first tooth or at one year of age.
Hope this was informative!
Monday, February 22, 2010
Monday, February 15, 2010
Folic Acid and Pregnancy
Throughout residency and in practice, I have seen many pregnant women. One of the most important pieces of advice I provide is the need to take a prenatal vitamin, more importantly, folic acid.
Folic acid is a B9 vitamin, essential in cellular production and division. It is found in green leafy vegetables, orange juice, dry beans, spinach, bananas, peanuts, enriched whole grain foods, and kale. The recommended daily allowance is 400 micrograms/day. Folic acid can help prevent coronary heart disease, anemia, and, in babies, neural tube defects.
Neural tube defect is a condition when the baby sustains a birth defect where there is incomplete development of the brain and spinal cord. Examples include spina bifida, anencephaly, and encephalocele. Typically, these defects occur in the first month of pregnancy, when the mother is unaware of her pregnancy. Folic acid can reduce the incidence of neural tube defects by up to 70%. Unfortunately, about 3000 babies are born each year with a neural tube defect.
The recommended dose for women who are pregnant or are expecting to be pregnant is 400 micrograms per day. Adequate folic acid intake should begin for all women who are of child-bearing age. It is wise to start a prenatal vitamin one month prior to conception to help ensure fetal nerve and brain development. One study indicated that three out of four women did not take their vitamin at least four times a week in the month before they became pregnant.
Folic acid can also reduce the possibility of cleft palates, preeclampsia, premature birth, congenital heart defects, and miscarriage.
There are special circumstances when more folic acid supplementation is required. Examples include previous child with a neural tube defect, family history of neural tube defects, personal history of diabetes, seizure disorder, or rheumatoid arthritis.
Folic acid supplementation does not stop at the birth. During breast feeding, the recommended amount is 500 mcg daily.
Typically prenatal vitamins contain 400mcg of folic acid. Most multivitamins also contain 400mcg. Check the label and verify that it has 100% of the RDA (recommended daily allowance).
Talk to your health care professional for more information. Thank you and have a nice day.
Folic acid is a B9 vitamin, essential in cellular production and division. It is found in green leafy vegetables, orange juice, dry beans, spinach, bananas, peanuts, enriched whole grain foods, and kale. The recommended daily allowance is 400 micrograms/day. Folic acid can help prevent coronary heart disease, anemia, and, in babies, neural tube defects.
Neural tube defect is a condition when the baby sustains a birth defect where there is incomplete development of the brain and spinal cord. Examples include spina bifida, anencephaly, and encephalocele. Typically, these defects occur in the first month of pregnancy, when the mother is unaware of her pregnancy. Folic acid can reduce the incidence of neural tube defects by up to 70%. Unfortunately, about 3000 babies are born each year with a neural tube defect.
The recommended dose for women who are pregnant or are expecting to be pregnant is 400 micrograms per day. Adequate folic acid intake should begin for all women who are of child-bearing age. It is wise to start a prenatal vitamin one month prior to conception to help ensure fetal nerve and brain development. One study indicated that three out of four women did not take their vitamin at least four times a week in the month before they became pregnant.
Folic acid can also reduce the possibility of cleft palates, preeclampsia, premature birth, congenital heart defects, and miscarriage.
There are special circumstances when more folic acid supplementation is required. Examples include previous child with a neural tube defect, family history of neural tube defects, personal history of diabetes, seizure disorder, or rheumatoid arthritis.
Folic acid supplementation does not stop at the birth. During breast feeding, the recommended amount is 500 mcg daily.
Typically prenatal vitamins contain 400mcg of folic acid. Most multivitamins also contain 400mcg. Check the label and verify that it has 100% of the RDA (recommended daily allowance).
Talk to your health care professional for more information. Thank you and have a nice day.
Wednesday, February 10, 2010
The Importance of Fiber
Fiber is an essential component in a healthy diet. There are numerous benefits in eating an adequate amount of fiber. Unfortunately, many Americans do not meet the recommended goals.
Fiber is a type of carbohydrate that can not be digested. It passes through the body without being metabolized but it participates in many roles to maintain health.
There are two main types of fiber:
Insoluble-Fiber that does not dissolve in water and thus can help with constipation.
Soluble- Fiber that can dissolve in water and forms a gel like substance. This helps with cholesterol and sugar control.
The recommended amount is based on age, gender, and caloric needs but on average one should consume about 25 grams a day of dietary fiber from food. The average American consumes about 5-15 grams per day.
The benefits of fiber include:
1. Improves bowel health and aids in constipation
2. Lowers risk of heart disease
3. Decreases risk for diabetes and helps stabilizes blood sugar
4. Reduces risk for diverticular disease
5. Helps reduce bad cholesterol levels
6. Helps with weight loss
7. Lowers risk for hemorrhoids
8. Helps with irritable bowel syndrome
9. Reduces chances of gallstones and kidney stones
Sources of fiber include whole grain foods, legumes, nuts, fruits, and vegetables.
Here are some tips about adding fiber to your diet:
1. Add color to your plate (green leafy vegetables, red apples, brown rice, etc).
2. Instead of "white" foods, go with colorful foods...brown rice instead of white, sweet potatoes instead of white potatoes, whole grain pasta instead of white pasta.
3. Add fresh or frozen vegetables to soups, casseroles, pasta dishes.
4. Eat more beans, legumes, peas, lentils...refried bean nachos!!!
5. Drink water to also avoid constipation and to help the beneficial effects of fiber
6. Snack on dried fruit, fresh fruits, veggie sticks, nuts, popcorn, whole grain crackers instead of chips.
7. Substitute white flour with whole grain flour...great for pancakes.
8. Choose whole grain cereals.
9. Read food labels.
10. Add fiber gradually to your diet.
11. Add a spoonful of flaxseed to your food.
Here are some examples of foods with their fiber counts:
2 slices of whole-wheat bread = 4 grams of fiber
1 cup of cooked brown rice = 4 grams
Reduced-Fat Triscuit crackers = 3 grams
¾ cup cooked oatmeal = 3 grams
1 cup of canned minestrone soup = about 5 grams
1/2 cup vegetarian or fat-free refried beans = about 6 grams
1/4 cup kidney beans, added to a green salad = 3 grams
1 large apple = 4 grams of fiber
1 banana = 3 grams
1 cup strawberries = 4 grams
1 cup cooked broccoli = 4.5 grams
1 cup raw carrots = 4 grams
1 sweet potato = 4 grams
1 cup cauliflower, cooked = 3 grams
2 cups raw spinach leaves = 3 grams
Talk to your health care professional about dietary fiber. In some cases, patients may need fiber supplements such as Metamucil or Benefiber
Thank you and drive carefully!
Fiber is a type of carbohydrate that can not be digested. It passes through the body without being metabolized but it participates in many roles to maintain health.
There are two main types of fiber:
Insoluble-Fiber that does not dissolve in water and thus can help with constipation.
Soluble- Fiber that can dissolve in water and forms a gel like substance. This helps with cholesterol and sugar control.
The recommended amount is based on age, gender, and caloric needs but on average one should consume about 25 grams a day of dietary fiber from food. The average American consumes about 5-15 grams per day.
The benefits of fiber include:
1. Improves bowel health and aids in constipation
2. Lowers risk of heart disease
3. Decreases risk for diabetes and helps stabilizes blood sugar
4. Reduces risk for diverticular disease
5. Helps reduce bad cholesterol levels
6. Helps with weight loss
7. Lowers risk for hemorrhoids
8. Helps with irritable bowel syndrome
9. Reduces chances of gallstones and kidney stones
Sources of fiber include whole grain foods, legumes, nuts, fruits, and vegetables.
Here are some tips about adding fiber to your diet:
1. Add color to your plate (green leafy vegetables, red apples, brown rice, etc).
2. Instead of "white" foods, go with colorful foods...brown rice instead of white, sweet potatoes instead of white potatoes, whole grain pasta instead of white pasta.
3. Add fresh or frozen vegetables to soups, casseroles, pasta dishes.
4. Eat more beans, legumes, peas, lentils...refried bean nachos!!!
5. Drink water to also avoid constipation and to help the beneficial effects of fiber
6. Snack on dried fruit, fresh fruits, veggie sticks, nuts, popcorn, whole grain crackers instead of chips.
7. Substitute white flour with whole grain flour...great for pancakes.
8. Choose whole grain cereals.
9. Read food labels.
10. Add fiber gradually to your diet.
11. Add a spoonful of flaxseed to your food.
Here are some examples of foods with their fiber counts:
2 slices of whole-wheat bread = 4 grams of fiber
1 cup of cooked brown rice = 4 grams
Reduced-Fat Triscuit crackers = 3 grams
¾ cup cooked oatmeal = 3 grams
1 cup of canned minestrone soup = about 5 grams
1/2 cup vegetarian or fat-free refried beans = about 6 grams
1/4 cup kidney beans, added to a green salad = 3 grams
1 large apple = 4 grams of fiber
1 banana = 3 grams
1 cup strawberries = 4 grams
1 cup cooked broccoli = 4.5 grams
1 cup raw carrots = 4 grams
1 sweet potato = 4 grams
1 cup cauliflower, cooked = 3 grams
2 cups raw spinach leaves = 3 grams
Talk to your health care professional about dietary fiber. In some cases, patients may need fiber supplements such as Metamucil or Benefiber
Thank you and drive carefully!
Tuesday, February 2, 2010
Eye Floaters
34 year old male presented to my office with complaints of seeing spots and transient blurry vision. He stated it began about a week ago after recovering from a cold. He describes the spots as bright "sperm-like" things. The blurry vision occurred when he was reading a book. He could not read the preceding word when focusing on a specific word but after a few minutes, the vision cleared. He also complained of a mild frontal headache. In the office, he continued to see the bright spots, but otherwise felt well. His blood pressure was excellent and his physical exam was unremarkable. He was sent to the eye doctor with the presumed diagnosis of visual floaters. The diagnosis was confirmed after the retinal examination.
Visual floaters (entopsias) are common, typically after the age of thirty five. They are from pieces of the vitreous gel in the eye that float and drift aimlessly in the eye ball. They can be described as spots, specks, cobwebs, light-flashes, strings, or clouds in the visual field. Floaters are more evident on a white or bright background. They may interfere with vision depending on the location but they are constantly moving and eventually settles to the floor of the eye.
Risk factors include older age, near-sightedness, Diabetes, sarcoidosis, syphilis, history of retinal disease, or previous cataract surgery.
Floaters are typically not a major problem. They tend to be an annoyance. An ophthalmologic examination is recommended to assess the retina. Medical concerns include retinal detachment (emergency), diabetic retinopathy, vitreous detachment (severe), bleeding in the eye, and infection.
If there is a sudden onset of floaters or if there are flashing lights with the floaters, contact the eye physician immediately. Also, if there seems to be a shade coming down the visual field, contact the eye specialist immediately. These are signs of a retinal detachment.
Floaters tend to dissipate with time. The brain also adapts to the presence of floaters and they become less annoying. There is no safe proven method to eliminate floaters. Surgical intervention may be utilized in very severe cases. Talk to you health care professional for more information.
Thank you.
Visual floaters (entopsias) are common, typically after the age of thirty five. They are from pieces of the vitreous gel in the eye that float and drift aimlessly in the eye ball. They can be described as spots, specks, cobwebs, light-flashes, strings, or clouds in the visual field. Floaters are more evident on a white or bright background. They may interfere with vision depending on the location but they are constantly moving and eventually settles to the floor of the eye.
Risk factors include older age, near-sightedness, Diabetes, sarcoidosis, syphilis, history of retinal disease, or previous cataract surgery.
Floaters are typically not a major problem. They tend to be an annoyance. An ophthalmologic examination is recommended to assess the retina. Medical concerns include retinal detachment (emergency), diabetic retinopathy, vitreous detachment (severe), bleeding in the eye, and infection.
If there is a sudden onset of floaters or if there are flashing lights with the floaters, contact the eye physician immediately. Also, if there seems to be a shade coming down the visual field, contact the eye specialist immediately. These are signs of a retinal detachment.
Floaters tend to dissipate with time. The brain also adapts to the presence of floaters and they become less annoying. There is no safe proven method to eliminate floaters. Surgical intervention may be utilized in very severe cases. Talk to you health care professional for more information.
Thank you.
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