Another Reason to Brush

Posted on April 14, 2013 by Terrance Cleveland DDS

There have been so many studies on Alzheimer’s Disease. Causes? Cure? This disease causes brain changes that gradually get worse. It’s the most common cause of dementia. In Alzheimer’s disease, brain cells degenerate and die, causing a decline in memory and mental function. Some days I am sure this is why I can’t find my cell phone! A recent study correlates daily brushing with dementia. The article below was posted by teethcenter.com, and while the study doesn’t seem definitive, it points strongly towards the benefits of brushing. Hoolulu Denist

Daily Brushing Associated with Lower Risk of Dementia

The Journal of American Geriatrics has released a study claiming that daily brushing is associated with a lower chance of developing dementia late in life. The study observed 5,468 people over a period of 18 years. All participants in the study resided at a retirement community in Southern California.

Of the 5,468 studied, 1,145 developed some form of dementia and those who developed dementia were much less likely to brush daily and maintain good oral health habits. Richardson, a spokesperson for TeethCenter said, “This report leaves plenty of room for interpretation. I think it’s safe to say that the adults that exercised healthy oral health habits had a lower case of developing dementia, but, why is that the case?”

Researchers on the study warned that the study “did not prove a cause and effect between oral health and dementia”. It has been long suggested that oral health is directly related to overall health as people who care for their teeth tend to care for their bodies, but, the direct correlation and causation is still unclear.

Source: http://www.teethcenter.com/daily-brushing-associated-with-lower-risk-of-dementia/ Sept 14, 2012. Reprinted by permission.

In my Honolulu dental practice, we really focus on preventative care. Good oral home care is the cornerstone of good oral health and should be supplemented with regular exams and cleanings. It makes sense that all of our bodies systems are connected, and oral health is connected to overall health. As a dentist, I know this is a fact. We are learning, more and more. Someday we will have all the answers… but until then, I’ll just brush at least twice a day… unless I forget.

Cambodia… Open Wide !!

Posted on March 31, 2013 by Terrance Cleveland DDS

A Honolulu Dentist on a mission to Cambodia

A lot of things have happened since November… here in Hawaii we get caught up in the holiday season, if you can imagine coconut trees strung with Christmas lights.

As if the holiday season was not busy enough, I spent all of February off island. I worked again at the Molokai Community Health Center, and then spent several weeks in Cambodia where I was blessed to participate with the Cambodia Health Professional Association of America (CHPAA) and their medical mission to Cambodia. Cambodia is one of the world’s poorest nations. The civil war from 1970 to 1975, the Khmer Rouge regime from 1975 to 1979, and the Cambodia-Vietnam War from 1978 to 1979 virtually destroyed Cambodia’s economy. Although progress is being made, as of 2007 the latest year UN Statistics are available, 30% of the population falls below the national poverty level. Poverty in Cambodia is overwhelmingly a rural phenomenon. Over 93% of the country’s total number of poor live in rural areas, 6.2% live in urban areas, with a tiny percentage in urban Phnom Penh. CHPAA’s mission is to provide medical and dental care to those desperately in need.

Patients came from miles around, lining up overnight with the hopes of being treated

In Cambodia, one of the free clinics was set up at the Khmuonh Health Center in Khan Sen Sok, a municipality of Phnom Penh and one of the most underserved areas in the Cambodian Capital. Seen on a first-come, first-served basis, patients came from the surrounding areas, other parts of Phnom Penh and distant provinces. The need for care is great. In addition to this clinic, radio and television announcements brought many patients to outlying clinics where part of the medical/dental team travelled to each day. It was a busy week. By midmorning of our first clinic day, there were thousands of people lined up. They came from surrounding villages, overnight and got in line.. hoping for their chance.

There were 11 dentists total participating in this 3 week clinic. About half of us stayed at the Khmuon Health Center, and the rest of us, travelled daily to outlying communities. The day started at 6am with an average of an hour bus ride and each day, we would visit a different location. I was responsible for making sure that all the equipment and supplies needed for the day was available, and was the only dentist who was assigned to the travelling clinic for the entire mission.

Once there, our first task was to set up the clinic.

Dental chairs ready to treat patients Again, patients lined up with the hopes of being treated were triaged, and the dental patients were sent our way. Many of the people had never seen a dentist, and were experiencing dental pain. Unfortunately, most teeth were not able to be saved, and needed to be extracted.

working on a patient It was a truly humbling experience. Poverty rates are high among those whose household heads have little or no education, dental education is non-existent at its most basic level. Many patients were unfamiliar with the use of a toothbrush and still had fears that an extraction of a tooth would result in blindness. My heart went out to them and I look forward to returning again.

It is dry season in Cambodia. It is beautiful and exotic. On the way to the outlying clinics, we saw some beautiful areas which were dedicated to agriculture.

True to form, I love to eat and found the food delicious and different. Most exotic? fried tarantulas… quite tasty actually.

Dental Gastronomy: Strenghtening your tooth enamel with Collards

Posted on November 14, 2012 by Terrance Cleveland DDS

I love being a dentist in Honolulu. I enjoyed living on the mainland while I was in college, and then again as I pursued my Doctorate in Dentistry, but I sure missed local style foods. Lucky for me, healthy eating is important for good oral health! Have you been to the new gastropub in Moilili? Gastronomy is the art or science of food eating… so why not dental gastronomy? Eating food that is good for your oral health!

Weak tooth enamel leaves your teeth vulnerable to tooth problems like cavities, chipping and sensitivity as the enamel thins and breaks. Ok, not so good, but not like anyone wants to think about tooth enamel all the time. I do like to think about food though! One of the strategies to stop the weakening of the enamel is to watch what we eat. Sugary, starchy and acidic foods feed the Streptococcus mutans and lacto bacillus bacteria that cause tooth decay. Even my beloved diet coke can be highly acidic. Yikes.

Lucky for me, I am one of those people who lives to eat.. as opposed to those who just eat to live! I am happy to eat those yummy foods that just happen to strengthen my tooth enamel at the same time. Vitamin K is known to strengthen tooth enamel when paired with Vitamin D. Since vitamin D is easy to come by in sunny Hawaii, (and also included in my skim milk), I am looking for vitamin K. Abundant in collards, which by the way has more calcium than milk, and is grown locally in Hawaii. I have been making a Hawaii style version of Brazilian collard greens Mineira. Super fast.. and tasty. It is nothing like the collards cooked to extinction that my dad remembers growing up in North Carolina. affordable honolulu dentist

Mineira Oahu

1 bunch collards, stems removed. (about 1 pound)
3 slices Spam (or bacon) thinly sliced into sticks
¼ round onion, minced
2-3 cloves minced garlic
1 c extra firm tofu, quarter inch dice
Lemon juice, dash of shoyu and dash of pepper to taste.

Directions:
Wash collards and remove stems, Stack the leaves one on another, and roll from stem ends to tips into a cigar shape. Cut cross wise into 1/8 inch strips, much as you would to chiffonade herbs)
In a non-stick skillet over medium high heat, cook spam, onion, garlic until onion is translucent, and spam has browned. Stir in tofu and sauté briefly. Add collards to pan and cook, stirring until just wilted and bright green (this will take 3 minutes or so) Honolulu Dentist helathy eating

I could eat this all myself, but it makes a great side vegetable dish for 4.

As a Honolulu Dentist, I have an interest in anything that impacts oral health. This dish is tasty, and great for your health!! Now that is a strategy I can sink my teeth into!!

Mouthpieces Improve Athletic Performance

Posted on November 5, 2012 by Terrance Cleveland DDS

The Hawaii Midweek – October 24 issue had a huge feature article on our Hawaii boys playing for the Oregon Ducks- particularly Marcus Mariota, the Ducks’ starting freshman quarterback! Looks like the UH Warriors missed out by not snatching him up this year.. auwe, what were we thinking? While I am not a consistent football follower, some things make you sit up and take notice. Marcus is definitely one to watch.

Hawaii’s own Marcus Mariota; graduated from St. Louis and now plays with the OregonDucks

Of course, as a Honolulu Dentist, I tend instead to follow everything related to oral health. This is probably weird, but while thinking about football, I am thinking about custom fitted mouthpieces! Mostly as a way to protect our athletes, and their healthy teeth and beautiful smiles…. but did you know that fitted mouthpieces can actually improve performance?? Honolulu Dentist

The use of mouthguards and sports have been documented since the 1800’s when a London dentist fitted boxers teeth with strips of resin. Dental and head injuries have increased in sports such as football, boxing, and hockey to the point that some professional to high school athletic teams have mandated the use of mouthguards in attempts to reduce these injuries. The 2008-2009 National Collegiate Athletic Association Sports Medicine handbook mandates the use of mouthguards during football, women’s field hockey, ice hockey and men’s lacrosse.

The American Dental Association’s Council on Access, Prevention and Interprofessional Relations and Coouncil on Scientific affairs concluded that mouth guards provide a protective effect against hard-tissue or soft tissue damage in the mouth. Injuries such as tooth fractures, lip lacerations and mandibular damage were impacted. Honolulu Dentist

A recent trend however, is the increased use of mouth pieces for improved performance. In the 1970-1980’s reports of improvement of muscular strength, endurance, and increased ability to train harder and recover from an injury at a faster rate with a mouthpiece, vs without a mouthpiece. This older research however was deemed unreliable because of the possibility of a placebo effect.

Recent research, conducted by Dena P. Garner, PhD; Wesley D. Dudgeon, PhD, Timothy P. Scheett, PhD, and Erical J. McDivitt, MS, The purpose of their study was to determine if use of a mouthpiece would alter the cortisol levels during training, and thus begin to explain the improved performance that mouthpiece users have been experiencing. They found that custom fitted mouthpieces resulted in a significant difference in Cortisol levels. Reducing levels of cortisol is ideal for an athlete to achieve tissue growth and positive adaptations to exercise training.

It seems that one factor required to improve results is to ensure a well fitting mouthpiece. The researchers reported that a 1991study (Francis and Brasher) showed a decrease in voluntary oxygen consumption, instead of the increases that they found in their recent study. They attributed it to the use of well -fitting mouthpieces that did not create any obstruction in breathing. Honolulu dentist

Dena P Garner, P., Wesley d. Dudgeon, P., Timothy P Sheett, P., & Erica J McDivitt, M. (2011, September). The effects of mouthpiece use on gas exchange parameters during steady-state exercise in college-aged men and women. The Journal of the American Dental Association, pp. 1041-1047. Honolulu dentis

Dena P Garner, W. D. (2011, October). The Effects of Mouthpiece use on Cortisol Levels during and intense bout of Resistance Exercise. Journal of Strenght and Conditioning Research.

Honolulu Dentist, affordable quality care

Honolulu Dentist does Molokai

Posted on October 27, 2012 by Terrance Cleveland DDS

I was on Molokai this week for the first time to work at the Molokai Community Health Center– Dental Clinic. From Oahu it is a short plane ride, and incredibly beautiful, so I wondered why I never went before. To get there I took a flight on Mokulele Airlines. Small 9 seater. It was fast- 20 minutes. No hassles, no long lines. That should have been a clue of more to come.

Molokai Community Health Center- Dental Clinic

The Molokai Community Health Center (MCHC) strives to provide accessible health care for the island of Molokai with respect and aloha. Dental health services are provided by a full time Dental Director, Dental Hygienist, several assistants, and a Dental Receptionist. Dental hygiene and patient education of dental care are among the priorities of the staff. I was fortunate enough to be able to participate and see the good work they do first hand this last week by filling in for the director who was off island. The dental clinic was busy attending to people of all ages, from children to seniors. We were fully booked each day I was there! One concern of mine was the amount of dental disease in the youngest patients. One child at 16 months had the condition referred to as “baby bottle caries”. This term refers to the pattern of decay in baby teeth caused by allowing infants to sleep with their bottle containing milk or juices etc. Sadly, Hawaii has a higher incidence of this decay as compared to children on the mainland.

In the “State of Children’s Dental Health: Making Coverage Matter”, the PEW Center on the States gave Hawaii an “F” for its performance in the area of children’s dental health. Hawaii was the worst overall performer among the fifty states and the District of Columbia. Auwe!

I was proud to be able to provide care. The Molokai Community Health Center- Dental Clinic’s priority of education and adoption of good dental hygiene habits, habits are so important to having good oral health. As a preventative dentist, I also emphasize regular dental cleanings and exams, consistent home care, consisting of tooth brushing, flossing and rinses, and timely intervention for any dental issues.

Kamehameha V Highway (Highway 450)

Molokai is quiet, remote, and beautiful. It is most famous for the Kalaupapa Leper Settlement, and Father Damien who recently achieved sainthood for the work he did for the people of Molokai. There is a mule trip that you can take down to visit the historic Settlement that I did not take this time. Instead, I chose to explore Highway 450 to East Maui.

We planned to head out to Halawa Park at the very end of the road. Before the trip, we were advised to stop at the Saint Joseph’s Church in Kamalo, established by Father Damien, and sign the guestbook. It is the second oldest church in Molokai, and worth a stop. Thus fortified, we were on our way. I was reminded of the ‘road to Hana’ another famous Hawaii road on Maui. Highway 450 was curvy, narrow and scary with speeds of 20 miles per hour or less in some areas, and seemed to take forever. In fact, the trip from Kaunakakai took an hour and a half, but was not very far!

Highway 450 was scenic and definitely worth the trip. Along the way we passed the Pu’u O Hoku Ranch which is a beautiful resort that you can visit and also stay at. Keep on going though, and you will be rewarded with Halawa Bay. This beach park was definitely worth the drive. We couldn’t stay long as it was getting dark. Next time we will start early, and bring a picnic lunch!

Back to Honolulu

I enjoyed my week, but back to Oahu and my Honolulu dental office. I could tell that the need for dental care was great in Molokai and am so grateful for the opportunity. It was such a great feeling to be doing what I love, providing dental care, in such a beautiful place.re almoana

Hello world!

Posted on October 17, 2012 by Terrance Cleveland DDS

Welcome to my blog! I started this blog as a way of connecting with you, and to have a dialog about all things relating to dental health… from new technologies and scientific learnings, to basic oral care information that will be useful to you as you go about your daily life. I have a passion for everything dental, so in addition to great oral health, I am also interested in products on the market, products for caring for your teeth.. and products we put in our mouths.. I guess in my case, that is mostly food.. and yes, we will talk about that as well… as it relates to oral health of course.

There is so much information out there… some really good… but sadly, some misinformation as well. I promise that the information on the topics we discuss will be well researched, and if it is just my opinion, I will let you know. I hope to engage you.. so please comment and let me know what you are thinking. I also hope you will find this blog entertaining, and enjoy reading this. Ask me anything, I will try my best to provide you with the information you need.

I was raised on the island of Oahu. In the summer when the surf is up on the South Shore, you will find me in the water at the crack of dawn. I can’t think of a better life, living in Hawaii, and doing dentistry. Every day, I get to live in paradise and take care of Hawaii’s oral health. I love the islands and the community. Through our discussions, I hope to give you insight into Hawaii and its’ oral health, and how it is to live and work in this beautiful place.

Terrance Cleveland DDS – Honolulu Family Dentist

Honolulu Dentist – Healthy Teeth make Beautiful Smiles