Ear Infections Prevention Tips

Ear Infections

 

Few pains are more excruciating to a young child than an earache. After the common cold, an ear infection is the most frequent childhood illness and three out of four children will experience an ear infection by their third birthday.

 

The ear has three parts: the outer ear, middle ear and inner ear, Rice explains. The outer ear, which collects sound, includes the part outside the head and the ear canal. At the end of the ear canal is the eardrum, a small circle of tissue about the size of a fingertip. Behind the eardrum is the middle ear, which is normally filled with air. When the eardrum vibrates, tiny bones in the middle ear transmit the sound to the inner ear, where nerves relay sound signals to the brain.

 

Causes

 

"Middle ear infections are usually a complication of upper respiratory infection, such as a cold," Rice says. Bacteria travel up the Eustachian tube, a tiny tunnel that connects the back of the nose and throat to the middle ear.

 

When the tube is blocked, fluid builds up in the middle ear, causing the ear to ache and swell. In children, this tube is shorter than in adults and allows germs to reach the ear more easily. Another reason children are more prone to earaches than adults is because their immune systems are not fully developed, Rice adds.

 

Symptoms

 

In babies and young children, symptoms of a middle ear infection include:

 

• Hearing problems
• Unusual irritability
• Tugging at ears
• Fever
• Vomiting
• Ear drainage
• Diarrhea

 

Complications

 

Although rare, complications from untreated ear infections include:

 

• Eardrum rupture
• Infection of the inner ear (labyrinthitis), which causes dizziness and imbalance
• Infection of the skull behind the ear (mastoiditis)
• Infection of the membranes around the brain and spinal cord (meningitis)
• Scarring and thickening of the eardrum
• Facial paralysir
• Permanent hearing loss

 

Treatment

 

"Ear infections, like other infections, are essentially treated with antibiotics," Antibiotic drops may be prescribed if pus is leaking from the ear. If a child has a bulging eardrum and is in severe pain, a surgical incision may be made to the eardrum to release the pus.

 

Prevention

 

"You can avoid middle ear infections by keeping your child away from cigarette smoke and playmates who are sick," says Rice. Studies have shown that children who breathe tobacco smoke have a higher risk of developing health problems, including ear infections.

Diphtheria Prevention Tips

What is it?


Diphtheria is an acute and highly contagious bacterial infection that mainly affects the nose and throat.

Who gets it?

Children under 5 years old and adults over 60 are particularly at risk for contracting diphtheria, as are those living in crowded or unsanitary conditions, the undernourished, and children and adults who do not have up-to-date immunizations.

Diphtheria is rare in the United States and Europe, where health officials have been immunizing children against it for decades. However, it is still common in developing countries where immunizations are not given routinely.

What causes it?

The toxin, or poison, caused by the bacteria can lead to a thick coating in the nose, throat, or airway. This coating is usually fuzzy gray or black and can cause breathing problems and difficulty in swallowing.

What are the symptoms?

In its early stages, diphtheria can be mistaken for a bad sore throat. A low-grade fever and swollen neck glands are the other early symptoms.

In more advanced stages, the patient may have difficulty breathing or swallowing, complain of double vision, have slurred speech, or even show signs of going into shock (pale, cold skin; rapid heartbeat; sweating; and an anxious appearance).

How is it diagnosed?

Children and adults with diphtheria are treated in a hospital.

After a doctor confirms the diagnosis through throat culture and blood counts, the infected person receives a special anti-toxin to neutralize the diphtheria toxin already circulating in the body, as well as antibiotics to kill the remaining diphtheria bacteria. The anti-toxin is given through injections or intravenously. The patient is closely watched while the anti-toxins are given because the solution, which is made from horse serum (blood), may cause an allergic reaction.

What is the treatment?

If the infection is advanced, patients may need mechanical assistance to breathe. In cases where the toxins may have spread to the heart, kidneys, or central nervous system, patients may need intravenous fluids, oxygen, or cardiac medications.

The patient must be isolated. Family members who have not been immunized, or who are very young or elderly, must be protected from contact with the patient.

Your child's doctor will notify the local health department and will take steps to treat everyone in the household who may have been exposed to the bacteria. This will include assessment of immune status, throat cultures, and booster doses of diphtheria vaccine. They will also receive antibiotics as a precaution.

Self Care Tips

Preventing diphtheria depends almost completely on immunizing children with the combined diphtheria/tetanus/pertussis (DTP or DTaP) vaccine and non-immunized adults with the diphtheria/tetanus vaccine (DT). Most cases of diphtheria occur in people who haven't received the vaccine at all or haven't received the entire course.

The immunization schedule calls for DTP or DTaP vaccines at 2, 4, and 6 months of age, with booster doses given at 12 to 18 months and then at 4 to 6 years. Booster shots should be given every 10 years after that to maintain protection.

Diabetes Health Tips

Diabetes - General Information

Artificial Pancreas Safe, Effective in Early Study

An "artificial pancreas" designed to deliver the key blood sugar-regulating hormone insulin to diabetic patients without the need for injections has been found safe and effective in a preliminary study with ten patients.

The device is an insulin reservoir, implanted in the tissue lining the abdominal cavity and connected to a sensor implanted in the jugular vein. The reservoir requires insulin refills every month or so. When the sensor detects an increase in blood glucose, the reservoir delivers the required amount of insulin.



Blood Glucose Testing

Most insurances now pay for diabetics to have blood glucose monitoring equipment in the home. Keeping the machines clean and in good working order are vital for accurate results. Follow the manufacturers' instructions for proper cleaning and maintenance.



Blood Glucose Testing Tip

Be sure hands are clean before performing the test, but don't use alcohol to cleanse your fingertip. It's drying and may cause fingertips to crack. Wash hands with a mild antibacterial soap like Dial.



Diabetes Test After Heart Attack Shows Future Risk

Testing patients who have had heart attacks for signs of diabetes before they leave the hospital may identify those with the highest risk of future heart attacks. Many people hospitalized for a heart attack have undiagnosed diabetes or prediabetes, a term coined to describe the millions of overweight and obese people who have blood sugar levels suggesting an elevated risk of full-blown diabetes. Medications, exercise and diet changes, all of which can restore normal glucose levels, may reduce the risk of heart attacks in patients who have already had a heart attack.



Diabetic Dental Care

Immaculate mouth care is a must. Diabetics are much more prone to gum disease. More frequent dental visits may be needed and careful brushing and flossing are a necessity. Avoid ill-fitting dentures that may cause mouth sores.



Diabetic Eye Care

If you're a diabetic, regular visits to your eye care professional are a must to prevent problems that could lead to blindness.



Diabetic Foot Care Tips

* Take the pressure off your feet by losing weight if you are obese.

* Inspect your feet at least once per day. If you can't see well, ask someone to do it for you.

* Wash feet with mild soap and lukewarm water daily.

* Wear white cotton socks rather than synthetic ones with dyes.

* Don't go barefoot or wear ill-fitting shoes.

* See a podiatrist regularly for toenail trims and other routine maintenance.



Diabetics Are Prone to Foot Problems

Diabetics have decreased sensation and circulation in their feet making them prone to foot infections/wounds that could eventually lead to amputation.



Drug Could Delay Diabetes

Acarbose, a drug that blocks the digestion of starch, could prevent or delay the development of the most common form of diabetes in those with slightly high blood sugar.



Exercises to Avoid

Diabetics should avoid exercises that involve pushing or pulling heavy objects and lifting weights. Blood sugar levels and blood pressure are raised during this kind of exercise.



FDA Approves New Sweetener Neotame

A non-nutritive sweetener said to be 7,000 to 13,000 times sweeter than sugar received approval from the U.S. Food and Drug Administration to be marketed as an additive in candies, soft drinks and various other products.

Like other familiar sweeteners, Neotame is a white crystalline powder that dissolves in water. It is made by Monsanto, which also makes NutraSweet's sweetener Equal. Neotame is approved for use in baked goods, nonalcoholic beverages, chewing gum, confections, frozen desserts, gelatins and puddings, jams, jellies, fruit, juices, toppings and syrups.

The FDA declared the product to be safe for consumption after reviewing more than 113 animal and human studies, some of which looked at any possible links with cancer-causing or neurological side effects.


Inhaled Insulin

Inhaled insulin may soon offer an alternative to needles for people with diabetes.

Novo Nordisk, a Denmark-based company, has ongoing clinical trials to test the safety and effectiveness of an electronic pulmonary insulin system. They say it may be available in the United States and Europe within a few years.

This is the first electronic pulmonary insulin system currently being tested in clinical trials. It works by converting a special liquid insulin into aerosol particles, which are inhaled into the lungs.

Regular Exercise Is a Must

Exercise is extremely important for diabetics as it strengthens the cardiovascular system, increases circulation to the arms and legs and helps control blood sugar levels. Walking, jogging, rowing and swimming are best.

Shoes for Diabetics

* Avoid plastic shoes and waterproof shoes. They encourage perspiration and fungal growth.

* Avoid tight or unventilated footwear.

* Don't wear boots all day.

* Choose cotton or leather shoes.

* Wear sandals as much as possible in the summer.

* Don't wear the same shoes two days in a row.

* Air shoes in the sun to inhibit fungal growth.


Small, Frequent Meals

Diabetics should follow their American Diabetic Association diet and eat small meals more frequently such as three small meals with one or two healthful snacks between meals. This helps maintain a more stable blood sugar level.

Treatment of Hyperglycemia

Some symptoms of hyperglycemia (high blood sugar) are: excessive urination, weight loss, excessive hunger and thirst. If you are experiencing any of these symptoms, you should see your doctor.

Treatment of Hypoglycemia

Some symptoms of hypoglycemia (low blood sugar) are: cool, clammy skin, numbness of the mouth, a fluttering in your chest, hunger and feeling faint. Emergency treatment includes ingesting something containing sugar like orange juice, a candy bar, or sugared soda pop. Follow that with some cheese or peanut butter crackers to sustain your blood sugar level.
What's an Exchange?

In an exchange diet, foods that are similar are grouped together. Serving sizes are well defined so that each will have the same amount of carbohydrate, fat, and protein as any other. Foods can be "exchanged" or traded with others in a category while still meeting the desired overall goals. Exchanges can be applied to most any eating situation and may make it easier to follow a prescribed diet. For example, if a nutrition plan calls for one starch exchange a person could choose 1/2 cup of cooked pasta, OR one slice of bread, OR a small (3 oz.) baked potato.

Rest

Having diarrhea for more than a couple of days can be very exhausting. If you have lost a lot of fluid you are bound to feel very tired and weak. So it's very important to let your body rest when you can.


Ask family and friends to help you with things like cooking, cleaning the house, shopping and collecting the kids from school. They really won’t mind so don’t be afraid to ask. It’s important you get all the help and rest you need.

Being prepared when you go out

One of the hardest things about having diarrhea is that it can sometimes happen so suddenly. You will probably want to be close to a toilet at all times to avoid accidents.

 

If an accident does happen it is very natural to feel embarrassed and upset, even if no one else knows about it. You may worry that people will smell it. This is very hard to cope with so try not to be too hard on yourself. Your close family and friends will understand and will only want to make things as easy as possible for you.

 

To avoid accidents when you go out, you can help to prepare yourself

 

• Know exactly where the toilets are in the place you are going
• Don’t go on long car, train or bus trips
• Take spare underwear, pads, soothing creams and a plastic bag with you, just in case. You can always rinse out underwear you have on in the bathroom sink and put it in the bag to take home. No one needs to know about this
• Wearing a pad can help protect your underwear and make you feel a bit safer
• If you have a colostomy take a spare colostomy bag with you. There are products on the market that can help mask the smell from a colostomy so ask your stoma nurse about these.

 

And also when you are at home, try to

 

• Protect your mattress - put a large pad or towel on your bed if you are worried about having an accident during the night
• Leave a night light on near your bed, in the hallway and bathroom so that you can see where you are going and get to the toilet quickly

 

There are disposable waterproof bed pads on the market that are made for toddlers during toilet training. These can be very handy and help you to feel more secure. You can buy these in supermarkets. Or your nurse may be able to give you some from the hospital, as they use a similar product.

 

If you aren’t able to move quickly, you may feel safer with a commode by the bed. Your nurse can help you arrange to borrow a commode for as long as you need it.

 

Even if it is embarrassing, it is important to let your doctor know if you are having accidents. They may be able to change your anti-diarrhoeal drugs

Looking after the skin around your anus

Looking after the skin around your anus


The skin around your back passage (anus) can become very sore and may even break down if you are having severe diarrhea.

These tips may help

Use unscented baby wipes instead of toilet paper to wipe yourself after you’ve been to the toilet

Have a warm bath to help soothe pain and help with healing. Do this a few times a day if necessary

Pat the area dry with a soft towel after a shower or bath - don’t rub

Ask your doctor or nurse about soothing creams to apply around your anus

Avoid wearing tight trousers or underwear

Cotton underwear will help to keep the area ventilated – nylon can make you sweat and cause even more soreness

Drinking plenty

You lose a lot of fluid if you have diarrhea so it is important to replace this to prevent dehydration. Drink as often as you can, even if it is just small sips. And avoid alcoholic drinks, as they make you lose fluid, rather than replacing it.


The best types of fluids to drink include

Water

Herbal teas

Clear soups

Non fizzy drinks

Electrolyte replacement drinks such as Dioralyte

Soy milk

Managing your diet

Although it is usually better for us to eat a diet high in fiber, this makes diarrhea worse. So if you have diarrhea you will need to break the rules for a while and eat foods that don’t contain too much fiber. It’s best to check with your doctor how long you should do this for.


Foods high in fiber include

High fiber cereals such as bran

Wholegrain breads

Dried and fresh fruit

Nuts

Vegetables such as broccoli, cabbage, cauliflower and beans

Other foods that tend to make diarrhea worse include

Greasy, fatty and fried foods

Foods with caffeine in them – chocolate and coffee

Dairy foods such as milk, yogurt, cheese, butter and cream

Some foods tend to make your stools firmer so try these instead

Rice and pasta

Potatoes without the skin

Dry cracker biscuits

Baked foods

White bread

Pretzels

Bananas

Chicken, beef or fish

Avoid pickled and spicy foods as these irritate the digestive tract and can make diarrhea worse. Eating several small meals a day instead of 3 large ones can help you feel less bloated.

Diarrhea Prevention Tips

Tips on how to cope with diarrhea


This page has some suggestions for ways to cope with diarrhea. As well as taking any medication from your doctor, it’s possible to make small lifestyle changes to help you cope better. These include

Psychological Treatment

There are a wide range of psychological treatments for depression.

 

Some of the main ones are:

 

• Cognitive Behavior Therapy (CBT)
• Interpersonal Therapy (IPT)
• Psychotherapies
• Counseling
• Narrative Therapy

 

CBT, IPT, psychotherapy and counselling all provide either an alternative to medication or work alongside medication. As always, a thorough assessment of the person is needed in order to decide on the best set of approaches.

 

Cognitive Behaviour Therapy (CBT)

 

People suffering from depression - particularly 'non-melancholic depression' - will often have an ongoing negative view about themselves and the world around them. This negative way of thinking is often not confined to depression, but is an ongoing part of how the person thinks about life. Many or all of their experiences are distorted through a negative filter and their thinking patterns become so entrenched that they don't even notice the errors of judgement caused by thinking irrationally.

 

Cognitive behaviour therapy aims to show people how their thinking affects their mood and to teach them to think in a less negative way about life and themselves. It is based on the understanding that thinking negatively is a habit, and, like any other bad habit, it can be broken.

 

CBT is conducted by trained therapists either in one-on-one therapy sessions or in small groups. People are trained to look logically at the evidence for their negative thoughts, and to adjust the way they view the world around them. The therapist will provide 'homework' for between sessions. Between 6-10 sessions can be required but the number will vary from person to person.

 

CBT can be very beneficial for some individuals who have depression but there will be others for whom it is irrelevant.

 

Interpersonal Therapy (IPT)

 

The causes of depression, or our vulnerabilities to developing depression, can often be traced to aspects of social functioning (work, relationships, social roles) and personality .

 

Therefore, the underlying assumption with interpersonal therapy is that depression and interpersonal problems are interrelated.

 

The goal of interpersonal therapy is to help the person understand how these factors are operating in the person's current life situation to lead them to become depressed and put them at risk to future depression.

 

The therapy occurs in three main phases:

 

an evaluation of the patient's history

 

an exploration of the patient's interpersonal problem area and a contract for treatment

 

recognition and consolidation by the patient of what has been learnt and developing ways of identifying and countering depressive symptoms in the future.

 

Usually 12-16 sessions of IPT will be required.

 

Psychotherapies

 

Psychotherapy is an extended treatment (months to years) in which a relationship is built up between the therapist and the patient. The relationship is then used to explore aspects of the person's past in great depth and to show how these have led to the current depression. Understanding this link between past and present - insight - is thought to resolve the depression and make the person less vulnerable to becoming depressed again.

 

Counselling

 

Counselling encompasses a broad set of approaches and goals that are essentially aimed at helping an individual with problem solving - solving long-standing problems in the family or at work; or solving sudden major problems (crisis counselling).

 

Narrative Therapy

 

Narrative Therapy is a form of counselling based on understanding the 'stories' that people use to describe their lives. The therapist listens to how people describe their problems as stories and helps the person to consider how the stories may restrict them from overcoming their present difficulties. It sees problems as being separate from people and assists the individual to recognise the range of skills, beliefs and abilities that they already have (but may not recognise) and that they can apply to the problems in their lives.

 

Narrative Therapy differs from many therapies in that it puts a major emphasis on identifying people's strengths, particularly as they have mastered situations in the past and therefore seeks to build on their resilience rather than focus on their negatives.

Physical Treatment

The main physical treatments for depression comprise


Drug treatments

Electroconvulsive therapy

A third physical treatment with as yet narrow application is

Transcranial magnetic stimulation.

Drug Treatments

There are three groups of drugs most likely to be used for depression:

Antidepressants

Tranquillisers

Anti-manic drugs or mood stabilisers

Antidepressants

There is a large number of antidepressants - they have a role in many types of depression and vary in their effectiveness across the more biological depressive conditions.

Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclics (TCAs) and Irreversible Monoamine Oxidase Inhibitors (MAOIs) are three common classes of antidepressants. They each work in different ways and have different applications.

At the Institute we believe that they are not, however, equally effective and that it is necessary to find the right antidepressant for each person.

If the first antidepressant does not work, it is sensible to move to a different kind of antidepressant. For the biological depressive disorders, more broad action antidepressants are usually more effective.

A well-informed health provider should be able to use their assessment of the type of depression, its likely causes and their understanding of the person to identify the medication most likely to benefit.

Finally, being able to decide not to use medication is important too.

Tranquillisers

These medications are usually called 'minor' or 'major' tranquillisers.

Minor tranquillisers (typically benzodiazepines) are not helpful in depression; they are addictive and can make the depression worse.

Major tranquillisers are very useful in people with a psychotic depression and in melancholia where the person is not being helped by other medications.

'Anti-manic' drugs or 'mood stabilisers'

These drugs are of great importance in bipolar disorder.

Their use in treating mania makes them 'anti-manic', while their ability to reduce the severity and frequency of mood swings makes them 'mood stabilisers'.

Lithium, valproate and carbamazepine are the most common.

It is important to remember that the anti-depressants and mood stabilisers are often necessary both to treat the depression that is occurring now, and to make a relapse in the future less likely. So people sometimes need to continue taking medication for some time after they are better.

Electroconvulsive Therapy (ECT)

Because of its controversial past many people feel the need to think carefully before having ECT or allowing it to be given to relatives.

Clinicians at the Institute firmly believe that ECT has a small but important role in treatment, particularly in cases of

Psychotic depression

Severe melancholia where there is a high risk of suicide or the patient is too ill to eat, drink or take medications

Life-threatening mania

Severe post-natal depression.

While there are some short-term side-effects, ECT is a relatively safe and, because an anaesthetic is used, not too unpleasant.

Transcranial magnetic stimulation (TMS)

A possible alternative to ECT is transcranial magnetic stimulation (TMS).

Transcranial magnetic stimulation is a procedure used by neurologists, both as a treatment and as diagnostic procedure. A coil is held next to the patient's head and a magnetic field created to stimulate relevant parts of the brain. Unlike ECT, there is no need for a general anaesthetic nor is a convulsion induced.

In our view, the evidence in favour of this treatment is not yet in, but it is a major area of research at the Institute and elsewhere. If TMS is shown to be as effective as ECT this would be a distinct advance in the treatment of many mood disorders. No clear evidence about its utility is expected for a number of years.

Treatments

A large number of different treatments are available for depression.

 

New treatments (particularly medications) appear regularly. Continuing research means that the evidence for how well a treatment works is always changing too. We have chosen to give only a brief summary of treatments and instead direct you to other sites which provide more comprehensive details.

 

Key points about treatments for depression

 

• We believe that different types of depression respond best to different sorts of treatments (see below).
• It's important that a thorough and thoughtful assessment be carried out before any treatment is prescribed.
• Treatments for depression include physical and psychological treatments.
• Depression can sometimes go away of its own accord but, left untreated, it may last for many months. Allow yourself to seek help.
• Depending on the nature of your depression, self-help and alternate therapies can also be helpful, either alone or in conjunction with physical and psychological treatments.

 

Different types of depression need to be treated differently

 

At the Institute we believe there are different types of depression, falling into the following three principal classes:

 

• Melancholic depression
• Non-melancholic depression
• Psychotic depression.

 

Those types of depression that are more biological in their origins (melancholic depression and psychotic melancholia) are more likely to need physical treatments and less likely to be resolved with psychological treatments alone.

 

We believe non-melancholic depression can be treated equally effectively with physical treatments (antidepressants) or with psychological treatments.

Causes of depression

While researchers often talk about ‘finding the cause’ of some disease or disorder this often obscures the fact that only part of the story is known.


Some causes are pretty straightforward. We know that a broken leg is usually the result of some kind of pressure or strain being applied. Moreover, if you have a broken leg you typically know when it happened (leg was fine yesterday, today it is broken) and how it happened (this morning you went skiing).

Things are not so simple with depression. We have good ideas about what some of the ‘pressures or strains’ that result in depression are – but they are not all agreed upon and there might be others.

For any one person there could be many ‘pressures’ in their life. It is often unclear when the depression started – much of the time it gradually has an effect.

We can see another complication by going back to the broken leg example. Some people suffer from osteoporosis which makes their bones more fragile (more vulnerable). If you only had a minor accident when you went skiing, your osteoporosis was probably as much the cause of your broken leg, since it made your leg more vulnerable to the effects of pressure. If you have a major accident, however, the leg will probably break, osteoporosis or not.

In other words, the causes of depression are some mixture of ‘pressure’ (mild to severe) combined with a vulnerability to depression (as a sort of ‘psychological osteoporosis’) which too can range from mild to severe.

As noted earlier, for each ‘type’ of depression, differing ‘mixtures of causes’ have differential relevance. Thus, for psychotic or melancholic depression physical and biological factors are generally more relevant. By contrast, for non-melancholic depression, the role of personality (osteoporosis) and life-event stressors (accident) are generally far more relevant.

Types of Depression

At the Institute we believe that there are three broadly different types of depression:

 

• Melancholic depression
• Non-melancholic depression
• Psychotic depression

 

each with their own features and causes.

 

A possible fourth type of depression is

• Atypical depression.

 

Why is this important? We believe that, as with any illness, the person suffering from it can’t be properly treated unless the specifics of their illness are understood.

 

We therefore believe that people who are depressed should receive a sophisticated assessment identifying their particular type of depression and its broad causes, whether biological, psychological or other.

 

 

 

Treatments should be selected according to the specific type of depression experienced by an individual, and its causes.

 

A description of the different types of depression follows.

 

Melancholic depression

 

Melancholic depression is the classic form of biological depression. Its defining features are:

 

a more severe depression than is the case with non-melancholic depression

 

psychomotor disturbance

 

Melancholic depression is a relatively uncommon type of depression. It affects only 1-2 per cent of Western populations. The numbers affected are roughly the same for men and women.

 

Melancholic depression has a low spontaneous remission rate. It responds best to physical treatments (for example antidepressant drugs) and only minimally (at best) to non-physical treatments such as counseling or psychotherapy.

 

Non-melancholic depression

 

‘Non-melancholic depression’ essentially means that the depression is not melancholic, or, put simply, not primarily biological. Instead, it has to do with psychological causes, and is very often linked to stressful events in a person’s life, alone, or in conjunction with the individual’s personality style.

 

Non-melancholic depression is the most common of the three types of depression. It affects one in four women and one in six men in the Western world over their lifetime.

 

Non-melancholic depression can be hard to accurately diagnose because it lacks the defining characteristics of the other 2 depressive types (viz psychomotor disturbance or psychotic features). Also in contrast to the other 2 depressive types, people with non-melancholic depression can usually be cheered up to some degree.

 

 

 

People with non-melancholic depression experience

 

a depressed mood more than two weeks

 

social impairment (for example, difficulty in dealing with work or relationships).

 

In contrast to the other types of depression, non-melancholic depression has a high rate of spontaneous remission. This is because it is often linked to stressful events in a person’s life, which, when resolved, tend to see the depression also lifting.

 

Non-melancholic depression responds well to different sorts of treatments (such as psychotherapies, antidepressants and counselling), but the treatment selected should respect the cause (e.g. stress, personality style).

 

Psychotic depression

 

Psychotic depression is a less common type of depression than either melancholic or non-melancholic depression.

 

The defining features of psychotic depression are:

 

an even more severely depressed mood than is the case with either melancholic or non-melancholic depression

 

more severe psychomotor disturbance than is the case with melancholic depression

 

psychotic symptoms (either delusions or hallucinations, with delusions being more common) and over-valued guilt ruminations.

 

Psychotic depression has a very low spontaneous remission rate. It responds only to physical treatments (such as antidepressant drugs).

 

Atypical depression

 

Atypical depression is a name that has been given to expressions of depression that contrast with the usual characteristics of non-melancholic depression. For example, rather than experiencing appetite loss the person instead experiences appetite increase; and sleepiness rather than insomnia. Someone with atypical depression is also likely to have a personality style of interpersonal hypersensitivity (that is, expecting that others will not like or approve of them).

 

The features of atypical depression include:

 

The individual can be cheered up by pleasant events

 

Significant weight gain or increase in appetite (especially to comfort foods)

 

Excessive sleeping (hypersomnia)

 

Arms and legs feeling heavy and leaden

 

A long-standing sensitivity to interpersonal rejection —the individual is quick to feel that others are rejecting of them.

FAQ

What are the signs of depression?

 

How depressed should I be before I seek help?

 

What should I do if I'm feeling (or someone close to me is feeling) suicidal?

 

Am I always going to feel like this?

 

How long does depression last?

 

How is depression treated?

 

Where can I get help for depression?

 

How should I behave with someone who is depressed?

 

1. What are the signs of depression?

 

The following are a list of the features that may be experienced by someone with depression.

 

Lowered self-esteem

 

Change in sleep patterns

 

Change in mood control

 

Varying emotions throughout the day

 

Change in appetite and weight

 

Reduced ability to enjoy things

 

Reduced ability to tolerate pain

 

Reduced sex drive

 

Suicidal thoughts

 

Impaired concentration and memory

 

Loss of motivation and drive

 

Increase in fatigue

 

Change in movement

 

Being out of touch with reality.

 

Note that, having one or other of these features, by themselves, is unlikely to indicate that someone is clinically depressed. Also, having these features for only a short period (of less than two weeks) is unlikely to indicate clinical depression. It's also important to know that many of the above features could be caused by or related to other things, such as a physical illness, the effects of medications, or stress. Help in coming to such decisions should be assisted by a proper assessment by a trained professional.

 

2. How depressed should I be before I seek help?

 

Everybody feels down or sad at times. But it's important to be able to recognise when depression has become more than a temporary thing, and when to seek help.

 

As a general rule of thumb, if your feelings of depression persist for most of every day for two weeks or longer, and interfere with your ability to manage at home and at work or school, then a depression of such intensity and duration may require treatment, and should certainly benefit from assessment by a skilled professional.

 

3. What should I do if I'm feeling (or someone close to me is feeling) suicidal?

 

See the list of emergency contact numbers (and add the numbers of your General Practitioner and your local Community Mental Health Service) and keep a copy handy somewhere. Don't hesitate to call one of them if in need of help.

 

Recognise that having suicidal thoughts is one of the features of depression, and seek help, either from your General Practitioner or another mental health professional such as a psychologist or a counsellor. Make sure you tell them you have been having suicidal thoughts.

 

If you have already received treatment for depression, and you are having suicidal thoughts, contact the person who has been giving you the treatment, or a close friend who you trust, and tell them you are feeling suicidal.

 

If someone close to you is suicidal or unsafe, talk to them about it and encourage them to seek help. Help the person to develop an action plan, involving him or her and trusted close friends or family members, to keep him or her safe in times of emergency

 

Take away risks (e.g. remove guns or other dangerous weapons and hold the keys of the car if the depressed person is angry, out of control and wanting to drive off into the night).

 

4. Am I always going to feel like this?

 

This is a common fear. It's important to know that depression can be successfully treated and that you will feel better in time and with the right treatment.

 

5. How long does depression last

 

Sometimes depression goes away of its own accord, but, depending on the nature and type of the depression, it may take many months and possibly considerable suffering and disruption if left untreated. Allow yourself to seek help in the same way you might if you had a physical illness.

 

6. How is depression treated?

 

There are a large number of different treatments for depression. At the Black Dog Institute we believe that different types of depression respond best to different treatments and it is therefore important that a thorough and thoughtful assessment be carried out before any treatment is prescribed.

 

Treatments can fall into the following categories:

 

Physical treatments, comprising :

 

drug treatments, of which there are three main groups: antidepressants, tranquillisers, and mood stabilizers.

 

electroconvulsive therapy (ECT) - a physical therapy that may be relevant in a minority of cases of psychotic depression, severe melancholia or life-threatening mania.

 

transcranial magnetic stimulation - a treatment that is still under development, but which involves holding a coil near to a patient's head and creating a magnetic field to stimulate relevant parts of the brain.

 

Psychological treatments, the most common ones being:

 

• Cognitive Behaviour Therapy - a form of therapy that aims to show people how their thinking affects their mood and to teach them to think in a less negative (and more 'realistic') way about life and themselves.
• Interpersonal Therapy - a therapy that aims to help people understand how social functioning (work, relationships and social roles) and personality operate in their lives to affect their mood.
• Psychotherapy - an extended treatment aimed at exploring aspects of the person's past in great depth to identify links to the current depression.
• Counselling - a broad set of approaches and goals that provide problem solving and learning skills to cope with difficult life circumstances.

 

7. Where can I get help for depression?

 

A good first place to start in getting help is to visit your local General Practitioner. Let him or her know if you think you might have depression. Your General Practitioner will either conduct an assessment of you to find out whether you have depression, or refer you to someone else, such as a psychiatrist or a psychologist.

 

Depending on the nature of your depression, your General Practitioner may recommend some psychological intervention, such as cognitive behaviour therapy or interpersonal therapy, and might prescribe antidepressant medication to relieve some of the symptoms of depression.

 

Because depression is a common experience these days, many General Practitioners are used to dealing with depression and other mental health problems. Some General Practitioners take a special interest in mental health issues and undergo additional training in the area. If you don't feel comfortable talking to your own doctor, find another one with whom you do feel comfortable. It is important that you feel comfortable talking about how you are feeling with your doctor so they have as much information to help you as possible.

 

If you are having trouble tracking down such a General Practitioner, you could telephone general practices in your area to find out whether any doctors in that practice have a particularly strong interest in mental health and, if so, whether they are taking on new patients.

 

8. How should I behave with someone who is depressed?

 

Someone with a depressive illness is like anyone with an illness - they require our care. You can provide better care if you are able to:

 

• Understand something about the illness
• Understand what the treatment is, why it is being given, and how long the person is expected to take to recover.

 

An important part of caring is to help the treatment process:

 

• If medication is prescribed encourage the person to persist with treatment (especially when there are side effects)
• Counselling or psychotherapy often results in the depressed person 'thinking over' their life and relationships. While this can be difficult for all concerned, you should not try and steer the person away from these issues.
• A resolving depression sometimes sees strong emotions released which may be hard on the carer. The first step in dealing with these fairly is to sort out which emotions really refer to the carer and which refer to other people or to the person themselves.
• Treatment has a positive time as well - when the person starts to re-engage with the good things in life and carers can have their needs met as well.

 

Don't forget that as a carer you too are likely to be under stress. Depression and hopelessness have a way of affecting the people around them. Therapy can release difficult thoughts and emotions in carers too. So part of caring is to care for your own self - preventing physical run-down and dealing with the thoughts and emotions within yourself.

Depression Prevention Tips

Depression explained

 

Depression is a common experience. We have all felt 'depressed' about a friend's cold shoulder, misunderstandings in our marriage, tussles with teenage children - sometimes we feel 'down' for no reason at all.

 

However, depression can become an illness when:

 

• The mood state is severe;
• It lasts for 2 weeks or more; and
• It interferes with our ability to function at home or at work.

 

Signs of a depressed mood include:

 

• Lowered self-esteem (or self-worth)
• Change in sleep patterns, that is, insomnia or broken sleep
• Changes in appetite or weight
• Less ability to control emotions such as pessimism, anger, guilt, irritability and anxiety
• Varying emotions throughout the day, for example, feeling worse in the morning and better as the day progresses
• Reduced capacity to experience pleasure: you can't enjoy what's happening now, nor look forward to anything with pleasure. Hobbies and interests drop off.
• Reduced pain tolerance: you are less able to tolerate aches and pains and may have a host of new ailments
• Changed sex drive: absent or reduced
• Poor concentration and memory: some people are so impaired that they think that they are going demented
• Reduced motivation: it doesn't seem worth the effort to do anything, things seem meaningless
• Lowered energy levels.

 

If you have such feelings and they persist for most of every day for two weeks or longer, and interfere with your ability to manage at home and at work, then you might benefit from getting an assessment by a skilled professional.

 

Having one or other of these features, by themselves, is unlikely to indicate depression, however there could be other causes which may warrant medical assessment.

 

If you are feeling suicidal it is very important to seek immediate help, preferably by a mental health practitioner.

Tooth Bleaching

Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day.


Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth has become popular in today's society and tooth bleaching can be the answer.

Tooth bleaching safely lightens the color of the teeth and can last for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

Is bleaching for you?

Generally, bleaching is successful in at least 90 percent of patients, although it may not be an option for everyone.

Tooth bleaching is effective for teeth darkened from extrinsic stains such as aging, coffee, tea or smoking. Teeth darkened by intrinsic stains caused by fluorosis, tetracycline, or other medications and by congenital abnormalities won't respond well to bleaching.

Teeth darkened with the color of yellow, brown or orange respond better to lightening than gray staining. If you have very sensitive teeth, periodontal disease or teeth with worn enamel, your dentist may discourage bleaching.

What's involved?

First, the dentist must determine whether you are a candidate for tooth bleaching and what type of bleaching system would give you the best results.

If you're in a hurry for whiter teeth, you may decide to have your teeth whitened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair.

However, most patients choose dentist-supervised, at-home bleaching, which is more economical and provides the same results.

At the next appointment, if you don't choose laser bleaching, the dentist or hygienist will make impressions of your teeth to fabricate a mouth guard appliance for you. (The mouth guard is used to hold the bleaching solution against your teeth.)

The mouth guard is custom-made for your mouth. It can be worn comfortably while you are awake or sleeping.

The mouth guard is so thin that you should even be able to talk and work while wearing it. Along with the mouth guard, you'll receive the bleaching solution and instructions on how to wear the mouth guard.

Some bleaching systems recommend bleaching your teeth from two to four hours a day. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10 to 14 days completing.

How long does it last?

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee or tea. At this point you may choose to get a touch-up. This procedure may not be as costly because you can probably still use the same mouth guard. The treatment time also is much shorter than the original treatment time.

How does it work?

The active ingredient in most of the whitening agents is 10 percent carbamide peroxide, also known as urea peroxide. When water contacts this white crystal, the release of hydrogen peroxide lightens the teeth, bleaching out the porous surface of the enamel.

The higher the strength of carbamide peroxide and the quicker the bleaching process is carried out, the greater the chances for sensitivity.

Is it safe?

Several studies during the past five years have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth-bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

What are realistic expectations?

No one can really predict how much lighter your teeth will become, but the key is to have a realistic expectation before starting the process. Every case is different.

Typically, there is a two-shade improvement as seen on a dentist shade guide. The success rate depends on the type of stain involved and your compliance. Bleaching can only provide a shift in color, from gray to a lighter shade of gray, for example.

Bleaching does not lighten artificial materials, such as white fillings (resins) or porcelains. So if you are considering bleaching, it would be best to bleach before resin fillings or porcelain crowns, onlays or inlays are placed, to allow for the shade to be matched.

Temporomandibular Disorder Affects Jaw Muscles, Joints & Nerves

What is the temporomandibular joint?


The TMJ is a joint that slides and rotates just in front of your ear, consisting of the temporal bone (side and base of the skull) and the mandible (lower jaw). Mastication (chewing) muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways, and open and close.

The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. Temporomandibular disorder, or TMD, may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

TMD describes a variety of conditions that affect jaw muscles, temporomandibular joints, and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after injury. TMD affects more than twice as many women than men and is the most common non-dental-related chronic orofacial pain.

What causes TMD?

Normal function for this muscle group includes chewing, swallowing, speech and communication. Most experts suggest that certain tasks, mental or physical, cause or aggravate TMD, such as strenuous physical tasks or stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism).

These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain. Additionally, abnormal function can lead to worn or sensitive teeth, traumatized soft tissues, muscle soreness, jaw discomfort when eating, and temporal (side) headaches.

What TMD symptoms can I experience?

An earache without an infection

Jaw pain or soreness that is more prevalent in the morning or late afternoon

Jaw clicking or popping when opening and closing your mouth

Difficulty opening and closing your mouth

Locked or stiff jaw when you talk, yawn or eat

Sensitive teeth when no dental problems can be found

What can I do to treat TMD?

In my experience, the majority of cases can be treated by patient education, unloading (resting) the joint with a custom-fit mouth guard from your dentist, taking an anti-inflammatory, eating a soft diet, applying moist heat and in some severe cases using muscle relaxants.

Benefits from conservative treatment are not quick and require application over time.

Even though you treat the symptoms, the cause of the problem also needs to be addressed with stress management and relaxation techniques. It's important to break bad habits to ease the symptoms. Each TMD case is unique, and a course of treatment should be initiated only after consultation with a dentist.

Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. If you still experience pain, you may be grinding or clenching your teeth at night. See your dentist for a nighttime mouth guard.

Most people will experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training, and orthopedic-appliance therapy (splint). Eating soft foods and avoiding chewing gum also help relax the muscles.

Some severe cases of TMD require surgery to correct the underlying cause that conservative treatment will not help. Generally, a referral to an oral surgeon for evaluation and an extensive radiographic series is needed to make this determination.

Is TMD permanent?

The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment by being aware of the causes of your jaw problems after seeing a dentist for a diagnosis regime. Make routine dental appointments, so your doctor can check TMD on a regular basis.

Smokeless Tobacco & Oral Health

Smokeless tobacco products such as chew or snuff are not safe alternatives to smoking.

 

The oral health problems that result are plentiful and include bad breath, tooth discoloration and decay, recession, disease of the gums, diminished sense of taste/smell, and white patches and red sores that can lead to oral cancer.

 

Smokeless tobacco contains nicotine that is very addictive. After using tobacco for a short period of time, you will need another dip every 20 to 30 minutes to keep the buzz from ending. You may become dizzy and shaky when trying to quit.

 

Nicotine in tobacco can cause your heart to beat faster and is also linked to hypertension.

 

Tobacco juices can damage your gums, expose the roots of your teeth, lead to sensitive teeth or tooth loss, or cause worn surfaces on tooth enamel. If tobacco juice is swallowed, it can produce stomach ulcers.

 

Many people ignore the warning signs about the serious long-term health problems related to chewing and smoking. They can better relate to bad breath, stained teeth and financial drain on their wallets.

 

If you quit using tobacco products, many of the gum changes and side effects will disappear, foods will taste better and you will significantly decrease your risk of developing oral cancer.

 

If you are concerned about your oral health, do not wait until it's too late. A family dentist can counsel tobacco users regarding the risks of using tobacco products and help plan a sensible tobacco-cessation program.

 

In addition, if you use smokeless tobacco, or have in the past, you should be on the lookout for some of these early signs of oral cancer:

 

• A sore that does not heal.
• A lump or white patch.
• A prolonged sore throat.
• Difficulty chewing/swallowing.
• A movement of the tongue or jaws.
• A feeling of something in the throat.

 

Pain is rarely an early symptom. For this reason all tobacco users need regular dental check-ups.

Oral Piercing

It's not a surprise these days to see some people sporting pierced tongues, lips or cheeks. The surprise for some of these folks, however, is that piercing can be dangerous.

 

Visits to the emergency room or doctor's office are not usually on the minds of those who are electing to have piercing. There are some things that should be considered, however. The human mouth contains millions of bacteria, and infection is a common complication of oral piercing. Other side effects include pain and swelling.

 

The most popular piercing site, the tongue, could swell enough to close off an airway. Regardless of how "experienced" the person doing the piercing claims to be, piercing can cause uncontrollable bleeding and nerve damage.

 

Piercing can be extremely painful and result in swelling and increased saliva flow and even drooling. Healing may take six weeks or longer, especially if there are complications.

 

Even if the piercing injury doesn't cause any trouble, you should be aware of the potential hazards that mouth jewelry presents:

 

• You can easily choke on any studs, barbells or hoops that come loose in your mouth.
• The jewelry can chip or crack your teeth.
• Jewelry worn in the mouth can hinder your ability to eat, not to mention your speech. It's hard to be cool when you can't pronounce your words or when pieces of your lunch are stuck to that tiny barbell.

 

Piercing is a fashion statement that involves more than just deciding what jewelry will be attached to the body and where. This decision could have major consequences for your oral health, too.

Oral Cancer

While the rates of oral cancer have dropped in the past 20 years, health agencies still anticipate that it will be diagnosed in more than 30,000 Americans this year.

 

Knowing the risk factors as well as the signs of oral cancer can go a long way toward limiting the influence this disease can have on your life.

 

Know what to look for

 

As with many forms of cancer, early detection of oral cancerous lesions can improve the chances of successful treatment. You can take an active role in detecting signs of oral cancer early by checking your oral tissues periodically. Take a few minutes to examine your lips, gums, cheek lining and tongue, as well as the floor and roof of your mouth.

 

You'll want to make note of the following:

 

• A color change in the oral tissues (whitish or red spots, for example).
• A lump, thickening, rough or crusted spots, or small eroded areas.
• A sore that bleeds easily or does not heal.
• Pain, tenderness or numbness anywhere in the mouth or on the lips.
• Difficulty in chewing, swallowing, speaking or moving the jaw or tongue.
• Changes in the voice.
• A change in the way your teeth fit together.

 

In addition, watch for changes beyond the mouth that could signify oral cancer:

 

• Drastic weight loss.
• Lump or mass in your neck.

 

If any of these conditions persists, contact your dentist for an examination.

 

Minimize the risk

 

You can take steps to reduce your risk of developing oral cancer by avoiding behaviors that researchers have identified as being strongly associated with the development of oral cancer.

 

The use of any kind of tobacco products (cigarettes, pipe tobacco, cigars or smokeless tobacco), particularly combined with heavy alcohol consumption, has been identified as the major risk factor for oral cancers in the United States.

 

The importance of professional dental care

 

Regular visits to your dentist are important in protecting yourself from the effects of oral cancer. As part of your regular dental examination, your dentist can quickly and easily check the oral tissues for signs of cancerous and pre-cancerous lesions.

 

Detecting and treating cancerous tissues as early as possible is critical in helping you beat a potentially deadly disease.

Fluoride

Fluoride is a mineral that is essential to the prevention of decay in teeth. It helps strengthen the tooth enamel to make it more resistant to the acid that is produced by the bacteria in our mouths.


There are several common sources of fluoride that are easily available in any part of the country.

The most readily attainable source is something you consume and use every day—water. The optimum level of fluoride in water is one part fluoride per million parts water.

If you would like to know if your water system contains fluoride, ask your dentist, local health department or water treatment department.

Water fluoridation has been shown to be very effective against cavities. In fact, nearly two thirds of cavities can be prevented in children who drink fluoridated water from birth. If you have your water tested and it is not fluoridated, a physician or dentist can prescribe fluoride supplements in the form of drops, tablets or mouth rinses.

Drops are best for infants. Gradually work from drops into tablets as the child gets older. In addition to water fluoridation, many school systems offer a fluoride program to provide rinses to the children at school.

During routine dental visits, the child will receive a topical application of fluoride gel, usually in soft foam mouthpiece trays. If the child has a high rate of decay or the present decay is extensive, the dentist may prescribe home rinses or prescription-strength fluoride toothpaste.

Another source of fluoride is in our daily diets. Dark green vegetables contain fluoride and can help supplement our attempt to be cavity-free.

Everyone should use fluoride toothpaste for extra protection against cavities. When purchasing toothpaste, read the label to make sure it contains fluoride. There are still toothpastes out on the market that don't contain fluoride.

Fluoride alone will not prevent cavities, but it greatly decreases the chance of them developing. Good tooth brushing, flossing, eating healthy foods, and seeing your dentist and hygienist regularly are all factors involved in preventing tooth decay.

Flosses & Water picks

Plaque is a sticky layer of material containing germs that accumulates on teeth, including places where toothbrushes can't reach.


This can lead to gum disease. The best way to get rid of plaque is to brush and floss your teeth carefully every day.

The toothbrush cleans the tops and sides of your teeth. Dental floss cleans in between them. Some people use water picks, but floss is the best choice.

Should I floss?

Yes. Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. Floss is the single most important weapon against plaque, perhaps more important than the toothbrush. Many people just don't spend enough time flossing or brushing and many have never been taught to floss or brush properly. When you visit your dentist or hygienist, ask to be shown.

Why should I floss?

Flossing is the one most important step in oral care that people forget to do or claim they don't have time for. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal or gum disease. Flossing cleans away the plaque from between your teeth, decreases the chance of interproximal decay and increases blood circulation in the gums.

Which type of floss should I use?

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridgework. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss, but does tear more than waxed floss.

How should I floss?

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side-to-side as if you're shining shoes. Bring the floss up and down several times forming a "C" shape around the tooth, being sure to go below the gum line. The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gum line forming a "C" on the side of the tooth.

How often should I floss?

At least once a day. To give your teeth a good flossing, spend at least two or three minutes.

What are floss holders?

You may prefer a pre-threaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss, or for caretakers who are flossing someone else's teeth.

Is it safe to use toothpicks?

In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. Toothpicks come round and flat, narrow and thick. When you use a toothpick, don't press too hard as you can break off the end and lodge it in your gums.

Do I need a water pick (irrigating device)?

Don't use water picks as a substitute for brushing and flossing. They are effective around orthodontic braces that retain food in areas a toothbrush cannot reach. However, they do not remove plaque. Water picks are frequently recommended for persons with gum disease.

Dry Socket

Dry socket, the most common post-operative complication from tooth extraction, delays the normal healing process and results when the newly formed blood clot in the extraction site does not form correctly or is prematurely lost.

 

The blood clot lays the foundation for new tissue and bone to develop over a two-month healing process. If the clot is disrupted, the bone in the extraction area is left exposed and susceptible to bacteria and response to hot and cold.

 

Exposed bone is very sensitive and must be covered as soon as possible, which can almost instantaneously reduce the discomfort the patient is having. If this happens to you, don't delay: see your dentist immediately.

 

Tips for preventing dry socket include:

 

• Avoid drinking through a straw because the suction will interfere with healthy clotting.
• Avoid smoking because it can contaminate the extraction site and also introduce suction to interfere with clotting.
• Avoid spitting and excessive mouth rinsing, which may interfere with blood clotting.
• Schedule extractions during the last week of the menstrual cycle, when estrogen levels are inactive.

Dental-Related Headaches

An average person swallows 2,000 times per day, causing the upper and lower teeth to come together and push against the skull.


People who have poorly aligned bites or missing teeth can have related health problems, such as frequent headaches or sleep disorders, because their jaw muscles are strained, according to a recent article in AGD Impact, the news magazine of the Academy of General Dentistry.

This strain, known as orofacial pain, is defined as any pain in and around the face. Some people may experience pain in the ears, eyes, sinuses, cheeks or side of the head, while others experience clicking when moving the jaw.

Orofacial pain can also be caused by nerve disorders, temperomandibular disorder, stress or muscle spasms. Serious causes of orofacial pain are tumors in the jawbone area, oral cancer or referred pain from cardiac disease.

At the first sign of discomfort or noted abnormality when closing your mouth, see your general dentist to have a preliminary evaluation to disclose any potential problems early. He or she knows your mouth best and how you handle daily stress.

Sometimes the pain may be difficult to diagnose if its origin is not localized in one area. The dentist will try to diagnose the pain source by conducting tests to rule out a cracked tooth, the need for a root canal, gum disease, clenching or grinding. These factors can cause pain in the facial area, but can be easily treated.

Orofacial pain that lasts longer than 10 days to two weeks, or is not related to a specific stressful event such as a car accident, may signal a more serious problem requiring additional tests.

Dental Anxiety

For many, going to the dentist's office can be a stressful experience associated with anxiety, nervousness, and even fear—feelings that may keep you from taking good care of your mouth and teeth.

 

Although these feelings are usually exaggerated and out-of-proportion to any actual risk, both patients and dentists need to understand and recognize that these feelings reflect a concern that must be addressed.

 

Anxiety about dental visits shows up in a number of different ways.

 

• Rapid heartbeat
• Faster breathing
• Sweaty palms
• Feeling "keyed-up," edgy or irritable
• Foot tapping or fidgeting
• Difficulty sleeping the night before a visit
• Putting-off making an appointment
• Not showing up for your appointment

 

Experiencing these feelings is not uncommon. Anxiety is a normal result of a built-in survival mechanism that is meant to help you stay safe and avoid things that could be harmful to you. The problem is that going to the dentist IS NOT harmful. Several aspects of routine dental exams and procedures can be unpleasant and slightly painful, making a person feel uncomfortable. Our minds and bodies relate these unpleasant sensations with any trip to the dentist. It causes us to be more anxious than we really need to be.

 

Use these methods to help ease some of these feelings:

 

• Schedule your appointment for a time when you will not feel rushed or under pressure.
• Get a good night's sleep. If you know that you have trouble sleeping, ask your dentist for a sedative.
• Eat a high protein-meal or snack before your visit.
• Avoid caffeinated or sugary beverages or foods on the day of your visit.
• Wear loose-fitting, comfortable clothing.
• Distract yourself by listening to music. Bring a portable radio, tape or CD player with headphones.
• Use relaxation techniques such as deep-breathing exercises, progressive muscle-relaxation exercises, or closing your eyes and visualizing restful or relaxing scenes.
• Make a list of any questions that you would like to ask and bring it with you.
• Talk with your dental provider about your fears. Your dentist may prescribe a small dose of a medication to be taken just before your appointment to help manage symptoms of pain and/or worry.
• Do not drink alcohol the night before or the day of your visit to calm you. Alcohol causes the pain-numbing medicine to not work to control pain symptoms.

 

When considering that next dental appointment, remember that anxiety associated with dental treatment is normal. Rather than letting anxiety keep you from taking care of your mouth, use the above simple and effective methods to manage your concerns while promoting good oral health.

 

Patients who feel that their providers are not taking their concerns seriously should use established patient advocacy mechanisms or use the dental clinic chain of command to get help.

Children's Oral Health

Q: At what age are my children supposed to see a dentist?


A: The general rule is between 30 and 36 months. Some children require a bit more time to be comfortable. If an area of concern is noticed, then the child should see a dentist as soon as possible.

Q: Why is it important to fix baby teeth that have decay? Aren't they going to come out soon anyway?

A: It is very important to maintain the baby teeth because these teeth hold space for the future eruption of the permanent teeth. If a baby tooth decays or is removed too early, the space necessary for the permanent teeth is lost and may only be regained through orthodontic treatment. Infected baby teeth can cause the permanent teeth to develop improperly, resulting in stains, pits and weaker teeth.

Q: When will my child lose his/her baby teeth?

A: Children will begin losing their teeth at approximately age 5 1/2 to 6. They will usually lose their front teeth first. Children will continue to lose baby teeth until the age of 12 or 13 when all of the permanent teeth finally erupt.

Q: When does thumb sucking become damaging to the teeth?

A: Generally, if the child has stopped sucking his/her thumb by age 5 there is no permanent damage. If the child is a vigorous and constant thumb sucker, however, there can be moderate to severe movement of teeth and prevention of normal bone growth.

Q: Should my child wear a mouth guard while playing sports?

A: It is strongly recommended that children wear mouth guards while playing any contact sport. It is always better to prevent an injury than to repair one. The earlier a child begins to wear the mouth guard, the easier it is to become comfortable and continue to wear it as the child gets older.

Q: What should I do if my child gets a tooth knocked out?

A: If the tooth is a permanent tooth, time is extremely crucial. Immediately stick the tooth back in the socket. Don't worry about getting it in straight or having it turned backwards, just get it in the socket and immediately call your dentist. If you are uncomfortable placing the tooth in the socket, put it in a glass of milk and get your child to the dentist as quickly as possible. If the tooth is a baby tooth, do not put it in the socket because damage to the permanent tooth can occur. When in doubt, put the tooth in milk and see your dentist immediately.

Q: What is a sealant?

A: A dental sealant is a thin plastic film placed on the chewing surfaces of molars and premolars (the teeth directly in front of the molars). Sealants have been shown to be highly effective in the prevention of cavities. They were developed through dental research in the 1950s and first became available commercially in the early 1970s.

Q: How effective are sealants?

A: Scientific studies have proven that properly applied sealants are 100 percent effective in protecting the tooth surfaces from cavities. Because sealants act as a physical barrier to decay, protection is determined by the sealants' ability to adhere to the tooth. As long as the sealant remains intact, small food particles and bacteria that cause cavities cannot penetrate through or around a sealant. In fact, research has shown that sealants actually stop cavities when placed on top of a slightly decayed tooth by sealing off the supply of nutrients to the bacteria that cause the cavity. Sealant protection is reduced or lost when part or the entire bond between the tooth and sealant is broken. However, clinical studies have shown that teeth that have lost sealants are no more susceptible to tooth decay than teeth that were never sealed.

Q: How are sealants applied?

A: Sealant application involves cleaning the surface of the tooth and rinsing the surface to remove all traces of the cleaning agent. An etching solution or gel is applied to the enamel surface of the tooth, including the pits and grooves. After 15 seconds, the solution is thoroughly rinsed away with water. After the site is dried, the sealant material is applied and allowed to harden by using a special curing light. Sealant treatment is painless and could take anywhere from five to 45 minutes to apply, depending on how many teeth need to be sealed. Sealants must be applied properly for good retention.

Q: How long will a sealant last?

A: Sealants should last five years, but can last as long as 10 years. One study reported that seven years after application, an impressive 49 percent of treated teeth were still completely covered. Sealants should not be considered permanent. Regular dental check-ups are necessary to monitor the sealants' bond to the tooth.

Q: Who should receive sealant treatment?

A: Children, because they have newly erupted, permanent teeth, receive the greatest benefit from sealants. The chewing surfaces of a child's teeth are most susceptible to cavities and the least benefited by fluoride. Surveys show that approximately two-thirds of all cavities occur in the narrow pits and grooves of a child's newly erupted teeth because food particles and bacteria cannot be cleaned out. Other patients also can benefit from sealant placement, such as those who have existing pits and grooves susceptible to decay. Research has shown that almost everybody has a 95 percent chance of eventually experiencing cavities in the pits and grooves of their teeth.

Caps & Crowns

Similar to a house that is built on a foundation of sand, a tooth that is extensively restored with fillings can crumble and wash away. This is why many dentists suggest placing a crown or "cap" on teeth that have very large fillings.


A crown is indicated when there is little tooth structure left or the remaining tooth is weakened, and it is likely that a tooth will fracture during normal chewing. If a tooth fractures, the only option may be to pull the tooth or have a root canal.

Crowns can also be fabricated to make the front teeth look more attractive or to achieve better chewing function in an individual with worn-down teeth.

Crowns may be fabricated out of various materials. Certain materials work better in different situations. However, the patient usually has the choice of gold, resin, porcelain or a mixture of the materials.

A dentist usually will need about two or three appointments before the patient can leave the office with the brand-new crown.

The first appointment is usually to examine the tooth and determine the type of crown to be placed.

After that, the dentist will actually drill around the tooth so the crown will fit perfectly over the remaining tooth structure. Once the dentist is satisfied with the drilling part, he or she will take an impression with a material that is about the same consistency as mashed potatoes. The dental lab will use this impression of the tooth to help make the final crown.

The patient may have to wait several weeks before the finished crown returns from the lab. During this time the patient will have a temporary crown glued on. This crown is weaker than the lab-fabricated one and should not stay on for more than a few months.

Finally, after the dental lab has fabricated the final crown, the dentist will use a very strong cement to glue the crown to the tooth.

Once the final crown is cemented on, the tooth or teeth have been given the chance to resist fracture for a very long time. However, the tooth still may break down if any decay gets under the crown or there is enough force during biting to dislodge or crack the crown.

Children may actually get a different type of crown that does not have to be made in the lab. These teeth do not fit the same way as the adult crowns. This is because the crown will go on the baby teeth that will fall out in a few years. It is important to put crowns on baby teeth with large cavities because the teeth could break, which could cause pain or movement. The latter could require the patient to have braces later in life.

Crowns are an important part of patient care in dentistry. Many patients avoid having crowns and wait until a tooth breaks to ask for one. This usually makes treatment more difficult and less successful. If your dentist suggests a crown should be placed, it would be a good idea to follow his or her advice so you may avoid a broken tooth.

Dental Health Tips

Baby-Bottle Caries

 

How early can a person have tooth decay? The answer is, as soon as a person has teeth erupted.

 

This means an infant under the age of 1 can start having tooth decay. Tooth decay that happens in infants is called Early Childhood Caries. ECC is a severe problem that causes debilitating tooth destruction in infants and young children.

 

The prevalence of ECC is estimated to be as high as 90 percent in some Head Start populations. However, by following the guidelines developed by the American Academy of Pediatric Dentistry and by visiting a dentist for the first check-up by the child's first birthday, ECC can easily be prevented.

 

ECC is a specific form of severe decay found in the teeth of infants and toddlers who fall asleep with bottles of milk, juice or any sweetened liquid in their mouths. ECC is also known as baby-bottle tooth decay, nursing-bottle caries and milk-bottle syndrome. It is the only severe dental disease common in children under 3 years of age.

 

Bacteria, which are found in the mouth, convert sugar into acids. These acids destroy the enamel and dentin of the tooth. The flow of saliva in the mouth helps to wash acids from the tooth surface during the daytime. However, when an infant is asleep, the flow of saliva is significantly reduced, and this allows acids to pool on the tooth. This, coupled with the sugars found in juices, milk or other soft drinks, will lead to early cavities.

 

The top four front teeth are most affected by ECC, which appears as white chalky marks on the teeth due to decalcification by the acids. If these teeth are left untreated, unsightly and often painful cavities will develop.

 

Baby teeth are important to a child for chewing and biting food, making a good smile, and speaking. However, the most important function of baby teeth is that they are holding space in the mouth for upcoming permanent teeth.

 

The first baby tooth erupts around 6 to 8 months of age, and usually all 20 baby teeth are erupted by the age of 2 or 2-and-a-half. Early loss of baby teeth can cause blocked eruption, drifting, crooking and crowding of the permanent teeth.

 

A child who prematurely loses baby teeth will have a very high chance of needing braces in the future. If an abscess or infection occurs around baby teeth with ECC, it may affect the development of the underlying permanent teeth.

 

The best treatment for ECC is prevention. But teeth affected by ECC can still be treated if intervention is early and the underlying causes are stopped.

 

The following are guidelines, developed by the American Academy of Pediatric Dentistry, for preventing baby-bottle tooth decay:

 

• Don't allow a child to fall asleep with a bottle containing milk, formula, fruit juices or other sweet liquids.
• Comfort a child who wants a bottle between regular feedings or during naps with a bottle filled with cool water.
• Always make sure a child's pacifier is clean, and never dip a pacifier in a sweet liquid.
• Introduce children to a cup as they approach 1 year of age. Children should stop drinking from bottles soon after their first birthdays.
• See the dentist if any unusual red or swollen areas appear in a child's mouth, or any dark spot on a child's tooth.

 

Healthy adult teeth begin with healthy baby teeth. Knowing and following the AAPD guidelines, and visiting a dentist for the first check-up around the age of 1, are very important for preventing young children from getting ECC.

Smoking and Heart Disease

Smoking and Home


If you are like many new nonsmokers, the most difficult place to resist the urge to smoke is the most familiar - home. The activities most closely associated with smoking urges are eating, partying, and drinking. And, not surprisingly, most urges occur when a smoker is present.


Smoking Triggers

A list of typical "urge to smoke" triggers:

* Working under pressure

* Feeling blue

* Talking on the telephone

* Having a drink

* Watching television

* Driving your car

* Finishing a meal

* Playing cards

* Drinking coffee

* Watching someone else smoke

Hypertension Fact

African and Hispanic Americans


African and Hispanic Americans have a much higher rate of hypertension. People of these ethnic groups need to be more diligent in getting their blood pressure taken on a frequent basis.

Alcohol and Hypertension

People with hypertension (high blood pressure) should limit their alcohol intake to two drinks or fewer per day. Alcohol consumption raises blood pressure.



Avoid Isometrics if Hypertensive

Hypertensive people should avoid isometric exercises like weight-lifting which can cause blood pressure to soar. Try aerobic exercises like walking and swimming instead.



Blood Pressure Machines

Only your doctor or other health care provider can tell you if you have high blood pressure. There are machines in stores and malls, but they SHOULD NOT substitute for the advice of a qualified professional.



Blood Pressure Measurement

As blood flows from the heart out to the blood vessels; it creates pressure against the blood vessel walls. Your blood pressure reading is a measure of this pressure. A health care provider may use a device called a sphygmomanometer, or blood pressure cuff, to take this measurement. The test is short and painless. When that reading goes above a certain point, it is called high blood pressure.



Blood Pressure Normal Range

Because hypertension is so common, everyone should have his or her blood pressure tested once a year. Blood pressure readings are given in two numbers. The upper number, the systolic, is indicative of the pressure in your arteries while your heart is pumping. The lower number, diastolic, is indicative of the pressure in your arteries when your heart is at rest. The average blood pressure reading for adults is 120/80, but a slightly higher or lower reading (for either number) may not be a problem. If blood pressure goes above 140/90, a doctor may recommend some form of treatment.



Compare Food Labels

Read the Nutrition Facts on food labels to compare the amount of sodium in products. Look for the sodium content in milligrams and the Percent Daily Value. Aim for foods that are less than five percent of the Daily Value of sodium.



Cut Down on Sodium

A diet low in sodium (salt) can help ease high blood pressure. Keep your sodium intake under 2,400 milligrams per day. Read food labels for sodium content!



Don't Worry, Be Happy

Positive people have lower blood pressures than negative people. Keep a positive attitude to ease your hypertension.



High Blood Pressure

If a doctor tells you have high blood pressure, or hypertension, you may be surprised. High blood pressure does not cause symptoms. You can have it even though you feel fine. But high blood pressure is a serious condition that affects as many as 50 million Americans. High blood pressure can lead to stroke, heart disease, kidney failure, and other health problems.



Marriage and Hypertension

The longer two people are married, the more similar their blood pressures become. If you have a high blood pressure reading, have your spouse's blood pressure checked, also.



New Blood Pressure Standards

New federal guidelines released May 14, 2003 say blood pressure levels once thought normal are actually high enough to signal "prehypertension" - putting those people at risk for high blood pressure later in life.

Normal Blood Pressure:

* Systolic - less than 120

* Diastolic - less than 80

Treatment:

* In otherwise healthy individuals: none

* In individuals with other diseases such as previous heart attack, diabetes, kidney disease, certain other diseases: none

Prehypertension:

* Systolic - 120-139

* Diastolic - 80-89

Treatment:

* In otherwise healthy individuals: none

* In individuals with other diseases such as previous heart attack, diabetes, kidney disease, certain other diseases: medically treat diseases

Stage one hypertension:

* Systolic - 140-160

* Diastolic - 90-100

Treatment:

* In otherwise healthy individuals: diuretics for most, possibly other drugs

* In individuals with other diseases such as previous heart attack, diabetes, kidney disease, certain other diseases: multiple medications

Stage two hypertension:

* Systolic - more than 160

* Diastolic - more than 100

Treatment:

* In otherwise healthy individuals: two-drug combo, usually one is a diuretic

* In individuals with other diseases such as previous heart attack, diabetes, kidney disease, certain other diseases: multiple medications



Obesity and Hypertension

Obese people are three times more likely to have hypertension (high blood pressure) than people of normal weight. Losing even a few pounds can make a significant difference.



Pets and Hypertension

Interaction with pets helps lower blood pressure, so take a dog or cat and call me in the morning :-)



Reducing Sodium When Eating Out

Measures to reduce dietary sodium when eating out include:

* Ask how foods are prepared. Ask that they be prepared without added salt, MSG, or salt-containing ingredients. Most restaurants are willing to accommodate requests.

* Know the terms that indicate high sodium content: pickled, cured, soy sauce, broth.

* Move the salt shaker away.

* Limit condiments, such as mustard, catsup, pickles, and sauces with salt-containing ingredients.

* Choose fruits or vegetables instead of salty snack foods.



Treatment of Mild Hypertension

With mild hypertension, a doctor may suggest exercise, weight loss and the reduction of salt (sodium) and alcohol intake. In some cases, these steps alone will reduce blood pressure to acceptable levels. There are also many medications available to treat high blood pressure.