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PERSONAL HEALTH : Preventing Cavities in Adult Teeth

Cavities aren’t just kid stuff.

One recent study of 900 dental patients, 54 and older, found most averaged one cavity a year.

Adult teeth are susceptible to decay for a number of reasons, said Mark E. Jensen, associate professor of dentistry at the University of Iowa College of Dentistry in Iowa City.

“The root of the adult tooth surface becomes more exposed, thus more susceptible to decay,” said Jensen, who spoke at spring scientific session of the California Dental Assn. last weekend in Anaheim.

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The composition of the root surface changes as well, making decay more likely, he said. And older patients with gum disease are also more likely to get cavities.

What to do? By and large, adults should follow the same preventive techniques dentists advise for children, Jensen said. That means twice-yearly checkups, twice-daily brushing with fluoride toothpaste and rinsing with fluoride mouthwash.

Once a cavity strikes, some prevention can be “built in,” via filling materials that release fluoride. “There have been improvements in these recently,” Jensen said.

If cavities persist, Jensen advised fluoride treatments.

Adults might also consider the pit-and-fissure sealants used on children’s teeth. These sealants are applied to chewing surfaces and natural pits. Jensen expects development of a special sealant to coat the root’s surface, thus reducing the risk of adult tooth decay.

Endodontics--the treatment of root-canal disorders--is becoming less feared by the public, said Albert Goerig, chief of endodontics at Ft. Ord.

A root-canal procedure is performed when the tooth’s nerve dies. First, the dead nerve tissue is removed. Then, the inside of the root canal is cleaned and filled with a rubberlike material. Finally, a crown or cap is placed over the remaining tooth.

In the past few years, the introduction of sonic vibrating instruments has made canal cleaning faster, Goerig said, while special “guns” speed the application of filling material.

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Another machine beeps when it reaches the end of the root canal, taking the guesswork out of how much cleaning and filling are needed.

Perhaps best of all, Goerig said, root-canal procedures now usually take one or two visits to the dentist, not the three or four required in the past.

POINT / COUNTERPOINT

Hormone, Hypnosis as Bed-Wetting Treatments

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Bed-wetting affects an estimated 5 to 7 million children in the United States. Treatments are plentiful, but experts don’t agree on which is best.

Among the recommended therapy routes are bed alarms, bladder stretching (involving prolonging the time between bathroom visits), hypnosis, medication or simply waiting for the child to outgrow bed wetting.

Recently, the FDA approved a nasal spray for bed-wetting treatment. Called DDAVP, or desmopressin acetate, the synthetic hormone helps regulate nocturnal urine production.

Here are two experts’ views on two possible treatments: DDAVP and hypnosis.

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Dr. Kenneth Saul, Thousand Oaks pediatrician and chief of pediatrics, Los Robles Regional Medical Center, Thousand Oaks:

“Many bed-wetters have low levels of an anti-diuretic hormone, which regulates urine production. Too much urine is produced at night, leading to bed-wetting.

“DDAVP nasal spray corrects this deficit. It is a synthetic anti-diuretic hormone. Children take DDAVP as a nasal spray right before bed. Usually there is improvement within a few days.

“We prescribe DDAVP for about three months and then wean patients. We have had good success in the weaning. Studies show 75% of children respond and the bed-wetting stops. Researchers are not sure exactly why.”

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Bruce Goldberg, hypnosis expert and president of the Los Angeles Academy of Clinical Hypnosis:

“I use hypnosis to take children back in time to find whatever caused the bed-wetting.

“Then we use cleansing techniques--such as mental confrontation--to remove the carry-over ‘blocks’ that cause the bed-wetting in the first place. Children are able to eliminate the bed-wetting cause.

“Hypnosis is a short-term treatment. Bed-wetting can usually be treated in two or three sessions, and then children can listen to follow-up tapes at home.”

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SHOP TALK

A Sports Drink Takes a Lighter Tack

For years, thirsty athletes--be they professional, weekend or in between--have had an array of post-workout “sports drinks” to guzzle. Now add one more choice to the menu: Gatorade Light, a lower-calorie version of the original.

Just introduced nationally, Gatorade Light replenishes fluids and provides minerals just like regular Gatorade, but with only 25 calories per 8-ounce serving. (Shoppers take note: At least one other sports drink beats Gatorade Light in the calorie department: Bodyfuel 100 has just 4 calories per 8-ounce serving, according to its label.)

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Who should consider the sports drinks? And are they any better, really, than drinking water?

It depends on the kind of athlete you are, said Pam Ivey, an exercise physiologist at St. John’s Center for Health Assessment in Santa Monica.

“Water is as good a fluid replacement as any for the recreational athlete--someone who exercises three times a week for 30 minutes a session,” Ivey said.

“But for more serious athletes who exercise six times a week, for 60 minutes or more a session, these replacement drinks can provide additional benefits--replacing fluid and electrolytes.”

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