David G Freeman DDS

The Tooth Fairy says: "All things in moderation. Well, almost all things." Today's lesson in diversity... Background... Dysbiosis of the oral microbiome can lead to local oral disease and potentially to cancers of the head, neck, and digestive tract. However, little is known regarding exogenous factors contributing to such microbial imbalance. Results We examined the impact of alcohol consumption on the oral microbiome in a cross-sectional study of 1044 US adults. Bacterial 16S rRNA genes from oral wash samples were amplified, sequenced, and assigned to bacterial taxa. We tested the association of alcohol drinking level (non-drinker, moderate drinker, or heavy drinker) and type (liquor, beer, or wine) with overall microbial composition and individual taxon abundance. The diversity of oral microbiota and overall bacterial profiles differed between heavy drinkers and non-drinkers (-diversity richness p = 0.0059 and -diversity unweighted UniFrac p = 0.0036), and abundance of commensal order Lactobacillales tends to be decreased with higher alcohol consumption (fold changes = 0.89 and 0.94 for heavy and moderate drinkers, p trend = 0.005 [q = 0.064]). Additionally, certain genera were enriched in subjects with higher alcohol consumption, including Actinomyces, Leptotrichia, Cardiobacterium, and Neisseria; some of these genera contain oral pathogens, while Neisseriacan synthesize the human carcinogen acetaldehyde from ethanol. Wine drinkers may differ from non-drinkers in microbial diversity and profiles (-diversity richness p = 0.048 and -diversity unweighted UniFrac p = 0.059) after controlling for drinking amount, while liquor and beer drinkers did not. All significant differences between drinkers and non-drinkers remained after exclusion of current smokers. Conclusions Our results, from a large human study of alcohol consumption and the oral microbiome, indicate that alcohol consumption, and heavy drinking in particular, may influence the oral microbiome composition. These findings may have implications for better understanding the potential role that oral bacteria play in alcohol-related diseases.

And... we're done! The midnight Surgical Extraction Team: Mission Accomplished! We're headed home...

Before we get too excited, these studies were done on rodents, who have teeth that are very different from humans. Let's look at some studies on people and then celebrate if the results are similar.

Merry Christmas and Happy Hanukkah to all our wonderful patients! :)

Hello Facebook friends! Happy New Year! We hope that your holidays were wonderful. I am excited to announce that we are going to be changing up our schedule in the coming year. Not to worry, we still will have evening and weekend hours as before, but we won't be here quite as late as before. Our new hours will be as follows: Mon-Thurs 10-2, 4-6 Fri 10-3... E/O Sat 12-5 We are looking forward to seeing you over the coming year. 2016 is going to be our best year yet :) See more

Hello Facebook friends! We hope you had a wonderful Thanksgiving. Ours was really awesome, we spent precious time with friends and family. We even got our tree up the very next day. :) So, the main dental hazards of December are mostly popcorn kernels. Watch out while you are eating those delicious chunks of chocolate toffee popcorn, because unpopped kernel chunks will sneak over to your silver fillings and crack pieces of your tooth off in revenge! We're not saying "don't", we're saying be really really mindful of what you are chewing, and be sure to brush and floss the sugar off later. Enjoy this beautiful season! :)

Hi Facebook friends! We did our annual continuing education conference over the weekend, and learned some cool stuff that I will be sharing over the next several weeks, until I have finally forgotten all of it again. Our favorite class was a seminar on wisdom teeth extraction. Not a class with pig heads or live volunteers, fortunately, but a lot of xrays and statistics about permanent nerve damage to the i/a nerve that runs through the jaw, supplying sensation to the lip, ton...gue, and lower part of the face. The wisdom teeth roots very commonly grow down to and around this nerve, forming wicked hooks and traps, so when the tooth finally goes bad and must be pulled, lasting paralysis of the nerve occurs. The very best oral surgeons cannot avoid this. The class illuminated the two best ways to deal with this problem: 1. coronectomy (leave the root tips behind) 2. regular panoramic xrays throughout the early teen years and subsequent germinectomy (remove buds of wisdom teeth before roots have the chance to form) This leaves us with a couple of cold hard facts. Not everybody is going to be able to do this for their kid, unless they have dental insurance. It is worth saving up for, though, better than a first car. They'll wreck that anyway. Wisdom teeth removal is a gift for life. When these teeth become problematic later in life, it interrupts college, jobs, pregnancy, parenting, you name it. And by then those root tips have grown long and bad. Coronectomies avoid the nerve damage issue, but you have to find an oral surgeon willing to do them (they take 4x as long as a regular extraction) and they are very pricey. But having a numb face and tongue and lip for life is a significant risk, and it is really sad for the patient. Feel free to reply with questions :) See more

Hello Facebook People! This has been an exciting week for us... the air conditioning is repaired at last, no more 85-degree afternoons! We have made the official jump to our new computer network and dental software, thanks to the IT wizardry of Mike Opina, our amazing office manager. We are picking up the new routines quickly, and we are so excited to be using a healthy young network again. In other news, we have started giving our patients a great new toothbrush, called the Tech Deep Clean by Sunstar/Butler/GUM. Not only is it perfect for 45 degree angled brushing, it has this ring of long bristles that penetrate the gum sulcus incredibly well. We are seeing great results! Although we give these out for free to our patients, here is a link to it on Amazon.com. Enjoy! http://www.amazon.com/Tech-Deep-Clean-Tbrush-//ref=sr_1_1

Happy Fall! It's been awhile, hope you are all brushing and flossing regularly. There is a lot in the news now about gum disease being linked with heart problems, Alzheimer's, rheumatoid arthritis, low fetal birthweight, etc. The fact is, human beings are immensely colonized by all sorts of yeasts and bacteria. Some we depend upon to break down sugars in our gut, some give us cavities. Some that live on us all the time can become overgrown and cause serious infections. Some a...re downright bad. We depend upon the turf wars these bugs have over us to keep their populations in check naturally. Scientists are trying to draw lines through the data to establish why patients would have linking symptoms, and it's very exciting as we await the answers. In the meantime, invest in a good countertop water flosser, which uses good old fashioned water to blast bacterial plaques out of your gums, which is just like using a garden hose to blast old muck out of a gutter. Our patients who use them have fantastic results. Then, with a soft bristled brush, scrub teeth then push into gums at a 45-degree angle. Then floss the toothpaste in. Following this routine will save you thousands of dollars over your lifetime, and avoid all kinds of pain... and other potential health issues too, as it may turn out. Temps in the 60's, Ugg boots and hoodies are just around the corner, hang in there San Diego! See more

Happy Winter, everyone! I think it's 80 degrees outside, not sure if I should pack up the winter wardrobe of long sleeve tees or not. I just wanted to share a tidbit about Water Flossers, also known as Water-piks. Do they replace regular flossing? No! Physical scraping of plaque from between the teeth is essential.. and how else can you floss the toothpaste in? ;) What water flossers do is flush the gum-irritating enzymes that bad bacteria produce to make you a bleedy, delici...ous open bar of the gums. We recommend first using a water flosser, then following up with brushing (including pushing into the gums), then flossing before you rinse, then rinsing lightly so a slight residue of toothpaste remains. Where can you purchase water flossers? Target, Wal-mart, Costco, and Amazon.com are a few great sources. Amazon will let you in on reviews of different models, too. We recommend using distilled water instead of San Diego Hard. To really help troubleshoot your gums, make sure your Vitamin C intake is good. Mankind and Guinea Pigs are the only mammals that can't just make their own, so we have to get this essential nutrient in our diet. Without Vitamin C, yer gums will be bleedin' like a scurvy sea dog, arrrrrrr. Enjoy the winter weather, people, and don't forget to floss! :) See more