Dec
10
Giving Your Best Smile
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Plaque. Since childhood, we’ve been trained to resist that dreaded enemy of teeth. Regular brushing and flossing are sure bets for dental health. What else could you be doing — or avoiding — to keep plaque off your knockout smile?
“Keeping plaque off your teeth isn’t complicated, but consistency is key,” says Richard Price, DMD, spokesman for the American Dental Association. “Good habits make for healthy teeth — for most people, it’s that simple,” Price tells WebMD.
What Is Tooth Plaque?
Plaque is a sticky mix of bacteria and the substances they secrete. Bacteria produce adhesive chemicals called mucopolysaccharides. The bacteria then live in this film on teeth, called a biofilm.
At first, this slimy layer is fragile and easily removed by tooth brushing. “Think of the film on a fish tank wall. It’s easy to wipe off with a washcloth, if you’re vigilant,” says Price.
And if you’re not? The bacteria in tooth plaque are free to release acids that damage tooth enamel. Regular acid assaults on enamel can wear holes in teeth, commonly called cavities.
If left alone, plaque buildup also gradually hardens, creating tartar or calculus on your teeth.
“Tartar is petrified plaque,” Price tells WebMD. “Once it’s there, you need a dentist’s help…tartar can’t be brushed off.” Tartar above the gum line also contributes to gingivitis, or gum disease.
The secrets to avoiding plaque buildup aren’t so secret. You’ve probably been hearing most of them since before you lost your baby teeth. But bad habits have a way of sneaking up on us. Make sure you’re pushing back against plaque by avoiding these five bad habits for tooth health.
Plaque Habit No. 1: Not Brushing Regularly
No one else might notice if you don’t brush your teeth twice a day, every day. But your teeth will.
“Plaque is a little like bees in the summertime,” offers Price. “One or two won’t really bother you, but if you let them build a beehive in the backyard, you’ve got a problem,” he tells WebMD.
Brush your teeth gently twice a day, using a fluoride-containing toothpaste. The exact technique isn’t so important as concentrating to make sure you’re softly brushing all the surfaces of your teeth.
Plaque Habit No. 2: Not Flossing Daily
Brushing doesn’t reach the spaces between teeth, but plaque does. A simple daily flossing between teeth clears away plaque before it can cause damage.
“Flossing also cleans plaque at the gum line, another area that brushing doesn’t reach,” says Price. If left alone, plaque past the gum line can lead to periodontal disease.
If you just can’t stand flossing your teeth, consider using one of the many other ADA-approved products to clean between your teeth daily. They’re available in any supermarket or drugstore; ask your dentist if you’re not sure which one to use.
Plaque Habit No. 3: Avoiding the Dentist
Even if you brush and floss your teeth daily, you’ll miss some plaque. Over time, that plaque hardens into tartar that needs to be removed at your dentist’s office. Yet more than a third of people surveyed haven’t seen their dentist in more than a year.
“Even dentists don’t like to go to the dentist,” jokes Price. But studies show that in general, people who neglect regular dentist visits get more cavities and have a higher chance of losing their teeth.
Once a year teeth cleanings are considered the minimum. Twice a year teeth cleanings may be better for many people. “Most dentists recommend twice a year cleanings or more,” according to Price.
Plaque Habit No. 4: Neglecting Nature’s Toothbrushes
Long before toothbrushes and fluoride toothpaste existed, certain foods played a role in keeping plaque off our teeth.
“Eating crunchy vegetables or fruits with the skin on can scrub off plaque,” Price tells WebMD. Carrots, apples, cucumbers, and many other raw fruits and vegetables are teeth-friendly, despite the sugar they contain.
In addition, eating a diet high in fruits and vegetables and low in processed foods helps protect you from obesity, heart disease, and cancer.
Plaque Habit No. 5: Indulging Your Sweet Tooth
Bacteria love simple carbohydrates like sugar. Eating candy or drinking sugary soft drinks lets sugar stick to our teeth, giving bacteria something to munch on. As the bacteria create a film of plaque, they digest sugar into acid, which damages teeth.
“All sugary candy, and most junk food in general, contribute to plaque formation,” warns Price. “High-sugar foods or drinks that are also soft or sticky are especially problematic. … Sugary soft drinks might be about the worst thing you can put on your teeth,” he tells WebMD.
Avoiding these five bad habits can help you keep plaque in check (and keep your teeth). There are other steps you can consider to prevent plaque, tartar, and cavities, too:
- Sealants. The pits and fissures on molars can be difficult to keep clean in some people, even with good dental care. Dental sealants are a clear plastic coating that covers the tooth surface, barring bacteria and acid from entering. Sealants are safe and effective in blocking plaque and preventing tooth decay.
- Mouth rinse. Some people may benefit from adding a therapeutic mouth rinse to their daily routine. Several ADA-approved mouth rinses with fluoride have been shown to help prevent plaque and tooth decay. No mouth rinse can substitute for brushing and flossing, however.
“No one’s teeth can stay plaque-free 24 hours a day, it’s just not possible,” says Price. But good habits over a lifetime will help you beat back plaque and save your smile.
Taken from WebMD
Sep
14
All About Lasers
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Back in the ’90s, blasting wrinkles meant horror-flick-like oozing and months of redness as “ablative” lasers burned off the skin’s surface and a younger-looking version grew in.
Not so with the new generation of smarter lasers, which target the hallmarks of aging—creases, brown spots, broken capillaries, sagginess—without destroying the skin you’ve got. The result? Faster healing, so you can get back in makeup and return to work with smoother skin in as little as 24 hours. Still, any searing laser beam has the potential to scar or damage pigment (especially for women of color), so treatments are best left to an M.D., who can adjust the intensity to work with your skin tone. And sun-worshippers beware: Because many lasers target pigment, give the beach a four- to six-week break before your first session. Here, a laser-by-laser guide to the treatments that’ll suit your trouble spots, budget, and schedule.
THE TREATMENT: Nonablative (i.e., surface skin is left intact) Fractional Resurfacing
WHAT IT’S FOR: Smoothing fine-to-moderate lines, evening out brown spots, and improving overall glow with quick weekend recovery. (It’s often referred to as “Fraxel,” the brand that debuted the device in 2004.)
HOW IT WORKS: Heat generated by the laser penetrates deep into the skin and stimulates collagen production without annihilating your epidermis (translation: no oozing or rawness). It’s typically performed over a course of three to five 25-minute treatments, one to two months apart, under topical anesthesia. And it’s safer for ethnic skin types than ablative lasers, but even women as light in tone as Lucy Liu should proceed with extra caution (your doctor can calibrate the laser at a lower intensity to minimize risks, but you may need extra sessions).
HOW IT FEELS: Less painful than ablative procedures, these treatments give the sensation of heat rather than pins and needles. Feels like a bad sunburn for about 10 minutes post-procedure; afterward, skin is pink and sandpapery for three to five days but can be camouflaged with concealer.
PRICE: $600 to $1200 per treatment
THE TREATMENT: Ablative (i.e., skin-wounding) Fractional Resurfacing
WHAT IT’S FOR: Smoothing fine-to-deep lines and evening out brown spots in a single treatment. Can also help tighten lax skin and carpet bomb broken capillaries if they fall in the laser’s direct path.
HOW IT WORKS: The laser beam strikes the skin in thousands of places, destroying tissue a millimeter deep in those microscopic spots only (think perforated paper). Surrounding skin remains intact, allowing for faster recovery than the original ablative devices but more intense results than the nonablative fractional laser. The hole-punching fires up the body’s wound-healing response, which generates collagen and smooths wrinkles. It’s ablative and therefore riskier for women of color, but can be executed successfully at a doctor’s discretion.
HOW IT FEELS: Generally performed with local anesthesia similar to what you’d get in a dentist’s office. After 15 minutes of post-treatment discomfort and an application of ice packs, pain is minimal. For 24 to 36 hours, skin oozes and bleeds (just as pretty as it sounds), followed by five days of crustiness. Once crust peels, new, pink skin emerges and makeup can be worn; complete healing within two weeks. (FYI, this laser comes in three varieties: CO2, Erbium, and YSGG. CO2 is harshest, while YSGG offers the quickest, easiest recovery.)
PRICE: $1500 to $5000
THE TREATMENT: Ablative Carbon Dioxide Resurfacing (i.e., the original ’90s procedure)
WHAT IT’S FOR: Still the most aggressive fix for hard-core lines and acne scars; can also tighten loose skin but is safe only for fair skin types (olive tones and women of color risk permanent pigment loss).
HOW IT WORKS: By blasting away the skin’s top layer, this aggressive single treatment bulldozes wrinkles.
HOW IT FEELS: During, like needles across the face (it’s sometimes performed under general anesthesia). Recovery-wise, think burn victim on day one as open wounds ooze and bleed, followed by five to 10 days of rawness while your obliterated epidermis regenerates (sorry, no makeup for up to two weeks). Overall pinkness persists for two to four months.
PRICE: Approximately $4000 to $8000, depending on size of area treated
THE TREATMENT: Intense Pulsed Light (IPL)
WHAT IT’S FOR: Eliminating brown spots and other sun-induced discoloration and spot-treating broken capillaries. When performed with nonablative fractional treatments, can amplify skin-tone-evening benefits–but it has no effect on wrinkles.
HOW IT WORKS: While not a “laser” per se, IPL devices work similarly. Short pulses of bright white light pinpoint brown pigment cells and redness, which are damaged when they absorb the light and the heat it creates. Safe for most skin types, but a doctor may dial down intensity for darker skin tones to avoid slim risk of de-pigmentation.
HOW IT FEELS: Sunburn-like. Patients experience slight swelling and pinkness the day of the procedure, but there’s no downtime, which is why it’s often categorized as a “lunchtime” treatment.
PRICE: $400 to $600 per treatment.
Originally published on May 21, 2009, Feature from “Marie Claire”
Sep
7
The Nonsurgical Nose Job
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Wish your nose could be different? Smoothen out irregularities? Correcting an downturned nose? There are some ways that a doctor can improve the appearance without you having to go under the knife.
Currently, there is a trend towards using injectable fillers to correct nasal features. For contour irregularities, hyaluronic acid fillers like Restylane, Juvederm, Perlane and Radiesse are most frequently used for injectable nose jobs to smoothen out irregularities.
Botox injections can also be given to relax the facial muscle that pulls the tip of your nose downward to create a more upturned appearance.
Injections can also be given around the nose, to soften the lines around the nose, giving an appearance of a younger looking nose.
However, its best to discuss with your doctor whether your nose is suitable for corrections by using injectables, and which injectables to most suitable for use taking into account your skin features and thickness. For example, Radiesse is injected deeper to fix contour irregularities, while the hyaluronic acids are great for fine creases at the bridge. Also, if it’s your first nonsurgical nose job, your doctor will probably recommend a hyaluronic acid filler since it can be dissolved with an injection of hyaluronidase if you don’t like the results. Radiesse lasts longer, but it costs more, so your budget may also help determine which filler is used.
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Aug
31
Perfect Facial Proportions: The Nose
Filed Under Aesthetic Medicine, Beauty, Plastic Surgery | Leave a Comment
The nose is in the middle of the face, and many people are conscious of its position and appearance. Many times we hear people commenting on the type or size of noses another individual has. Some different descriptions of noses we hear are those of:
The Roman or Aquiline Nose: This type of nose is convex in shape, like a hook. It is also known as ‘hooknose’ because of its shape. The word aquiline is derived from the Latin word ‘aquilinus’ which means ‘eagle like’.
The Greek or Straight Nose. This type of nose is perfectly straight with no curves or hooked like shape. It is known as Greek nose because it is generally noticed that the Greek people have this kind of nose.
The Nubian Nose: This type of nose has wide nostrils. It is generally a little narrow at the top, thick and broad at the middle and wide at the end. The term ‘Nubian’ comes from the ethnic group ‘Nubians’ who belong to northern Sudan.
The Hawk Nose: The hawk nose is so called because it is very convex, to the extent that it almost looks like a bow. It is very thin and sharp as well. Since it resembles the beak of a Hawk, it is known as the hawk nose.
Snub Nose: This type of nose is quite short in length and is neither sharp, nor hook like nor wide. It is almost as short as a nose possibly can be. Hence, it is known as snub nose
The turn up Nose: This type of nose is also called as the Celestial nose. It is so called because it runs continuously from the eyes towards the tip.
Like all other features of the face, there are guidelines and measurements that allows the nose to be viewed as more aesthetically pleasing. Here are the proportions for the ‘ideal’ nose:
- The ideal nasal length should be equal the distance from the stomion (the middle point of the oral slit when the lips are closed) to the menton (the lowermost point of the chin when seen in profile).
- The ideal nose tip projection should be equal to 0.66 x ideal nasal length.
- The distance from the infraorbital rim (lower bony edge of the eye socket) to the base of the nose is equal to the width of the base of the nose, and is half the length of the middle third of the face (ie, the distance between the brow to the base of the nose)
- The nose is straight by following a line falling from the midglabellar area (point between the brows), the nasal bridge, the nasal tip and the Cupid’s Bow of the lips.
- The width of the alar base (where the flare of the nose joins the cheek) should be equal to one eye width.
- The width of the bony base of the nose should be 80% of the alar width.
- The alar rims should have a slight outward flare in the inferior direction.
- The lines connecting the tip defining points (the most projecting area on each side of the nose tip), the supratip break area (the depression just above the tip), and the columellar lobular angle (angle formed by the junction of the infra-tip lobule with the columella) form 2 equilateral triangles.
- A line outlining the alar rims and the columella (the skin separating the nostrils) resemble a gull in gentle flight
- From the front, the nasofrontal angle (angle of demarcation between forehead and nasal dorsum, best seen in profile) lies at a level between the upper eyelashes and the supratarsal crease.
- In women, the nasal dorsum should lie 2mm behind and parallel to a line from just above the nasofrontal angle to the tip defining points. In men, the dorsum should be slightly higher.
- 50-60% of the tip should lie in front of a vertical line drawn adjacent to the most projecting portion of a normally positioned upper lip.
- The tip projection should be equivalent to the alar base width.
- The tip rotation is determined by the degree of the nasolabial angle, as measured by the angle between the vertical and a line drawn through the most anterior and posterior edges of the nostrils (normally 95-100° in women and 90-95° in men.
- The columellar lobular angle is approximately 45°.
- On the basal view, the outline of the nasal base forms an equilateral triangle, the lobular to nostril ratio is 1:2.
- The upper lip projects 2mm more than the lower lip, and in women, the chin lies slightly posterior to the lower lip, slightly stronger in men.
- The distance from the angle of the jaw to the menton is half the distance from the menton to the natural hairline.
As always, these are just guidelines, but the final appearance and modifications should be worked through with a qualified plastic surgeon.
Eager to find out what aging does to your nose? Check out the upcoming post!
Aug
24
Topical Botox Shows Effectiveness In Treatment Of Crows Feet
Filed Under Aesthetic Medicine, Aesthetic Procedures, Aesthetic medicine | Leave a Comment
NEW YORK – A topical, noninjectable form of botulinum toxin asserted its ability to effectively treat crow’s feet through impressive data from a recently completed phase II clinical trial released here.
Seventy-five patients at four study sites were treated with the novel topical toxin or placebo to the crow’s feet area. On a four-point static scale, a significant number of participants showed two point moves, according to Michael Kane, M.D., a principal investigator in the trial who released aggregate data from the study at the American Society for Aesthetic Plastic Surgery annual meeting.
“As one of the study centers, I was not unblinded as to which of my patients had toxin and which were [treated with] placebo. But, clearly, by looking at the patients, there were those whose crow’s feet got a lot better and some whose didn’t,” Dr. Kane, a plastic surgeon in private practice in New York City, tells Cosmetic Surgery Times. “The difference was night and day, both at rest and smiling. The people who showed significant difference, unsurprisingly, had lateral brow elevation, as well. Obviously, the toxin was working on the muscle.”
TRANSDUCTION TRANSFORMATION
The concept of simply applying a topical to eliminate wrinkles is not new, but proving the theory has yet to be conclusively accomplished. Yet, researchers involved with the development of the topical form of botulinum toxin think they are close. Its developers at Revance Therapeutics, Inc., a privately held company based in Mountain View, Calif., claim that the topical allows large macromolecules to cross the skin and other barrier membranes enabling local, targeted delivery. Delivered through the firm’s proprietary TransMTS™ (Macromolecule Transport Technology), the neurotoxin is based on a single, straight-chain, peptide that allows skin to be a gateway for drug delivery, rather than a barrier.
“Adding a peptide as a separate component within the [toxin] formulation allows the toxin to cross the skin,” explains Jacob Waugh, M.D., co-founder & chief scientific officer, Revance. “The peptide forms an ionic bond with the toxin and the peptide also has a Protein Transduction Domain (PTD), which is responsible for transcutaneous flux. It is essentially a quite broad and powerful transduction.”
Although the topical toxin’s technology is fairly obscure and complex, the use of two pathways on both the dead and living layers of the skin allows for a significant result, according to Dr. Waugh. Currently, there have been 600 crow’s feet areas treated via the TransMTS™ technology, with a fairly low local irritation rate and no evidence of adjacent paralysis above placebo grade, say the developers.
“TransMTS technology relies on the fluidity of the dead skin, that essentially is the equivalency of the typical topical that loads the stratum corneum, but more interesting is the second pathway that [also] happens on the living cells,” Dr. Waugh details.
“Basically, it’s a variation the cell uses to take a drink, then it dumps the drink back out on the other side of the cell.”
The key to TransMTS technology, say its developers, is a protein carrier featuring protein transduction domains that hold on to the cell membrane and allow larger molecules to pass through it undisturbed. The transport technology is also currently being studied for early applications of new cardiovascular disease drugs. Additionally, three different cancer drug trials are being investigated based on the system’s ability to transport molecules, according to the firm.
ADVANTAGE: EYE
While TransMTS technology may benefit additional medical innovations including insulin and other compounds, a phase III trial is underway to establish the neurotoxin adjunct’s effectiveness and advantages when treating crow’s feet. An area greatly sensitive to injections, a topical toxin may be a relief to most patients.
“I don’t think there’s much question regarding [the topical toxin’s] clinical effect for lateral crow’s feet,” says Richard Glogau, M.D., clinical professor of dermatology at the University of California and participant in the phase II clinical trial. “Yet, they [will need to] keep continuing to improve the formulation due to a delivery problem with the gel vehicle,” he adds.
The gel that allows the combination of the peptide and the toxin to get through the skin and the mechanics of using the gel present challenges in terms of getting it to stay where it is applied, according to Dr. Glogau, who completed a recent study for primary axillary hyperhidrosis with the topical form of botulinum toxin type A.
In that study, researchers used the topical agent to treat 12 patients in a randomized, blinded, vehicle-controlled study that also showed promising results: A 65 percent mean reduction of sweating on 10 axillae treated with the BTX-A (200 U) was observed after four weeks of treatment, compared with a 25 percent mean reduction in sweating on the vehicle controlled axillae. Although the topical toxin displayed its ability to reach the bottom of the dermis when treating hyperhidrosis, the one-time dosage upon which the crow’s feet trials’ results are based may be problematic says one investigator.
“It’s a very artificial situation, and I think that anything in dermatology ends up being a serial treatment — patients are looking for long-term effect,” Dr. Glogau says. “Yet, I think the neurotoxin is realistic in its abilities.”
“My one concern is that the topical toxin will be thought of as just the same as an injectable toxin, but in reality it’s another tool,” Dr. Waugh says. “Yet, it can be used to do some of the things that injectables can’t do.”
REFERENCE
Glogau RG. Topically applied botulinum toxin type A for the treatment of primary axillary hyperhidrosis: results of a randomized, blinded, vehicle-controlled study. Dermatol Surg. 2007;33(1 Spec No.):S76-S80.
DISCLOSURE
Dr. Kane is a paid consultant to Revance Therapeutics with an ownership equity interest comprising stock options whose value is less than $50,000 during the time of the study and for one year following completion of the study. Dr. Kane does not have a proprietary or financial interest in a product, patent, trademark, copyright, or licensing agreement, and has not received significant payments from Revance exclusive of the costs of conducting the clinical study or any financial arrangements whereby the value of the compensation could be influenced by the outcome of the study or tied to sales of the product.
Aug 1, 2009
By: Beth Kapes
Cosmetic Surgery Times
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