We are facing an epidemic of chronic inflammation, not only in United States, but globally. Chronic inflammation can be manifested in many different ways: cardiovascular disease, obesity, diabetes, high cholesterol, rheumatoid arthritis, or periodontitis, cavities and oral ulcers, to name a few. As a periodontist, I know that inflammation of the gums or ulcerations are indicative of someone’s overall health. Just as the eyes are windows to the soul, the mouth is the gateway to one’s health and well-being.

So where is this chronic inflammation epidemic coming from? Mainly, our Standard American Diet (SAD). We see patients who are overfed and undernourished and this wreaks havoc on their bodies inside and outside. Depression is a common phenomena with the SAD diet and lets face it: someone who is depressed is not motivated to live, let alone go to the dentist or brush their teeth.

I believe that we, as dentists have an amazing opportunity here. We can make our communities healthier by incorporating a short nutritional evaluation and encouraging patients to make lifestyle changes that will improve not only their oral health, but their overall health. Statistics show that more people go to the dentist than to see their physician for a physical. Furthermore, unless someone goes to an integrative or functional medicine practice, most physicians do not even discuss the importance of healthy eating. We are not doing any better, either, as dentists. A recent poll shows that only 4% of dental practices offer any form of nutritional counseling. As a periodontist and nutritionist, I know that most dental offices don’t have a nutritional evaluation questionnaire. The easiest way I found is to incorporate this dietary questionnaire as part of the medical history. Part of this should be a list of the patient’s nutritional supplements, as these can cause blood thinning or interaction with some medications.

Nutritional deficiencies manifest in the mouth. Redness at the corners of the mouth, shiny, glossy tongue, burning mouth, bleeding gums, can all be signs of different deficiencies, such as B-6, iron or vitamin A or C. If someone has ulcers on the check or tongue, it may be a sign of food intolerance. If you are not comfortable treating these symptoms, it is important to create a good relationship with a nutritionist in your area to be able to diagnose and treat these problems. I am not a fan of prescribing corticosteroids to mask the problem and not get to the root of it.

Having a dental practice is about creating long lasting relationships with our patients. Some of my patients have benefited more from one advice I’d give them about nutrition than any dental procedure I did for them. Some have told me they will always remember to take a probiotic for example, or that canker sores can be a result of gluten intolerance and that this 5-minute conversation they will never forget. “I have told all my friends about your nutritional advice” is a common thing I hear from my patients. Not only I feel a tremendous amount of satisfaction and joy to help them feel better overall, but also, and there’s nothing more I can ask for than to be brought up in their conversations after they leave my office.

So I encourage you to start talking with your patients about their diet and supplements they take, start changing their lives. Consider taking a class to update your nutritional knowledge. It has come a long way since just a few years ago. It will improve your relationship with your patients because they’ll know you care about their well-being, and also, it’s a great way to generate more referrals.

In great health,
Dr. Sanda

To uncover nutritional deficiencies through nutritional evaluation contact Dr. Sanda Moldovan to schedule a consultation.

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September is already here, but here in Southern California we are still experiencing scorching hot Summer days, with temperatures in the 90s in Beverly Hills.

Often times I recommend ice cream post surgery, but now I can really use one myself! But, like many of you, I don’t do well with dairy and too much sugar. I have some great news! I found a great alternative this past year! It’s called Arctic Zero, only 150 cal per pint and only about 5 g of sugar per serving! It’s a frozen dessert that’s made with whey protein, not with whole milk, so it doesn’t cause gas, for those of you who are lactose intolerant. I sometimes put whey protein in my smoothies, but i’m excited to finally see it in a frozen desert.

Chicory root is also added to this frozen dessert, which is not only a good source of dietary fiber, but also a prebiotic, due to the inulin content. A prebiotic is important food for out gut-friendly bacteria. Overall, it’s a great alternative to ice cream and it includes all natural ingredients. My favorite flavors are mint chocolate, coconut and coffee.

This is a great desert for those of you on a weight loss program, due to its low calorie, and high protein and fiber content. So when you get that craving for something sweet, go ahead and eat the whole pint of Arctic Zero! You don’t have to feel guilty anymore!

In great health,
Dr. Sanda

For more sweet tips from an award-winning periodontist and nutritionist contact Dr. Sanda Moldovan to schedule a consultation.

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Photo by einalem

It’s summertime and vacation travel brings with it the challenges of keeping up your healthy food plan while you are away. The first step to clean eating on a trip starts for many of us when we step onto the airplane. Airline food is no longer as limited as it was back in the day–when the only options were “beef” or “chicken.”

You will now find most airlines provide a variety of meals that cater to all sorts of  personal preference diets, medical needs and religious food plans. You must select your entrees ahead of time and schedule your meals during the booking process, because most flights don’t have the special meals on the plane as they are prepared as special menus.

While on my computer checking in for my 15 1/2 hour flight to Australia, I wanted to really think through my options in advance for what would be the equivalent of two full days of eating. I was given the options of vegetarian, gluten free, vegan and octo-lacto vegetarian. I prefer to maintain mostly a gluten-free diet which is void of wheat, flour, barley, oats, rye, sauces, gravy, stock cube, sausages, or sausage meats and pasta. My protein comes from fish, eggs and legumes.

So, what’s this girl to do, when faced with the following decisions: should I check vegetarian–knowing I’m going to get a pasta dish full of gluten? Or do I choose gluten free, and then it’s going to be all chicken and beef, which I respectfully do not eat? Instead of ‘where’s the beef?’ — as in the familiar old Wendy’s fast food restaurant ad–where are the meals suitable for those of us who are fish-atarians and gluten-free? And, a salad alone is not going to fill me up for the entire flight.

I spent a lot of time on these food choices, before going with ovo-lacto vegetarian. Sure enough, pasta shows up on my plate when my tray is served for dinner on the flight. I knew this would be the case, so I took several enzymes which assist in gluten breakdown. This always prevents me from bloating which comes after a pasta dish.

I countered the temptation of sweet biscuits, cakes pastries or cookies by bringing snacks with me. I had an arsenal of apple slices, raw sprouted almonds and my mom’s homemade grain-free crackers. As a result, I felt satisfied and my energy level was stable, even better than if I had indulged in any of the treats the airline provides. Let’s face facts and accept their desserts are not going to be homemade and will most likely be full of over processed ingredients. They are not worth the calories and there is usually zero nutritional value.

Since flying can be stressful all on its own, l want to share some travelers’ tips to stay the course and start your trip out right, by staying in the healthy eating zone.

1. It’s okay to say no. Assert yourself and know that it’s okay to politely decline when the airline attendant stops at your seat offering inflammatory foods.

2. Prepare your favorite healthy snacks ahead of time. Pack protein bars with less than 11 g of sugar and nuts.

3. Most shops in the airport sell raw almonds. If you forget or find you didn’t have time to stash some snacks away, being in a hurry doesn’t mean you have to worry.

4. Drink loads of water to stay hydrated. Liquids will help with jet lag and help prevent blood clots on long travels.

5. Take chewable vitamin C. It will help satisfy your sweet tooth and keep you from getting sick.

Have an amazing time– knowing you are starting your trip with the optimal health you and your family enjoy at home!

In great health,
Dr. Santa

For more tips on maintaining your oral and nutritional health while traveling contact Dr. Sanda Moldovan to schedule a consultation.

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I open a health magazine and there it is: an advertisement for a new drug. Can we escape these anymore? Even on TV, we are constantly bombarded with information about a new medication that will make us feel better. But have you ever read the small print with all the possible side effects? As a periodontist I often see the effect that some of these medications have on your teeth and gums.

The number of prescriptions for antidepressants has gone up tremendously in United States. The most common oral side effect I see in my patients taking antidepressants, as well as other medications, is dry mouth. Most patients with dry mouth know how uncomfortable it can be. But there’s a bigger problem with having dry mouth, outside of the fact that it is so uncomfortable: the rate of cavities exponentially increases when there’s a lack of saliva. I have seen patients who ended up with almost a cavity in every tooth in as little as six months, because dry mouth was not addressed. Some cavities can get deep under the gums and teeth cannot be saved.

If you suffer from dry mouth, ask your dentist what you can do to prevent cavities and watch this video for more information.

We live in a world where obesity is a rampant epidemic and stress is a common factor in everyday life. As a result, high blood pressure is prevalent and blood pressure medications are one of the most common prescribed by physicians. One group of such medications, called calcium-channel blockers, is known to cause gingival enlargement in about 20% of the patients. This is not only esthetically displeasing, but it can create inflammation and possible periodontal disease if left untreated.

If you’ve had any organ transplant, such as heart or kidney, and your doctor prescribes a medication called cyclosporine, you may also note gingival enlargement around your teeth, accompanied by bleeding gums and tenderness. Enlarged gums harbor pathogenic bacteria, which can be detrimental to your new transplanted organ. See a periodontist regularly and have this condition treated.

Some medications can cause white patchy lesions in the mouth or even ulcers, which can persist for months. Ulcers can be very painful and may need to be biopsied. If you recently started taking a new medication and you notice a white or red lesion in the mouth, it may be from your medication. After seeing your dentist, have a consultation with your physician to switch you to something else.

On a deeper level, some medications can affect the ability of the bone to heal. A group of medications, called biphosphonates, is used to treat osteoporosis and cancer. You remember Sally Fields advertising for Boniva? Yes, that’s one of these biphosphonates. Some of these medications are taken once a week or once a month. Some of my patients even forget to tell me about it, as they think of it as more of a supplement for their bone strength. If you are taking this medication, it is very important to inform your dentist, especially if you are going to have any oral surgery, such as a tooth extraction. You may have a delayed healing ability if you are on this medication, and we need to take the right precautions before your procedure.

Medicine is changing constantly and we know now more than ever about the strong oral-systemic connection. The mouth is our window, through which we can see what’s really going on inside us. Dentists and other health care professionals should work together as a team to better treat our patients.

In great health,
Dr. Sanda

Bring an award-winning periodontist and nutritionist into your overall health plan. Contact Dr. Sanda Moldovan to schedule a consultation.

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“Pickles?” you might ask. No, most pickles have no probiotic benefit. Fermented foods actually have live bacterial cultures that are so beneficial to our health.  When I stop eating them, my digestion suffers and I feel more bloated.

Our intestinal passage holds about 2 to 3 pounds of bacteria. We cannot live without them and many things affect their well-being, such as antibiotic intake, stress, and processed foods.  Here are some ways that we know these little bacteria benefit our bodies:

– enhance immune function
– decrease inflammation
– prevent allergies
– provide energy by producing B12
– decrease bloating and constipation
– help with depression and weight loss

My recommendation is to have a serving of fermented foods daily: kefir, yogurt, sauerkraut (the fermented kind, not the one with vinegar), kimchi, kombucha, miso, natto. If you don’t like any of these, not to worry!  You can take a daily probiotic capsule to make up for it.

I recommend 10-20 billion daily of a probiotic with at least 10 different kinds of beneficial bacteria, and make sure they are from the refrigerated section.  I personally use Klaire Labs Therbiotic Complete, but there are other great brands out there.  A great new drinkable probiotic is BioK, with 50 billion in each dose.

Cheers to the little friendly probiotics who are protecting us against the bad bugs!

In great health,
Dr. Sanda

Want more tips from an award-winning periodontist and nutritionist? Contact Dr. Sanda Moldovan to scheduled a consultation.

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