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You Are What You Eat

March 24th, 2014

You Are What You Eat

April is Oral Cancer Awareness Month.  Consuming a diet rich in vitamins and minerals is part of any recommended cancer prevention diet.  We should try to do this by eating food.  There is much discussion about the value, and in some cases, safety of supplements.  Try to incorporate foods rich in anti-oxidants and foods that are considered anti-inflammatory. This includes green leafy vegetables, colorful vegetables, and fruits.

Smoothies can be a convenient way to incorporate more fruits and vegetables into your diet.  Incorporate some of the foods listed below and you can create a healthy and delicious smoothie.   Don’t be afraid to experiment to find the most flavorful smoothie you can enjoy daily.  Another benefit is that blended foods also provide more satiety, which is also known as the “fullness factor” and appear to empty from your stomach more slowly, thus making you feel full for a longer period of time.

For about the past 10 years, my breakfast is a smoothie.  Here are my tips:

Dr. Markiewicz makes a smoothie from Anthony Markiewicz, DDS, FAGD on Vimeo.

  • You will need: A cutting board, a good knife for chopping, a colander, a salad spinner, a storage container (I use zip-lock bags), and a strong blender (Healthmaster, Vita-Mix, Magic Bullet Blenders work well).
  • I shop and prepare all my produce weekly, thus I have always have a convenient supply for my smoothie.  You can purchase packaged produce, but I find fresh produce I clean is less expensive and stays fresh longer.
  • Some suggestions (see video):
    • Try using spinach, kale, chard, and/or collard greens
    • Fresh ginger and turmeric
    • Avocado
    • Ground flax or chia seeds (good source of Omega 3 Fatty Acids)
    • Frozen Berries
    • Protein: I use a powder or low fat Greek yougurt




Fruits and Vegetables highest in Anti-oxidants


1. Prunes

2. Raisins

3. Blueberries

4. Blackberries

5. Strawberries

6. Raspberries

7. Plums

8. Oranges

9. Red grapes

10. Cherries



1. Kale

2. Spinach

3. Brussels sprouts

4. Alfalfa sprouts

5. Broccoli flowers

6. Beets

7. Red bell peppers

8. Onions

9. Corn

10. Eggplant

I hope you find this helpful.

Tony Markiewicz

April is Oral Cancer Awareness Month

March 24th, 2014

April is Oral Cancer Awareness Month
Helping you keep your teeth for a longer lifetime
As can be seen by the statistics I cite below, Oral Cancer is a growing threat.  Oral cancer is growing at double digit rates despite declines in alcohol and tobacco use.  As with most cancers, early detection is the key.  We have always routinely screened for Oral Cancer and have offered an enhanced Oral Cancer screening for the past several years.  Yes, that was the exam that required the rinse with “that vinegary tasting stuff”.  In our continuing quest to offer you the best care possible and being responsive to changes in your healthcare needs, we have introduced a new enhanced method of Oral Cancer Screening.  We now offer the VELscope Oral Assessment System.  This is a  handheld scope that applies tissue fluorescence visualization to help  identify  abnormalities.  No rinses needed!  We are incorporating an evaluation with this advanced scope for all our patients.  This is the best system currently available.

These statistics are alarming:
  •  Close to 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year.
  •  It will cause over 8,000 deaths, killing roughly 1 person per hour, 24 hours per day.
  •  Of those 42,000 newly diagnosed individuals, only slightly more than half will be alive in 5 years  (Approximately 57%) This number has not significantly improved in decades.
  •  The death rate for oral cancer is higher than that of cancers which we hear about routinely such as cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid, or skin cancer (malignant melanoma). In fact, it is three times more common than cervical cancer.
  • If you expand the definition of oral cancers to include cancer of the larynx, for which the risk factors are the same, the numbers of diagnosed cases grow to approximately 54,000 individuals and 13,500 deaths per year in the U.S. alone. This is 1 person every 45 minutes.

Oral  Cancer is especially dangerous because in early stages it: 

  • Goes unnoticed by patients  
  • Causes no pain, Has no symptoms  
  • Has high risks of producing a second primary tumor
Historically, the death rate associated with this cancer is particularly high because the cancer
is routinely discovered late in its development. When discovered, 65-75% are in stage 3 or 4
and is often discovered after it has metastasized to lymph nodes, when the prognosis is
significantly worse.
  •  78% of those diagnosed with stage 4 die within 5 years. Oral cancer is more deadly in terms of 5 year mortality rate then cervical, breast, liver, kidney, thyroid, colon or prostate cancer
  •  90% success rate if detected early. Stage 1 has 80-90% survival rate
  •  70% recurrence rate (reason uncertain)
  •  Oral cancer patients have 20 times higher risk of 2nd, different type of cancer in next 5-10 years
  •  Oral cancer is growing at double digit rates despite declines in alcohol and tobacco use
  •  Fastest growing group is females in their 40s
  •  According to the CDC, 12% of all dysplasias will become cancer within five years
HPV plays a role in the increase in Oral Cancer
  •  The human papilloma virus, particularly versions 16 and 18, has now been shown to be sexually transmitted between partners, and is conclusively implicated in the increasing incidence of young, non-smoking oral cancer patients.
  •  Based on recent revelations in peer reviewed published data in the last few years, it is the belief of the Oral Cancer Foundation, that in people under the age of 50,  HPV16 may even be replacing tobacco as the primary causative agent in the initiation of the disease process.
  •  Most Americans will have some version of one of the 130 strains of HPV viruses in their lifetime.
  •  HPV related oral cancer contributes to 40-80% of all oral cancer cases in the US currently. This is the same virus, along with other versions of the virus that is  the causative agent in morethan 90% of all cervical cancers.
  • The location where oral cancer most frequently occurs is also shifting. The anterior of the mouth, tobacco and alcohol associated cancers have declined along  with a corresponding decline in smoking, and posterior of the oral cavity sites associated with the HPV16 viral cause are increasing.
  •  HPV lesions are buried deep within tissues below the basement membrane barrier at the base of the tongue, in the tonsillar area and in the oropharynx
  • HPV related oral cancers cannot be detected with traditional tools, fluorescence, tissue reflectance or brush cytology
  • HPV related oral cancers often do not manifest pre-cancerous lesions which historically have been early warning signs with other oral cancers
  • The addition of HPV as a risk factor for oral cancer has made it difficult if not impossible to easily define high risk individuals. OPPORTUNISTIC mass screening  is the only viable choice to find oral cancer at precancerous or very early stage high survival stages.
Viral causes are changing demographics rapidly for the first time. The fastest growing population segment at risks is the under 50 non smoker.
Every adult must be considered at risk.
  •  40 years of age or older (does occur at younger ages)
  •  Tobacco use or history of use
  •  Alcohol use (1 drink per day)
  •  Alcohol and tobacco use increases risks by 15%
  •  Human Papilloma Virus especially HPV 16 and HPV 18
  •  25% of oral dysplasias are discovered in patients with no identifiable common risk factors
  •  2 times more often in men
  •  2 times more often in blacks
  •  More prevalent in patients with diet low in fruits and vegetables
  •  Exposure to ultraviolet radiation (especially the lip)
  •  Exposure to radiation other than dental radiographs
  •  25% of oral cancer patients have no life style risks
  •  In the past 30 years, a 60% increase in tongue cancer detected in patients under 40
  •  Oral cancer history
Early screening is the key and as  dentists, we are best suited to perform this screening exam for you.  Remember, screening is not a diagnosis.  If warranted, a referral for a biopsy is necessary for a diagnosis.
We need you to help us by answering these questions for us: 
• Can you tell me about any swelling or pain that you have experienced in your face, mouth, neck, tonsils,     or throat areas?
• Can you tell me about any painless, non-moving, firm bumps on your neck?
• Can you tell me about any mouth sore that you have had lasting more than 2 weeks?
• Can you tell me about any oral bleeding that you have experienced?
• Can you tell me about any changes in the way things have recently tasted?
• Can you tell me about any changes in the way your voice sounds?
• Can you tell me about any changes to the surface of your mouth?
• Can you tell me about any problems that you have experienced eating or swallowing?
• Can you tell me about any recent changes in your weight?
In order to provide you with the best care possible, we continue to improve our skills and technology.
I realize this was a lot of information.  Be sure to ask any questions you may have.
Tony Markiewicz

So what is a Biofilm?

March 19th, 2014

To understand oral health, it is important to understand what a biofilm is. Here is a great video that teaches you all you need to know.

Optimal Oral Hygiene Program

March 17th, 2014

Optimal Oral Home Care

Optimal Oral Home Care is extremely important to maintaining the health of your teeth and gums and as I have previously stated, my team and I have been reviewing the studies consistently showing the importance of Optimal Oral Health to maintaining your general health.


Optimal Oral Health simply means the absence of Oral disease:
• Absence of Infection (Tooth and Gum)
• Absence of inflammation (gingivitis and/or periodontitis)
• Absence of tooth decay
• Absence of failing restorations
• Adequate natural teeth or adequate restored missing teeth to allow proper eating, speech, and esthetics
• Absence of Pre-cancerous or cancerous growths
• Absence or control of parafunction (grinding or clenching)

To achieve Optimal Oral Health requires a partnership between us. We will monitor your Oral Health and recommend treatment options for you when necessary. We need you to follow our Continuing Care recommendations, our treatment recommendations, and follow a recommended home care program.

Let’s talk about an Optimal Home Care Program

A different way to look at Oral Hygiene
(Please be advised that this is a very simplified discussion of dental disease)
Our teeth exist in a warm and wet environment that promotes bacterial growth. It is bacteria that are responsible for both gum disease and dental decay, although not all bacteria are harmful. Some of the bacteria promote health, while others are harmful and are responsible for dental disease.
• Bacteria on your teeth produce acid and cause tooth decay.
• Bacteria at and below the gum line cause an immune response from your body which results in inflammation, namely gingivitis and periodontitis.
Our focus has been to remove bacteria from your teeth and control any damage those bacteria can cause.   Some examples are using fluoride to strengthen enamel and make it more resistant to the acid that causes decay and removing decay and restoring teeth with fillings and crowns.

Let’s look at this a little differently. Think of the saliva as water in a fish tank. Think of your teeth as stones in the fish tank. You could polish (and floss) the stones until they were perfectly clean, but if the water in the tank was dirty, the stones would immediately get dirty again.  Regular cleanings by our hygienist, brushing, and flossing are extremely important. By regularly removing calculus, bacterial plaque, and disrupting biofilms, we are reducing the bacterial load present in your mouth, thus promoting health. Is there anything else we can do to create an environment of clean saliva by promoting the growth of healthy, good bacteria, and eliminating the bad bacteria? Current research seems to show that there is.  Healthy saliva will help reduce the number of bad bacteria. Bacterial plaque will be less adherent to your teeth and easier to remove. It will allow gum inflammation to heal, and will help close off the connection between your mouth and the rest of your body. It will also strengthen and protect the enamel on your teeth. The return on your effort will be very tangible:
• Reduced plaque and easier cleanings
• Reduce your risk of tooth decay and other diseases of your teeth and gums
• Most importantly, you may significantly reduce your risk of several systemic diseases
Head to your local pharmacy and walk down the Oral Hygiene Isle. I get confused. What is truly good and what is hype.  To follow is the revised Oral Hygiene program I myself am following and recommend.

Here is a short video showing the recommended products:

Oral Care products from Anthony Markiewicz, DDS, FAGD on Vimeo.

There are 2 components to my optimal home oral hygiene regimen. One is a specific combination of tongue scraping, brushing and mouth rinses. The other component is the regular consumption of xylitol.
Scraping, Oral Rinses and Brushing:
1. Scrape with a tongue scraper for 10-15 seconds.
2. Floss
3. Irrigate (Closys mouth rinse in an Airflosser or a 1:10 dilution in a Water Pik)
4. Brush for 2 min. Use fluoride toothpaste. I am using the Closys with fluoride.
5. Rinse with Closys mouth rinse for 60 seconds.
1. Scrape with a tongue scraper for 10-15 seconds.
2. Floss
3. Irrigate (Closys mouth rinse in an Airflosser or a 1:10 dilution in a Water Pik)
4. Brush for 2 min. (Studies repeatedly show that electric toothbrushes are far superior to manual. I like the Oral-B, many like the Sonicare. Use fluoride toothpaste. I am using the Closys with fluoride.
5. Rinse vigorously with Listerine or Crest Pro-health for 30-60 seconds.
6. Rinse with an Anti-cavity fluoride rinse for 60 seconds or use a recommended fluoride paste. Don’t rinse.
Why Use Closys?
This chlorine dioxide rinse offers 2 benefits. It complements Listerine or Pro-health by more effectively killing the oxygen hating anaerobic bacteria. Closys is also good because it neutralizes any acidity in your mouth prior to brushing. Focus on bathing your back teeth and tongue. This is where anaerobic bacteria live, and deeper pockets usually form in your back teeth first.
What is Xylitol?
Xylitol is a 5-carbon sugar alcohol used as a sweetener. It is very different from other sugar alcohols like sorbitol and mannitol. Its very low glycemic index of 7 makes it the ideal sweetener for diabetics. Humans don’t actually use insulin to metabolize it!  Xylitol was originally extracted from birch bark, but now mainly comes from corn cobs. American Indians chewed on sticks made from birch bark, which is likely why their dentition was so good. Military dentists provide xylitol to troops in the field who often aren’t able to brush regularly.  Xylitol works by killing the bad bacteria. The disease causing bacteria are able to ingest xylitol, but they are not able to use it for food. Therefore, they starve themselves to death! Xylitol promotes the growth of good bacteria, which are not as adherent to teeth, so are more easily brushed and flossed off.
Some other pearls about xylitol:
• The bacteria mix produced by consuming xylitol is less adherent to teeth, so it brushes off more easily.
• Xylitol plus the fluoride rinse whiten teeth. The film of bacteria can accentuate staining substances like coffee and red wine. Stains brush away when the less adherent good bacteria are released. Enamel strengthened with fluoride will better resist staining. Also, strong enamel reflects light and will appear whiter than soft teeth that are more translucent and show the underlying yellow dentin.
• Studies show that 6-10 g must be consumed daily to receive the beneficial effects. More is not likely dangerous, just not shown to be more effective.
• Xylitol must be consumed 3-5 times over the course of a day. Gum, breath mints, and a granular form for drinks make this easy.
• Xylitol effectively neutralizes an acidic meal or drink, so consuming xylitol after meals and snacks is perfect.
• Purchasing 100% xylitol without significant other ingredients is important. Other ingredients can reduce its effect.
Like Chocolate, keep xylitol away from your dog. It can be deadly!
Spry products contain Xylitol. Try the mints. The gum is not very satisfying.

Feel free to ask questions.

Tony Markiewicz

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