Saving a Knocked Out Permanent Tooth

John T. Rowe, MD / March 26, 2014

Having a Tooth Knocked Out is a Common Injury

Having a permanent tooth knocked out is a fairly common accident in the United States with more than 5 million dental avulsions, as they are called, occurring in children and adults each year. Most cases are due to sports injuries or fighting, but accidental falls, car accidents and biting on hard food can be other causes of this largely preventable injury.

What to Do

Because the tooth in many cases can be saved, these injuries should be treated as a medical emergency. The chance of saving the tooth is greatest if the following steps are started within 30 to 60 minutes of the injury:

-First locate the tooth and rinse it gently under running water.

-Next, try to replace it in the socket, applying gentle pressure.

-If you cannot replace it in the socket, place the tooth in a glass of milk.

-Finally, go immediately to the dentist or nearest emergency room.

It is important to handle the tooth carefully, picking it up by the chewing surface, so as not to injure the root. The tooth should not be scrubbed and should be kept moist at all times.

Follow Up and Prevention

While the root of the tooth can reattach to bone, usually within 3 to 4 weeks, the nerves and blood vessels cannot be repaired. For this reason, your dentist will most likely have to perform a root canal procedure. Tooth injuries are best prevented by wearing a mouth guard while playing contact sports, avoiding fights, always wearing seatbelts in the car and avoiding hard foods.

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France, The Gastronomic Capital of the World!

The French Diet

John T. Rowe, MD / February 25, 2014

Is the French Diet the Real Lean Cuisine?

There has been much speculation about why the people of France seem to stay slim and have a lower incidence of heart disease, all the while living in a country that is known as the gastronomic capital of the world. We’re all familiar with the fabulous cuisine of France…the fat and calorie laden dishes topped with rich sauces. If you’ve ever been to Lyon, you know what I’m talking about! Some thoughtful scientific articles have suggested that the wine that is introduced into their diet at an early age may be cardio-protective. A number of studies have shown that moderate alcohol intake along with a healthy diet may raise HDL cholesterol or the ‘good’ cholesterol by as much as 20%. But what about the paucity of paunches in France?

Healthy Habits of the French

Suzanne Havala Hobbs, a registered dietitian and professor at the University of North Carolina, made some interesting observations during her recent trip to France and reported them in an article appearing in the News Observer. Sizing up the people she met along the way confirmed her impression that there are fewer overweight folks in France. In addition to seeing little consumption of soft drinks, she found that limiting portion size seemed to play a big role. In France, the people are more likely to walk to and from the market, getting exercise along the way, and buying smaller items and less food since they have to carry it. The stores, in turn, stock food in smaller sizes to accommodate this practice. Hobbs noted that at home, the French people have small refrigerators and therefore keep less food on hand. This would seem to put an automatic control on ‘grazing’. Definitely some food for thought. The bottom line…healthy eating habits, exercise and perhaps a small amount of alcohol if you are so inclined may help keep you slim and healthy.

Check out Hobbs’ complete article, ‘How French People Stay So Slim’.

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Why We Should Not Legalize Marijuana

2 Comments / John T. Rowe, MD / January 30, 2014

Why We Should Not Legalize Marijuana

Many of you have been following the ongoing debate over whether marijuana (pot, weed, cannabis) should be legalized. On the one side are those who say it is no more harmful than smoking cigarettes or drinking alcohol and that each individual should be able to make his or her own decision concerning whether or not they want to use it. They further state that making marijuana legal would empty out the prisons, put dealers out of business and bring in tax revenue. On the other side are those who are deeply concerned about making a potentially harmful substance even more readily available than it is already. They site numerous reliable scientific studies that chronicle the health and safety consequences of using cannabis and point out that in general Americans do obey the laws regulating mind altering substances. I fall into the latter group and strongly oppose legalization of pot. Since it’s already illegal, why open Pandora’s Box and open ourselves to all the problems that would come with its increased availability and use.

The Scientific Evidence Against Legalization of Marijuana

The American Academy of Pediatrics, the foremost professional organization dedicated to the health of all children worldwide, opposes the legalization of marijuana. And with good reason! The scientific evidence is overwhelming that tetrahydrocannabinol, the principle psychotropic ingredient of marijuana, has both short term and long term negative consequences. In the short term, it causes problems with memory and learning, distorted perception, loss of coordination, increased heart rate, anxiety and difficulty with thinking and problem solving. In the long term, marijuana increases the risk of developing psychosis, depression and personality disorders. When marijuana is smoked it has the same adverse health consequences as smoking cigarettes, including an increased risk of developing lung cancer, chronic lung disease and heart disease. Because there are many more chemicals in marijuana smoke, it is thought that these effects might be even more pronounced with smoking weed. Impairment from marijuana can last hours and metabolites of the drug can be detected in the body for up to a month. Perhaps the most significant negative impact of marijuana concerns its effects on the developing brain. When used by teenagers it can have lasting effects, including an increased risk of intellectual decline, suicidal thoughts, schizophrenia and other emotional problems. Furthermore, marijuana use can blunt a young person’s motivation, drive and ambition. It can also negatively affect the sexual and reproductive physiology of both males and females. It is important to note that tetrahydrocannabinol and other substances ingested with it can cross the placenta during pregnancy to be absorbed by the developing fetus and it is transmitted in breast milk to be ingested by a nursing infant. Finally, despite claims to the contrary, a certain number of marijuana users will become addicted to it. Considering all of these negative health consequences, it is not surprising that so many individuals on both sides of the political spectrum, from Patrick Kennedy to William Bennett, oppose the legalization of marijuana.

The Prohibition Experience

Of course, no one is suggesting that we make alcohol illegal again, but our nation’s experience with Prohibition, as it was known, did teach us an important lesson…laws against mind altering substances can be effective and most Americans abide by those laws. Students of history will remember that in 1919 the 18th Amendment to the Constitution of the United States prohibited the manufacture, sale and distribution of alcohol and alcoholic beverages. Prohibition ended with its repeal by way of the 21st Amendment in 1933. It is a common misconception that prohibition did not work. In actuality, it did to a considerable extent. Public Health Records during that period show that a substantial number of Americans obeyed the law and that per capita consumption of alcohol decreased by more than half. Taking into account the lag time between the beginning of heavy alcohol consumption and the development of cirrhosis of the liver, the incidence of this life threatening condition decreased concomitantly with the decrease in alcohol consumption during Prohibition. Arrests for public drunkenness and hospital admissions for alcoholic psychosis also declined significantly. So, Prohibition showed that, in general, Americans follow laws that are intended to protect them. I think we can all agree that some regulations are necessary for public health and safety reasons and if keeping marijuana illegal will protect a large number of Americans from its harmful effects, then that is what we should do.

What I See Ahead

With the combined forces of libertarians and progressives pushing for legalization of pot, it is likely that we will see more and more states going that way and perhaps even an easing of restrictions on a national level. If that happens we will see more children, teens and adults using marijuana, because ‘if the government says it’s ok to use, then it must be safe’. The result will be that we’ll see more automobile accidents, more rudderless children and more mentally disturbed adults. Ironically, while the medical marijuana scam was used as a way to get the foot in the door so that it could be opened to full legalization, those who have been dispensing medical marijuana would be out of business. So will the marijuana drug smugglers and pushers who will be forced into the business of promoting more dangerous drugs like cocaine. Just as marijuana has been a gateway drug that leads users to more serious addictions, and medical marijuana was just a gateway to full easing of restrictions, will legalization of marijuana just be a gateway to legalization of more dangerous drugs? It all comes down to ‘where do we draw the line’. I say we keep the line where it is. For our children’s sake, let’s not let this genie out of the bottle.

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Clogged Arteries

John T. Rowe, MD / December 29, 2013

Begins at an Early Age

A heart attack or myocardial infarction occurs when blood flow through the coronary arteries, which supply oxygen and other nutrients to the heart muscle, is interrupted. It is usually caused by a blood clot in arteries that have already become narrowed by atherosclerosis (deposition of fats and cholesterol on the inner surface of the arteries). A heart attack can cause damage to the heart and even death. Autopsies performed on Korean War casualties gave one of the first indications that atherosclerosis or clogging of the coronary (and other) arteries begins at an early age. About 75% of the hearts studied in those autopsies showed evidence of heart disease, even though the subjects may have experienced no symptoms during life. This study was a wake-up call back in the 1950s, bringing attention to the insidious nature of coronary heart disease and its early age of onset.

Making Progress

Similar studies involving casualties of the Vietnam War indicated that about 45% of young men had atherosclerotic involvement of the coronary arteries. A more recent study by Dr. Bryant Webber of the Uniformed Services University of the Health Sciences at Bethesda, Maryland showed that about 9% of service members who died in the Iraq and Afghanistan Wars from 2001 to 2011 had coronary artery plaque buildup, an early sign of atherosclerosis. These numbers seem to indicate that progress has been made in stemming the tide of coronary artery disease which had reached epidemic proportions 60 years ago.

What You Can Do

The likely reasons for this progress include better control of cholesterol and blood pressure levels and awareness of the negative effects of smoking on the arteries. While the CDC reports that about 385,000 individuals die in the U.S. every year as a result of coronary heart disease, the good news is that young people today can expect to have less heart disease than previous generations. To maintain this progress we should all monitor and control our blood pressure and cholesterol levels and abstain from smoking. Two risk factors for coronary atherosclerosis which have not shown progress are obesity and diabetes and these should be the new targets in the war against heart disease. To learn more about what you can do to promote a healthy lifestyle for both you and your family start with a visit to your physician, physician assistant or nurse practitioner.

Risk Factors for Heart Disease That Can Be Treated or Changed:

Smoking

High Blood Pressure

Elevated Cholesterol

Diabetes

Obesity

Sedentary Lifestyle

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Fiber

1 Comment / John T. Rowe, MD / November 29, 2013

An Important Part of Your Diet

Fiber, or what we used to call roughage, is an important part of a good, healthy diet. Foods with fiber help us in a number of ways. They help satisfy our appetite without adding lots of calories and because they take longer to chew, they help us reach the point where we feel full before we overeat. Since fiber is not absorbed and moves through the digestive tract intact, it helps keep food moving through the stomach, small intestine and colon. It also helps prevent constipation or hard stools by making stools softer and more bulky. Fiber may also help prevent hemorrhoids and diverticuli or pouches in the colon. In addition, fiber provides nutrients and vitamins and may help lower cholesterol levels. Because it slows the absorption of sugar, fiber may reduce the risk of developing type 2 diabetes and may help diabetics control their blood sugar levels.

Sources of Fiber

Some of the most important sources of fiber include vegetables, fruit, beans, peas, nuts and whole grain breads and cereals. You may have noticed that some good sources of fiber are incompatible with a gluten-free diet, such as whole grains like wheat, oat and barley. Fiber can also cause gas, particularly beans, but you can minimize their propensity to cause flatulence by soaking them overnight in water and then disposing of the water. As a last resort, Beano can help by providing a natural digestive enzyme that will prevent gas. Just how much fiber should you have each day. There’s nothing complicated about the recommended guidelines. Just eat at least five servings (a total of two and a half cups) of fruits and vegetables each day along with some of the other foods mentioned above and you’re good to go! And if that isn’t enough to keep things moving add some powdered fiber in the PM for a BM in the AM.

Powdered Fibers

It’s a good idea to check with your healthcare provider if you have any questions before you begin using these commercially available fiber products. It is best to use sugar free products like the two mentioned below. Citrucel has a pleasant taste and is less likely to cause gas than some other fiber products. Always mix the recommended dose with a full 8 oz. glass of water, stir thoroughly and drink promptly to prevent choking. These products are recommended for adults and children over the age of 12. Check with your pediatrician for recommendations on treating constipation in children.

Psyllium Fiber (Konsyl or the less expensive CVS version)

Methylcellulose Fiber (Citrucel)

Doctor John’s Fiber Cocktail Recipe: mix one slightly rounded teaspoon each of psyllium and methylcellulose in 10 oz. water and take one hour before bedtime.

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Gardener Working on the Floral Clock, Princes Street Gardens, Edinburgh

Non-exercise Activity is Good for You

John T. Rowe, MD / October 30, 2013

Gardening is in My Blood

I must be the only guy in my neighborhood who still mows his own lawn. Every week, rain or shine, summer or winter, I’m out there for several hours raking, digging, chopping and trimming. It’s therapeutic for me. After all, my yard is one of the few things in my life that I have almost complete control over. I get a lot of thinking done out there and make a lot of important decisions while I’m plodding away. It must be in my genes. I can remember as a kid following my Dad with my toy lawn mower as he pushed the old reel mower we had back then. Everyone wondered why we had the best roses on the street, but I knew why. I watched my Dad run out in the street with his shovel to clean up after the horses that went by and then but the manure in his garden. And I’m proud to know that his grandfather was the Superintendent of the Princes Street Gardens in Edinburgh, Scotland at the turn of the 20^th Century and designed the famous Floral Clock that still attracts visitors there today.

The Princes Street Gardens, Edinburgh, Scotland

Non-exercise Activity is Good for You

A recent study conducted by Elin Ekblom-Bak and colleagues at the Karolinska Institute in Stockholm, Sweden seems to confirm my long held belief that non-exercise activity like gardening is good for you. Their study showed that while intentional exercise is important, what you do the rest of the day has a significant impact on your health as well. For individuals 60 and older, activities like housework, gardening and maintenance projects such as working on a car, anything that keeps you on your feet, could reduce your risk of stroke or heart attack by 27% and the risk of dying from any cause by 30% according to their findings. Individuals who were active tended to be closer to their ideal weight and have better levels of cholesterol, triglycerides and glucose. So, in addition to not-smoking, getting regular exercise and eating properly, remember that all those activities of daily living are good for you, too. Oops…gotta run. There’s grass to be cut, leaves to be raked and trees to be trimmed!

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