Author Archive

A Dentist to Count On

High-quality care, comfortable atmosphere relax patients

As a military career officer, Ron Sellers did his share of moving between assignments, and landed twice at a base near Satellite Beach. He and his family had relocated to the area for the second time when he met Merrill A. Grant, DMD.

Ron Sellers has been a patient of Merrill A. Grant, DMD, for nearly 30 years, and is among a large group of Dr. Grant’s patients who have been with the practice for years.

Ron has entrusted his dental care to Dr. Grant for nearly three decades.

“My family and I had just gotten back to Satellite Beach – in August 1988 – and were looking for the typical services that need to be set up after a move. My wife asked someone in the community if they knew a good dentist and was told, You need to check out Dr. Grant on Jackson Avenue,” recalls Ron.

Many years later, Ron can still remember what he experienced and how he felt during his first visit with Dr. Grant.

“During my first visit at Dr. Grant’s office, I told him that I wasn’t very comfortable going to the dentist. Being apprehensive about the dentist was just something that’s been an issue throughout my whole life. And I was pleasantly surprised by how he accepted me saying that,” Ron shares.

Despite any initial worries, Ron soon found it was easy to feel comfortable in Dr. Grant’s office. The friendly atmosphere helped him feel at ease. Dr. Grant also is an Air Force veteran, which gave Ron a sense of rapport.

When Ron retired from the military, he and his wife, Annette, decided to stay in Satellite Beach. They have lived in the area for nearly 30 years.

A lot can change over three decades – their kids are now adults, for example – but their choice of dentist never did.
Dr. Grant has been their dentist since they first saw him in 1988. They are part of a large segment of Dr. Grant’s patients who have entrusted him with their dental and preventive care for years.

The People Connection

“We have a lot of patients who have stuck with us over the years and keep coming back,” notes Dr. Grant. “I think part of that is because we listen to our patients. We find out what their needs and wants are and do our best to give them what they need and want.”

Dr. Grant specializes in general and preventive dentistry and has a wide range of skills that includes cosmetic and restorative dentistry. He has a reputation for excellence in a comprehensive range of services, including custom crowns, dental implants and periodontal therapy.

With a keen attention to detail, Dr. Grant is meticulous about planning and welcomes the patient as a partner in creating customized treatment plans. For instance, he keeps people informed through taking photographs and videos of their smiles and thoroughly explaining the treatment process. He presents choices when people need dental care and encourages them to make their own decisions about which course of treatment to pursue.

“We take our time with patients instead of being in a hurry,” says the skilled dentist. “We don’t work up some sort of treatment without consulting with them. We discuss everything we do, and I think people are comfortable with that.”

Dr. Grant and his staff place a priority on creating a caring atmosphere within the office. His goal is to have a “high-trust, low-fear” relationship with patients. He understands that most people would rather avoid the dentist’s office, and he goes above and beyond to help everyone feel comfortable.

“We like people to feel secure,” emphasizes Dr. Grant. “The treatments we do on our patients are the same as I would do on my family, if one of my family members needed treatment. I think people sense that.”

“If you really want a good dentist, and want to go someplace where you’ll end up staying, you need to see Dr. Grant.” -Ron

A key characteristic of the practice is how Dr. Grant and his team take the time to get to know people in his dental chair.

“We actually get to know our patients and they get to know us,” says Dr. Grant. “A lot of places aren’t like that anymore, but we believe that it really makes a difference.”

Ron agrees wholeheartedly.

“Dr. Grant is very approachable. He has a manner about him that allows people to connect with him,” describes Ron. “His staff is also good in how they connect with people and make them feel comfortable. I’ve been in the people business my whole life, in the military and out, and I was struck right away by the quality of his staff.”   

Lasting Impressions

Under Dr. Grant’s care, Ron has kept his teeth and gums healthy through regular preventive visits. He also has occasionally needed other dental work, such as crowns.

He appreciates that Dr. Grant always takes the time to call him later in the day after he’s undergone a procedure.

“I don’t think Dr. Grant ever forgot the fact that I came in the door saying, I’m not very comfortable going to a dentist’s office,” comments Ron. “Any time that I’ve had any type of procedure beyond a cleaning, I can count on him to call later. He’ll call just to check up on me and say, How are you doing? Everything okay?

“To have a dentist make that kind of call is unusual. It’s made a lasting impression on me that he remembered what a patient said to him thirty years ago about being uncomfortable at the dentist’s office.”

Ron admits he’s still a little apprehensive about dental care, but having Dr. Grant as his dentist has eased his discomfort.

“It’s still not the most comfortable thing I do in my life, but one of the things that puts me at ease when I realize that I have to go and have something done is that I’m going to Dr. Grant,” he explains.

“Whenever anyone tells me they need a dentist, or mentions the word dentist, I don’t let them leave without telling them: If you really want a good dentist, and want to go someplace where you’ll end up staying, you need to see Dr. Grant.

FHCN article by Susan Hemmingway. Photo by Jordan Pysz.

Straighten Teeth in Months, Not Years

Jessica Cosden is careful about how she smiles in photographs. Her lips are turned upward in a friendly way, but they always stay closed.

Jessica Cosden treated with Piezocision™-assisted orthodontics to shorten the time she needs to use Invisalign® for misaligned teeth.

Woman wearing orthodontic silicone trainer. Invisible braces

She doesn’t want her teeth to appear on camera. Jessica has natural gaps on either side of her front teeth. Four permanent teeth, two on the top and two on the bottom, never grew in when she was a child.

“It’s a genetic condition that runs in my family – the lateral incisors on the top and the bottom are missing. They were there when I had baby teeth, but after the baby teeth fell out, there weren’t any permanent ones,” says Jessica. “My other teeth that came in drifted and took up some of the space. So there aren’t huge gaps, like you’d expect with a missing tooth, but there still are gaps.”

The look of her smile never shook her confidence, even though she often thought about seeking cosmetic dentistry. At 33, Jessica is a city councilwoman in Cape Coral, where she was born and raised. She has two young children, works for a data marketing company, is pursuing a graduate degree and plays keyboard in a band.

Jessica won her seat on the Cape Coral City Council in 2015. She plans to stay in politics, a goal that got her thinking again about her smile.

“I’ve wanted to do Invisalign® to improve my teeth for a long time. My parents couldn’t afford braces when I was a kid, so Invisalign was always on my mind,” she shares.

“After I was elected and in the public eye, I thought now would be a really good time to do it. If I’m going to stay in this field of politics, I’ve got to get used to smiling.”

Invisalign is a teeth-straightening system that is virtually invisible. Instead of metal wires, the system utilizes a series of customized, clear trays called aligners that fit over the teeth. The aligners are held in place by enamel-colored attachments that are secured onto the teeth.

Normally, the trays are changed every two weeks, with each tray sized to shift the teeth a little more. The number of trays needed – and thus the amount of time required before teeth are straight – depends on the individual.

On average, treatment takes about 12 months, but some people need longer. Their teeth are more of a challenge and need extra time to move into the correct position.

It’s the category Jessica fell in. When planning her treatment, her dentist determined she would need 43 trays to achieve optimal results. The standard amount of time for each tray is two weeks.  This meant she would be in treatment for more than a year and a half. Plus, she might need additional cosmetic follow-up work.

“When I got the treatment plan, I knew I wanted to do it, but I was thinking, Is there anything I can do that can make this quicker?” states Jessica.

Fortunately, her dentist knew of a solution. Jessica was referred to Vani Prabakaran, DDS, a periodontist in Fort Myers. Highly trained in her specialty, Dr. Prabakaran’s professional education includes three years of post-doctoral specialty work at Boston University.

In Boston, Dr. Prabakaran studied under the periodontist who developed Piezocision™-assisted orthodontics and performs the technique in her office. The minimally invasive procedure dramatically shortens the amount of time needed for teeth-straightening systems like Invisalign.

Instead of wearing Invisalign trays for more than 18 months, Jessica could see final results much more quickly, in about half the time.

Key Healing Response

“Piezocision offers a way to speed up orthodontics by up to fifty percent,” educates Dr. Prabakaran. “It involves microincisions between the roots of the teeth and into the bone. This in turn softens the bone, which allows the teeth to move faster.

“The procedure is minimally invasive with no sutures or flap involved,” she continues. “Because the incisions are so small, the gum tissue closes in on itself quickly.”

The microincisions placed in the bone transiently demineralizes the bone, she explains. This allows the orthodontic devices being used to realign the teeth to work faster. When the bone surrounding the teeth is softer, the teeth can be moved into a correct position more quickly.

“It’s a great option for our adult patients who don’t want to wear Invisalign trays or braces for a long period of time,” comments Dr. Prabakaran. “An individual who would have declined
conventional orthodontics strictly due to the length of treatment time now has a viable alternative.”

Jessica underwent the procedure and in Dr. Prabakaran’s skilled hands found it to be simple and effective.

“I watched it through a mirror because I’m fascinated by medical technology,” she recalls. “Dr. Prabakaran numbed the area all up and then made simple incisions between the teeth
and gums. They were much smaller than I imagined.”

Jessica went home and was back at work the following day. “I went back to work and was fine. There were no complications,” she says.

Jessica Cosden treated with Piezocision™-assisted orthodontics to shorten the time she needs to use Invisalign® for misaligned teeth.

Jessica chose a procedure to dramatically shorten orthodontic treatment.

The procedure began to work right away.

“I immediately started going to one week between trays for Invisalign – instead of waiting to change the trays every two weeks – because my teeth were moving faster,” remarks Jessica. “I can see the difference already. I can see that my teeth are moving.”

New Smile on Horizon

Dr. Prabakaran stays in touch with Jessica to see how she is progressing.

“The effect of Piezocision will last for a period of six months. Because Jessica’s treatment time is estimated to be about eleven months, she may feel tightness with each Invisalign tray change at about the six-month mark,” says
Dr. Prabakaran.  “She may need a second visit for Piezocision at that point. Each patient’s treatment plan is different, which is why I check in with both Jessica and her dentist.”

Jessica appreciates Dr. Prabakaran’s accessibility and knowledge.

“I really like her. She knows what she’s doing,” reports Jessica. “I couldn’t find a lot about the procedure online, so I talked with her about it and felt confident.”

Jessica is thrilled that her Invisalign treatment could be completed as early as late summer, less than a year after she started, and eager for when her new, improved smile is unveiled.

“I think my last Invisalign tray will be finished in mid August. Assuming there are no refinements that have to be done after that, I could be looking at my new smile then, which is exciting.

“I’m so glad that I got this treatment from Dr. Prabakaran and for how it sped up the time needed for Invisalign,” she stresses. “When everything is finished, I’m going to have a beautiful headshot taken. I’ll smile with my teeth showing and post it online for the first time ever.”

FHCN article by Susan Hemmingway. Photo by Fred Bellet. Stock photo from istockphoto.com.

Easing Joint Pain

Body’s own platelets help relieve effects of osteoarthritis.

Cliff Parker worked as a truck driver for more than 40 years, a job that required transferring freight on and off the truck. Over time, the extensive driving and heavy lifting took a toll.Cliff Parker treated for shoulder pain, Louis Politano for knee pain with platelet-rich plasma therapy, or PRP. Sidebar on the P-Shot®, a PRP treatment for erectile dysfunction.

“I pretty much wore out my shoulders and arms,” shares Cliff.

He was retired when the effects on one of his shoulders became evident.

“My shoulder would be aggravated by whatever I did around my house,” he says. “If I worked in the yard or did something like skim my swimming pool, by the time I got finished, I couldn’t lift my arm above my shoulder.

“I would be in so much pain that it would take about three or four days to get over it. At night, I’d toss and turn. My shoulder hurt every time I moved.”

Cliff made an appointment with a physician, who diagnosed arthritis. The doctor recommended surgery.

“He wanted to rebuild my whole shoulder. I didn’t want to go through that. Plus, I would have needed a lot of physical therapy afterward,” comments Cliff.

He went home to think about what step to take next. Later, he read an article about Physical Medicine Center and Robert C. Lupo, DC, in Florida Health Care News. The article featured a man who experienced significant relief from knee pain through platelet-rich plasma therapy, known as PRP, which relieves injured joints, tendons, ligaments and muscles.

“I decided to go see Dr. Lupo about whether PRP could help my shoulder,” relates Cliff.

Restoring Function

Physical Medicine Center is a multidisciplinary care center in Tampa offering chiropractic care, physical and massage therapy, medical care, anti-aging treatments and low-level laser therapy.

The center offers PRP for relief from musculoskeletal conditions and has a program to relieve pain from osteoarthritis in the joints of knees, shoulders, hips and the spine through PRP therapy.

During Cliff’s first appointment, Dr. Lupo examined x-rays of Cliff’s shoulder and noted how shoulder pain and restricted motion were affecting him.

“Cliff came to us with some pretty rough shoulder pain. He was unable to lift the arm forward, backward, side to side or in rotation,” says Dr. Lupo.

“His biggest complaints were how this was affecting his lifestyle. He wanted to be able to clean his house, rake the yard and take care of his property. All of that had become very painful to do and certainly difficult.”

Dr. Lupo noticed that Cliff had small tears in his shoulder’s rotator cuff and degenerative changes in the AC joint, where the collarbone meets the highest point of the shoulder blade.

“He also had degenerative changes in the shoulder itself due to osteoarthritis damage. That was the biggest part of his shoulder issue – wear and tear from years of use,” adds Dr. Lupo.

Dr. Lupo determined that Cliff was a good candidate for PRP therapy.

“PRP therapy really shines when it comes to relieving osteoarthritic damage. I explained to Cliff that the degenerative joint changes wouldn’t simply go away but that we could improve his range of motion and certainly bring down his pain level.”

Power of Growth Factors

PRP is autologous, meaning the patient’s own cells are used. The therapy utilizes the body’s platelets, the blood cells that promote clotting, to repair wounds and accelerate healing.

The first step is to draw blood from the patient, similar to how blood is drawn for routine blood work. While the patient waits, the blood is spun in a centrifuge to create a concentration of platelet-rich plasma.

Once the platelet solution is ready, it is injected into the area of the body being treated. The key to PRP treatment is that when platelets are activated in the body, they release healing proteins called growth factors.

“PRP treatment has the ability to utilize growth factors to promote the healing process and rejuvenation of damaged tissue. It also has a very good anti-inflammatory action,” educates Dr. Lupo.

Cliff liked how Dr. Lupo took the time to explain how PRP therapy worked and what it could do for his shoulder.

“He didn’t rush me into anything and explained it all,” describes Cliff, who underwent a series of three PRP treatments.

“After the second one, I started feeling better,” he reports. “It only took a short time after the third treatment before I was feeling immense relief.”

Cliff estimates his pain level has dropped by 80 to 85 percent, and his ability to function has tremendously improved. He’s able to do all the chores that keep his home well maintained.

“I’ve got a pretty big house, and I have a lot to do to keep it looking sharp, including a lot of yard work,” stresses Cliff.    

Cliff Parker treated for shoulder pain, Louis Politano for knee pain with platelet-rich plasma therapy, or PRP. Sidebar on the P-Shot®, a PRP treatment for erectile dysfunction.

“My knee is perfect now. I have no pain at all. It’s like I have a new leg.” – Louis

“The treatment from Dr. Lupo helped me immensely. And it kept me from needing surgery and all the therapy afterward. That was a big relief.”

Relief for Aching Knee

Like Cliff, Louis Politano was having trouble with an arthritic joint. He had a throbbing right knee that seemed to be getting worse.

“I’m a security manager, and I’m on my feet constantly,” relates Louis. “My knee was destroying me. It constantly ached, and I couldn’t take enough Advil®.”

At age 68, Louis had a history of physically demanding jobs and hobbies.

“I was very active in sports when I was younger, and I was a bartender for a lot of years, so I was standing all of the time,” he notes.

On a scale of one to ten, his knee pain was nearly always a nine. He was at the point where he thought knee replacement surgery might be the next step. Louis was determined to avoid surgery at all costs. He had witnessed how knee surgery affected family members.

“My brothers had knee replacement surgeries and they suffered,” he explains. “The recovery is forever.”

In his research for an alternative, Louis read about PRP therapy and consulted Dr. Lupo.

“Louis was experiencing classic symptoms of degenerative joint changes from osteoarthritis,” notes Dr. Lupo. “His knee was stiff and achy, and it was difficult for him to rise from a sitting position to a standing position. He had trouble climbing stairs and standing for long periods of time.”

Dr. Lupo agreed with Louis that knee surgery should be a last resort and recommended PRP therapy. Louis was treated with injections of PRP in both sides of his arthritic knee in three treatment sessions about a month apart.

“The procedure was painless,” says Louis. “I started feeling better after the first set of injections.”

The overall results were dramatic: Louis could barely walk before the therapy. After PRP, the knee pain he had suffered with for months was gone.

“My knee is perfect now. I have no pain at all,” enthuses Louis. “It’s like I have a new leg. I went to Europe on a vacation where I walked about fifty miles. I didn’t have one issue with my knee.”

Louis is grateful that he discovered PRP therapy and sought treatment from Dr. Lupo.

“Dr. Lupo is very knowledgeable and knows what he’s doing,” he comments. “I hadn’t heard of PRP before, but when you’re in a lot of pain, you want to try something else. And it worked!”

FHCN article by Susan Hemmingway. Photos by Jordan Pysz.

Healthy Mouth, Healthy Body

Oral health care pays off for seniors.

Margit Paczier wants to keep her teeth for a lifetime. At age 68, she relies on the expertise and friendly service at Village Dental, her dental home for the past decade.

Margit Paczier, 68, has healthy teeth and gums because of preventive oral health care at Village Dental.

Margit takes care of herself through regular check-ups and cleanings at Village Dental.

Part of her routine is dental cleanings three to four times each year.

“I’m so thrilled with Village Dental because they do an excellent job. My teeth and gums are very healthy,” she relates.

Studies show that Margit is making a wise choice through diligence about oral hygiene. Not only is she protecting her teeth, she is protecting her overall health.

In fact, the health of the mouth can be seen as a mirror that reflects the health of the body. This makes regular dental care essential for seniors, especially if they have chronic health conditions or want to avoid them.

For instance, studies have shown that periodontal disease can contribute to heart disease and make controlling diabetes more difficult. Preventive dental care also may lower the risk of pneumonia by decreasing harmful mouth bacteria that could migrate to the lungs, according to a study in 2016. It showed that people who never see a dentist had an 86 percent greater risk of contracting pneumonia than people who got cleanings and check-ups at least twice a year.

While not everyone is eager to go to the dentist, the Village Dental staff strives to help even the most hesitant patient look forward to dental visits.

The practice combines the best of both worlds: a highly trained staff that uses the most advanced equipment, plus a friendly, warm atmosphere where people are treated like family.

Personalized Pampering

Margit, who lives in The Villages, first visited Village Dental after friends recommended it. She was having trouble with a crown and consulted Richard P. Hall, DMD.

From the start, Dr. Hall and the entire Village Dental staff impressed her. The staff has worked hard to earn the trust of patients, and it shows. They are welcoming, caring and highly trained, but most importantly, they make you feel comfortable.

For this reason, many patients, like Margit, have remained with Village Dental for years.

It all starts with Village Dental’s chief philosophy: Going to the dentist should be a good experience. To meet that goal, the practice maintains a home-like environment, where patients are treated to personalized pampering.

All three locations are designed to feel warm and inviting. Personal touches include blankets and massage mats on exam chairs. Patients can choose to watch cable TV during appointments or listen to their favorite music on iPods®, with lights lowered during treatment if desired.

An important part of Village Dental’s commitment to Five Star customer service includes comprehensive care. Many services that typically require a specialist can be done in-house.

All four dentists at Village Dental have attained mastership status from the Academy of General Dentistry. This elite distinction puts the practice in a rare league: Mastership status requires hundreds of hours of continued education, achieved by only one percent of dentists in the academy.

Patient Rewards

“I’ve had three crowns from Dr. Hall and never had such good crown work before. The quality is just incredible,” reports Margit.

Patients at Village Dental have the same certified dental hygienist from visit to visit, and for years, hygienist Heather Perry has cared for Margit.

Heather explains that dental cleanings every three months helps control bacteria that cause periodontal disease.

“As hygienists, we can reach places with our instruments that patients can’t reach at home,” she notes. “After about ninety days, certain bacteria in the mouth can become destructive and cause some damage to tissue. By living longer, you also have more opportunity to be exposed to the type of bacteria that causes gum infections. So having cleanings every three months can help people maintain their oral health and prevent bone loss that can occur from periodontal disease.

Preventive care also includes oral cancer screenings, says Heather, and fluoride treatments. The fluoride treatments can protect tooth roots that are susceptible to cavities when exposed by receded gums. Certain medications that cause dry mouth can also put seniors at risk for cavities.

Because preventive care is so important, Village Dental rewards patients who are diligent about appointments. Patients that participate in its Lifetime White program receive a complimentary tube of teeth-whitening gel at cleanings and check-ups.

Margit likes another way the staff of Village Dental says thank you. Each patient goes home with a long-stemmed rose.

“You always get a rose when you leave,” offers Margit. “They really do treat you like family.”

FHCN article by Susan Hemmingway. Photo courtesy of Margit Paczier.

Quick Exam Could Save Your Life

Advanced technology screens for oral cancer at routine dental visit.

Preventive dental care can keep gums and teeth healthy. But did you know a routine dental visit that includes an oral cancer screening might also save your life?

VELscope® system can reveal changes that could be signs of oral cancer before they can be seen with naked eye; Walker and Raynal includes the technology as part of preventive dental care.

The VELscope Vx screening takes only a few
minutes and is non-invasive.

That’s because when oral cancers are caught early, they are more likely to be treatable. On average, the five-year survival rate of early-stage oral cancer is 83 percent.

Unfortunately, though, most oral cancers are caught in later stages. Once the cancer has spread to other parts of the body, the long-term survival rate falls to less than 40 percent, according to the National Cancer Institute.

Dentists have been at the forefront of raising awareness about oral cancer screenings, and at Walker and Raynal, DMD in Brandon, the screenings are viewed as a responsibility to patients.

The practice offers comprehensive dental care, from “same-day teeth,” where implants and crowns are implemented on the same day, to other restorative dental work, cosmetic dentistry and orthodontics.

Helping people maintain healthy gums and teeth through preventive care, such as through regular cleanings, is at the core of its commitment to promoting oral health. Adding an oral cancer screening that takes only a short amount of time is another protective layer of preventive care.

“Oral cancer screenings should be a standard part of preventive care dental visits,” notes David Walker, DMD, of Walker and Raynal.

“One of our most important duties as dentists is to detect and prevent oral diseases before they progress. When oral cancer is caught early, people have more treatment options, and their chances of better outcomes are higher.”

In keeping with Walker and Raynal’s dedication to providing advanced dental technology, the practice utilizes the most advanced system available for detecting oral cancer and pre-cancerous lesions.

Called VELscope® Vx Enhanced Oral Assessment System, the screening is comfortable and noninvasive. It doesn’t require any liquids or dyes, and takes only about two minutes.

Revealing the Invisible

In an oral cancer screening, the dentist or hygienist visually examines the patient’s lips, gums, tongue, palate and other mouth surfaces. The inspection is to note any possible signs of oral cancer such as patchy, white areas; fissures or lesions. The patient’s jaw will also be palpated to check for enlarged lymph nodes or lumps.

Adding the VELscope Vx screening takes the exam a step further. It can reveal potentially suspicious areas before they can be seen with the naked eye.

“By the time you can see or feel oral cancer, it’s usually advanced to Stage 3 or higher. The VELscope Vx system allows us to see suspicious areas at an earlier stage,” educates Dr. Walker.

The VELscope Vx exam utilizes a handheld device to detect abnormal tissue within the mouth, gums or tongue. The device emits a soft, blue light that causes the soft tissue of the mouth to fluoresce. In other words, the tissue absorbs and reflects the light back.

Healthy tissue will reflect the light in distinct patterns. Disruptions in the patterns may indicate abnormal tissue, even though the abnormality isn’t yet visible to the eye alone.

The VELscope Vx is simpler and more effective than older technology designed to reveal abnormalities in their earliest stages, notes Dr. Walker. With less advanced technology, people had to rinse their mouths with a vinegary solution, followed by another solution that made mouth tissue luminescent when lighted by a device similar to a glow stick.

The VELscope Vx eliminates the mess: Instead of swishing a liquid solution, the patient only has to open his mouth while the dentist shines the blue light to carefully examine the interior surfaces.

The exam is completed in minutes, and the results may indicate the need for follow-up with a physician.

“When we see areas that look suspicious, we recommend that patients see a specialist,” says Dr. Walker.

Dr. Walker recommends once-a-year oral cancer screenings that include VELscope Vx. While some people are more at risk of oral cancer, due to factors such as tobacco use, the screenings are protective for everyone.

“Risk factors for oral cancers are smoking and tobacco use, which is probably commonly known,” comments Dr. Walker. “What people are not as knowledgeable about is that alcohol use also increases rates of oral cancer. And the combination of smoking and alcohol really raises the risk.

“Another risk factor is infection with the human papillomavirus, or HPV, which is usually associated with cervical cancer. It’s now being shown that HPV acquired orally is a big risk factor for oral cancer.”

Sun exposure can also make the lips vulnerable to oral cancer, especially the lower lip.

“A lot of people don’t really think about it, but the lower lip can be affected the most because of how it is exposed. There are a lot more incidences of cancer on the lower lip than the upper lip because of sun damage,” says Dr. Walker.

VELscope® system can reveal changes that could be signs of oral cancer before they can be seen with naked eye; Walker and Raynal includes the technology as part of preventive dental care.

Healthy tissue and possible abnormalities appear differently under the VELscope light.

A Valuable Tool

The VELscope Vx system can also detect signs of viral, fungal and bacterial infections, and inflammation that may stem from a variety of causes. It will show traumatic lesions and areas of trauma.

As such, it is a valuable tool in tracking any changes from year to year. At Walker and Raynal, detailed notes are added to patient charts at each appointment. This can help in detecting minor changes that could signify more serious issues, especially if they persist or more change occurs.

“We want all of our patients to have the best in dental care,” observes Dr. Walker. “It’s why we added VELscope Vx to our oral cancer screenings. It’s a simple yet important adjunctive procedure that has the potential to make a difference in people’s lives. Catching abnormalities early is by far the better option.”

FHCN article by Susan Hemmingway. Photos courtesy of LED Dental.

Best Hearing Care Starts with the Right Provider

When Elizabeth Keeler decided it was time for new hearing aids, she knew to be selective in choosing a provider. Elizabeth has worn hearing aids for most of her life; more than 60 years ago, when she was a preschooler, a virus left her with a significant hearing loss.

Elizabeth is able to hear the fountain outside her home for the first time.

Elizabeth is able to hear the fountain outside her home for the first time.

As a child, she went on to overcome the challenge of hearing loss, thanks to medical care, speech therapy and hearing aids. In adulthood, she enjoyed a satisfying career as a nurse and retired when she was 62.

Elizabeth’s hearing aids were ten years old when she wanted to replace them. Her hearing had grown slightly worse, which she assumed was from normal aging. Plus, she knew her decade-old devices might become harder to repair as time passed.

Her first step was finding the best hearing care professional. One of her chief concerns was choosing an audiologist with advanced equipment and resources for hearing evaluations. She also wanted an audiologist who doesn’t push a particular hearing aid brand and has access to a range of manufacturers.

Her research led her to Drianis Duran, AuD, at Gulf Coast Audiology.

“I met Dr. Duran and she told me about her background and showed me the soundproof room where she does hearing tests,” recalls Elizabeth. “I had an instantaneous recognition of, I’m in the right place.”

Hearing New Sounds

Dr. Duran emphasizes to her patients that providing hearing care is her main focus, and that hearing aids are one of the tools that can be used to do so. When evaluating an individual, Dr. Duran asks questions about lifestyle and social activities.

“There are different levels of technology, depending on what your needs are,” explains Dr. Duran. “If you are an active individual who goes to restaurants and the movies and gets together with groups of people, you need something that has the ability to reduce background noise, plus directional technology for hearing what’s around you. Someone who mostly stays home or is at a nursing home may need a more basic product.

“Elizabeth is an active lady so we went with the level of technology that is geared toward her particular social needs,” says Dr. Duran. “We came up with an option that is completely different as far as not only the technology but also the style she was using before.”

Dr. Duran fitted Elizabeth with Phonak hearing aids featuring technology called SoundRecover. In certain high frequencies, Elizabeth is virtually deaf. SoundRecover is able to shift those frequencies into the ranges she is able to hear.

A Lovely Experience

Elizabeth is now hearing many sounds for the first time, like birds chirping and the gurgle of a water feature.

“I can hear the microwave beep, which I’d never heard before. I can hear the front door go beep-beep when someone comes in. It’s from our alarm system – I think that’s really important to be able to hear from a safety standpoint,” she says.

Elizabeth also likes how it’s easier to talk on her cell phone; she can stream voices of callers directly into her hearing aids.

Her new hearing aids help her at home and in her volunteer work. Spending time with her grandchildren is an important part of Elizabeth’s life, as is volunteering with the garden council near her home.

“It’s just a lovely experience for me every day when I put my hearing aids on,” shares Elizabeth.

“I’m telling you, Dr. Duran gave me my life back. Her personality is one of compassion. She’s such a good person. Her goal is to find the best hearing aid for you and help solve whatever problem you may be having.”

FHCN article by Susan Hemmingway. Photo by Fred Bellet.

Seeing the Light about Sleep

April 3rd, 2017

seeing-the-light-about-sleep_istock_15019901The promise of better sleep makes me want to go camping. Sleeping outdoors for just a few nights – without a smartphone – is enough to reset body clocks in a way that makes it easier to get more sleep, according to studies.

The crux is how light affects circadian rhythms, the body’s built-in system for signaling sleep time and when to wake.

Camping provides exposure to plenty of natural light and dark, which researchers suggested prompted a shift in the campers’ sleep-wake cycles. Their levels of melatonin, a hormone associated with sleepiness, started to rise around sunset. They went to bed much earlier than they did at home and woke around sunrise.

In other words, their bodies began to follow a sleep schedule more in tune with the light-dark patterns of nature.

I’ve been fascinated about the role of light and how it affects sleep. After a bout of insomnia several years ago, I read how exposure to bright morning light  helps you fall asleep at night and decided to try it.

You aren’t supposed to wear sunglasses because your eyes need to be exposed directly to the sunlight. Since I’m a slow mover in the morning – no first-thing-in the a.m. walks are typically on my schedule – I just sat in the middle of my backyard right after waking and had coffee. It was pleasant and maybe it helped. Coincidence or not, I started to fall asleep again at a decent hour.

We all know how artificial light has changed how we sleep. But I never knew how much until reading about the myth of eight-hour sleep and how people once snoozed.

It goes way back before the invention of the light bulb, in fact: Until the late 17th century, “bi-modal sleep patterns” were the norm. People went to sleep for four hours about two hours after the sun went down. This “first sleep” was followed by one to two hours of wakefulness, then another “second sleep” of four hours.

People started sleeping in the now-familiar eight-hour stretch when they had more things to do at night, thanks to more use of candles and other forms of lighting.

An experiment by a researcher in the 1990s showed how two-part sleep cycles could be a natural inclination. Study participants naturally started sleeping in two four-hour shifts, punctuated by one or two hours of being up. This occurred after they had been exposed to darkness for 14 hours every day for a month.

Today, of course, we can live in a world of 24/7 artificial days, if we choose, and there are sleep-busting forms of light that our ancestors never imagined. It’s not enough to be tempted by the fact that we don’t have to turn off the light and go to bed, if we have work to do or just want to stay up.

We now have to deal with avoiding things like smart phones and tablets because of the spectrum of light they emit. Digital screens emit blue light, which can interfere with melatonin production and throw sleep cycles out of whack. Teens may be particularly susceptible to sleep-interference from blue light from electronics close to when they should be sleeping.

Sleep experts recommend avoiding blue light before bedtime. Put down the tablets and smart phones early on as a nightly ritual for better rest. This puts midnight scrolling in the realm of midnight noshing. You know it’s not good for you … but temptation is hard to resist and screens-at-all-hours become a habit.

Maybe it’s time to go camping for a body clock reset under the bright light of real days and the darkness of actual nights.

Better Hearing Requires the Best Care

A busy surgeon discovers the power of hearing technology.

Paul Zak, MD, is a busy orthopedic surgeon who specializes in spinal surgery. In the operating room, the environment is often noisy.Spinal surgeon Paul Zak, MD, fitted with hearing aids at Sound Advice Hearing Solutions by Kelly Murphy, AuD.

“I have to use certain types of equipment like high-speed drills. They’re very high-pitched and can be fairly loud,” he explains. “I think over the years that took a toll on my hearing. Plus, when I was young, I went to a lot of rock concerts.”

As a teenager, Dr. Zak went to shows by bands like Led Zeppelin and Jethro Tull. His best friend always managed to get good tickets. They sat near the stage and afterwards his ears would ring for days.

Years later, when he was 48, he began to notice his hearing wasn’t optimal. Plus, he had developed tinnitus, a constant ringing in the ears.

“I started losing my hearing and denied it for a while. It got to the point where I couldn’t hear my daughters or my wife very well when they were talking. I covered that up by being a pretty good lip reader,” Dr. Zak reports.

However, his attempts to compensate for poor hearing didn’t work at home indefinitely.

“My wife would say something, and I would answer according to what I thought she said. She would say, No, no, and would get frustrated with me.”

He noticed Sound Advice Hearing Solutions’ St. Petersburg location when he was working nearby. A nudge from his wife convinced Dr. Zak to make an appointment.

“She told me, You know, it would be really nice if you could just go and get your hearing tested and see what they can do for you.

Tinnitus Disappears

Dr. Zak’s first visit to Sound Advice Hearing Solutions was ten years ago. The expertise of its hearing care professionals and superb customer service has made him a loyal client.

As a physician, he appreciates how they take the time to educate about hearing loss and what hearing aids can do to help.

“They are very professional and very knowledgeable,” he explains. “When they complete the hearing tests, they graph it all out and show it to me: Here’s where you’re having hearing deficits, and this is how we can tweak the hearing aids to improve it.”

He now sees Kelly Murphy, AuD, whose specialty as an audiologist at Sound Advice Hearing Solutions includes treating tinnitus.

“Dr. Zak has a mild sloping to profound hearing loss in both ears from noise exposure,” explains Dr. Murphy. “The noise exposure also created tinnitus, which can be experienced as ringing, buzzing, hushing or hissing sounds in the ear.”

Dr. Zak recently decided to upgrade his hearing devices. As an independent hearing aid center, Sound Advice Hearing Solutions has access to all of the top brands and therefore can tailor a product specifically to what a client needs.

“We’re very focused on patient-
centered care,” notes Dr. Murphy. “We have to meet the needs of each person individually because no two people are the same.”

Sound Advice Hearing Solutions offices in St. Petersburg and Largo are designed to put customers at ease. Both offices feature a warm, inviting and serene setting, including spacious, spa-like sound suites for hearing tests.

Once the hearing test is performed, the hearing specialist completes an in-depth consultation that includes questions about current hearing difficulties and how they affect the client’s lifestyle.

“Working with Dr. Zak, we had to make sure he had hearing instruments that gave him the best clarity possible,” comments Dr. Murphy. “We had to find a way to make sure the hearing aids helped him hear what was going on in the operating room when he’s in surgery, while not amplifying the noise from the loud equipment he uses.

“Additionally, he still loves to go to concerts, and we wanted to fit him with devices that would allow him to enjoy music,” she continues.

Spinal surgeon Paul Zak, MD, fitted with hearing aids at Sound Advice Hearing Solutions by Kelly Murphy, AuD.

Dr. Zak likes the clarity of sound from his new
hearing aids.

Boosting Clarity

In recent years, hearing aid technology has advanced exponentially. When he tried the new devices recommended by Dr. Murphy, Dr. Zak was stunned by the clarity, even in challenging listening environments with background noise.

“My new hearing aids are just so much more advanced than the ones I had before,” says Dr. Zak. “My older devices were pretty good in their day, but they amplified all of the noise, which meant if I was in a restaurant, everything was loud. They helped in quieter environments but not as much in a place that was noisy.”

He can also control his new devices through his smart phone, a feature he finds handy.

The new hearing aids correct his tinnitus simply by wearing them. They don’t require a sound masker that targets tinnitus, like his old devices did.

“Tinnitus is different for everybody, and a lot of times, it’s counseling, education and using devices with sound maskers that make a difference,” describes Dr. Murphy.

“When Dr. Zak updated his devices to new technology, there was so much more clarity because the instruments go beyond the speech range of sounds to help reduce tinnitus sounds. Almost within a few minutes, he couldn’t hear his tinnitus because of how well this technology works for him.”

Dr. Zak can hear his patients clearly during office appointments, and he can easily hear in the operating room despite a noisy environment.

Being able to hear clearly is important for a doctor, he acknowledges. He also likes being able to hear clearly at business meetings.

“If I didn’t have hearing aids, I might be misunderstanding what my patients are telling me when I see them in my office,” he notes. “Also, before getting my new hearing aids, I’d be in a business meeting or a dinner meeting somewhere and couldn’t really hear when the environment was loud. But I can hear people who are talking now and understand them. It’s been great not to worry about being embarrassed about saying the wrong thing because you misheard what was said.”

Added bonuses: Dr. Zak doesn’t need to turn on closed captioning like he once did when watching television because he can understand what people on the screen are saying. He is able to easily carry on a conversation when going out to dinner with his wife, even amid background noise.

“My hearing aids are able to dampen the ambient noise in a restaurant, so I can sit and have a conversation with my wife and not need to try to read her lips. It’s been good,” he says.

A lifelong music lover, he is now able to hear more clearly when attending live concerts. At the Amalie Arena in Tampa recently, he was surprised by how he could understand the lyrics of the singer on stage.

“My new hearing technology has really made a difference because I used to have trouble with understanding the words being sung, especially with female singers,” he continues. “I’m now able to control the hearing aid by modifying the volume if it’s too loud for me, and I can hear the singer’s words.

“I’m doing really well with my new hearing instruments, and I’m really pleased,” says Dr. Zak. “I’m very happy with what Dr. Murphy and Sound Advice Hearing Solutions have done for me.”

FHCN article by Susan Hemmingway. Photos by Jordan Pysz. Stock photo from istockphoto.com.

Laser Treatment Beats Unsightly Nail Fungus

Becky Worthington first noticed a slight discoloration on her big toenail.

“I thought maybe it was just a bruise, where I had dropped something on it, and let it go,” she shares. “Then, it started turning yellow and I said to myself, Oh no, this has got to be toenail fungus.”

Becky Worthington treated with PinPointe™ FootLaser™ for onychomycosis (toenail fungus) by podiatric surgeon Dawn Chiu, DPM, at Sarasota Foot and Ankle Center.

Becky enjoys wearing flip-flops again.

Becky tried daubing the nail with tea tree oil as a remedy, but it didn’t work.

She went to a physician, who confirmed toenail fungus and gave her a prescription for anti-fungal oral medication. When she learned about possible side effects, she declined the treatment.

“I would have had to get a blood test every six weeks to make sure it wasn’t damaging my liver,” she says.

Becky is a police officer, and on duty she wears thick socks and sturdy, nine-inch boots that lace snugly above her ankles. She speculates the footwear – plus working in the rain at times – could have contributed to developing nail fungus, which flourishes is a moist environment.

Off duty, she likes to wear flip-flops and sandals, and the fungus-laden nail was visible. To save herself from embarrassment, Becky covered her toe with a BAND-AID® when going anywhere special, like out to dinner with her boyfriend.

Becky had put up with the unsightly condition for about a year when a friend told her that lasers are being used successfully to treat nail fungus. She was thrilled to discover the PinPointe™ FootLaser™ treatment was available in her own backyard through Dawn Chiu, DPM, a board-qualified podiatric surgeon at Sarasota Foot and Ankle Center.

Painless and Effective

In examining Becky, Dr. Chiu diagnosed onychomycosis, a common disorder caused by microscopic fungi.Becky Worthington treated with PinPointe™ FootLaser™ for onychomycosis (toenail fungus) by podiatric surgeon Dawn Chiu, DPM, at Sarasota Foot and Ankle Center.

The condition typically begins when the fungi enter the nail bed through a tiny break in the nail. As the fungi feed on the nail’s protein, the nail grows thicker, yellowed and more fragile.

The PinPointe FootLaser is Dr. Chiu’s weapon of choice for defeating a persistent fungus. It works by killing the underlying fungus.

“We first grind down the nail, then pass the light over it repeatedly in crisscross patterns so that we know the laser gets good coverage,” explains Dr. Chiu. “The patient will feel a warm sensation, but no pain.”

After the treatment, patients use an antifungal nail solution at home to keep the fungus at bay and accelerate healing. The success rate is more than 80 percent, notes Dr. Chiu.

Although the laser kills the fungus, the nail doesn’t clear immediately. The portion with fungus damage must grow out.

“The laser treatment was really simple and not painful at all,” reports Becky. “
Dr. Chiu makes you feel very comfortable. She’s awesome.”

Becky appreciated that Dr. Chiu advised her to get bigger boots to prevent recurrence. Cramped toes are more susceptible to nail fungus.

“My toenail looks like nothing ever happened to it now. It’s perfect,” says Becky. “My experience with Dr. Chiu and the results she achieved were just a hundred percent great! I recommend her to everybody who is having a problem with toenail fungus.”

FHCN article by Susan Hemmingway. Photo by Fred Bellet. Before and after images courtesy of Sarasota Foot and Ankle Center.

Memory Care with Purpose

The community’s staff is eager to help new residents feel cared for and at home.

Gretchen Espinetti’s father, Henry, is a member of “The Greatest Generation,” a World War II veteran who served under Gen. George S. Patton in the US Third Army. A sturdy New Englander, Henry went on to earn a college degree at Boston University and enjoyed a long career in business management.

Daughter enrolls her father at Symphony at St. Augustine; with background about the memory care community.

Today, Henry is 92. He is affected by Alzheimer’s disease and needs continual care in a community setting.

Gretchen wants more for him than many memory care communities are able to offer.

“I prefer, even at my dad’s level [of dementia], that there is more to his day than eating two or three meals and then sitting in his room watching TV. That’s not very stimulating for a very intellectual man,” she says.

Recently, Gretchen read an article in Florida Health Care News about a new memory care community scheduled to open in February 2017. Called Symphony at St. Augustine, the community features 64 studio apartments and is exclusively for seniors with Alzheimer’s disease, memory loss and other forms of dementia.

Every detail of Symphony at St. Augustine is designed to make life feel secure and enjoyable for those with memory impairment. Instead of living in the wing of a facility, each resident will have his or her own private studio apartment within a community that meets their unique needs.

Gretchen, who has a PhD in multicultural education and co-authored a book about aging and brain health, liked what she read about Symphony at St. Augustine’s holistic approach to memory care.

The approach, called In the Moment®, is based on six principles: physical engagement, spiritual support, artistic expression, community connections, continued education, and lifestyle and leisure. The principles are designed to meet residents in the moment they are experiencing for kind and compassionate engagement to guide them through their day.

“In the Moment is just what its name says: It is a program for engaging the person with dementia according to what they are experiencing at that moment,” explains Tara Tosh, the community’s executive director.

“For instance, a woman who once had small children may be in the mindset of that point in time. If she is having maternal instincts at that moment, it can be soothing for her to go into the life station where we have baby dolls, diapers and other items. She can care for the baby doll with a feeling of purpose.”

Designed for Special Needs

Everything, from paint colors to light fixtures, at Symphony at St. Augustine was selected for how they affect people with memory loss. The interior design is serene, with a calming tropical theme and subtle patterns that aren’t overwhelming.

Each studio apartment features a spacious bathroom with a wide, walk-in shower and elevated toilet. The bathroom floor flows seamlessly into the shower, thus reducing the risk of falls.

All apartments are unfurnished, so residents can bring their own furniture and favorite personal items. It’s all part of the overriding theme of helping residents feel at home.

The entire community is secured for safety, and residents can walk freely throughout common areas and grounds while being overseen by a trained staff 24 hours a day.

“This can help with residents who may be experiencing some of the side effects of Alzheimer’s and dementia like sundowner’s syndrome, which can cause agitation and the urge to wander at night,” continues Tara. “Staff members are on duty at all times, and if a resident wants to take a walk around the courtyard, go to an activity station or get a snack, we’re here for them.”

A primary aspect of Symphony at St. Augustine is how staff members are trained to interact with residents based on the In the Moment memory care approach.

The care program is designed to help residents feel engaged and valued throughout the day. It features life stations, which are areas where residents can participate in purposeful activities, such as working in a small garden. Also on site are a library, hair salon and laundry.

Twyla Hamlin, the community’s health and wellness director, will work with families to learn details about residents that help staff members engage with them in a personal way. One aspect of staff training is to know 24 aspects of the personal life of each resident, such as a favorite color and former occupation.

“Even staff members working in the kitchen, who aren’t involved in direct patient care, receive this training. It goes back to being able to give personalized, individual attention to every resident,” explains Twyla.

Exceptional care of residents and communication with their families are top priorities of Symphony at St. Augustine.

Stephanie Persinger, the concierge for the community, will be on hand to help family members. She will also assist in communicating the needs of residents to staff members as part of a team approach to care.

“Stephanie is going to make sure that she knows each resident on a personal level and the family members,” notes Tara. “She wants families to feel welcomed right when they walk in the door.”

Quality of life for residents, and finding daily enjoyment, are vital.

“Our goal is to provide a warm, lively environment where people with dementia can thrive,” says Tara. “Happiness and joy don’t have age limits. Even with a disease like Alzheimer’s, we can still have good days and smiles.”

A variety of monthly entertainment will include live music and local artists who assist in art classes. Day trips will be offered as well. And a team will be on hand whose only job is to engage residents.

To ensure excellent food quality, a gourmet chef will be on staff to oversee the preparation of three daily meals and healthy snacks – all made with fresh ingredients.

Community Connection

Talking with Tara confirmed Gretchen’s belief that Symphony at St. Augustine is the small, personalized community her father needs. He is now on the reservation list to move into the community as soon as it opens.

“It has that neighborly feeling and a community connection that is missing in so many assisted living facilities,” she says about Symphony at St. Augustine. “Many facilities seem to be very sterile and almost robotic.

“I believe in a holistic approach in caring for people with dementia,” she continues. “I think so much more can be done. I know even with my dad, he may have lost some of his conversational ability with me, but everything I say to him he comprehends.”

Symphony at St. Augustine is the kind of environment Gretchen wants for her father.

Gretchen wants him to enjoy a life of dignity and respect, despite having Alzheimer’s. She wants him to be engaged and stimulated by activities he can pursue that have the potential to feel meaningful. She wants him to feel safe and secure and that he is cared for.

“I really like what I learned about Symphony at St. Augustine,” she notes. “I’m hoping that it can give my father a little more life. The six elements of the In the Moment program – physical, spiritual, artistic, community connection, education, and lifestyle and leisure – will be more engaging and compassionate and more of what people with Alzheimer’s deserve for the remainder of their lives.”

FHCN article by Susan Hemmingway. Photo by Nerissa Johnson.
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