What’s All The Buzz About E-cigarettes?

E-cigaretees_Drl Larry  Stone Blog

E-cigs are electrical devices that vaporize propylene glycol or polyethylene glycol-based liquid solutions into aerosol mists typically  containing various concentrations of nicotine. Having been marketed since 2007 or so, the use of e-cigs (vaping) has now exploded to a multi-billion dollar industry primarily targeted at young people and now heavily controlled by the tobacco industry. The three largest tobacco companies now control over 70% of the e-cig market.

According to the Centers for Disease Control and Prevention the prevalence of use of e-cigs has increased nine-fold among high school students and now exceeds the use of cigarettes in that population. Having prevailed in federal court cases, the industry has succeeded in having e-cigs labeled as “tobacco products” instead of “ drug delivery devices” which makes it much easier to market these products, especially to young people. Because there are currently no product standards for e-cigarettes, they are almost entirely unregulated on the U.S. market!

There have been precious few studies evaluating the health consequences or long term effects of e-cigs, especially in young people. What the scientific community does know is that:

  1. The effects of nicotine on the developing brains of teenagers include altered development of the cerebral cortex and hippocampus.
  2. Smokers who use e-cigs are 59% less likely to quit smoking than those who do not use them.
  3. High levels of nicotine dosing via e-cigs may increase the risk of periodontal disease.
  4. The American Heart Association, The American Association for Cancer Research, the American Society of Clinical Oncology, the Forum of International Respiratory Societies and the American Association for Dental Research have all cautioned against the use of e-cigs.

So there you have it! Just don’t do it!

See you soon for your next appointment! If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have regarding the use of e-cigarettes.

Are Dental X-Rays Safe

Dr.LarryStone_Dental Xrays

Most people are familiar with having dentals x-rays taken periodically at dental visits and recognize the benefits of a dental x-ray examination. Occasionally someone still asks me if these X-rays are “safe”. The short answer Is “yes”, but some explanation may be more helpful.

First, dental X-rays involve a fraction of the amount of radiation delivered versus a medical X-ray. Radiation delivered for a treatment purpose, such as targeting cancerous cells in the body (as opposed to X-rays taken for diagnostic purposes), deliver many times more radiation than is required in a dental exam. For example, the amount of radiation one receives for dental purposes is often compared to the amount a person would receive from the environment after spending a sunny day at the beach or after a plane flight at 39,000 feet.

Second, only a small part of the body is typically exposed to a dental X-ray, with the rest often protected by a lead lined shield.

Third, the American Dental Association has instituted a safety protocol referred to as ALARA (As Low As Reasonably Allowable),which offers guidance in minimizing the dosage of radiation needed in specific situations.

Fourth, Pennsylvania requires regular inspection and registration for all X-ray machines (including dental X-rays equipment) to guarantee the public’s safety.

And lastly, many scientific organizations have developed recommendations or regulations on the proper, safe and effective use of X-rays in dentistry, including the Center for Devices and Radiological Health of the U.S. Food and Drug Administration, the American Dental Association as I mentioned, the American Academy of Oral and Maxillofacial Radiology, and the National Council on Radiation Protection and Measurements.

Therefore, as you can see, a lot of people are concerned with your safety with respect to the use of dental X-rays so that you can relax more and enjoy your visit!

See you soon at the office! If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have regarding dental x-rays.

Tooth Sensitivity


Tooth sensitivity is one of the most common complaints we see on a daily basis at the office. There can be many different causes for dental sensitivity including overzealous brushing, using a toothpaste that is too abrasive, unsupervised “whitening”, frequent consumption of acidic beverages (i.e. soda), deficiencies in the structure of the teeth, and so on.

Treatments for sensitive teeth can include using a desensitizing toothpaste, use of prescription strength fluoride toothpastes and rinses and application of any one of a number of desensitizing medicaments in the office.

While sensitivity is not usually a sign of a more serious dental problem, it can be! If you find yourself experiencing this annoying symptom, please bring it to our attention as soon as possible.

Also, we are currently participating in a federally funded National Practitioner Data Bank Research Network Study of sensitivity. If you are having problems with sensitive teeth you may qualify as a compensated subject in this observational study. You will be treated as anyone else with sensitive teeth and will not be subject to any experimental treatments!

You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have regarding sensitivity and to schedule an appointment.

Polypharmacy – Are you at risk for prescribing cascade with your medications?


As the population in the United States ages, so does the population of dental patients that are typically seen each day. One of the most noted characteristics of this group is the sheer number of prescription medications they take. The average 65 year old is taking five or more medications for a variety of reasons. One of the most serious side effects of many medications is drug-induced xerostomia (dry mouth), which can be devastating to one’s oral health!  (See my prior blog on Xerostomia.)

Another aspect of this “polypharmacy” is that patients taking five or more drugs are at risk of experiencing “prescribing cascade”, which occurs when unrecognized side effects of an existing drug prompts physicians to prescribe a new drug to then treat these new symptoms! The elderly and persons with disabilities are especially prone to prescribing cascade. The Beers list, developed by an expert panel to assess inappropriate drug prescribing, consists of a list of medications that are particularly prone to adverse effects in the elderly.

Please consult with your personal physician should you have any questions regarding this issue. And please let us know if you are experiencing “dry mouth”. Be sure to ask us at your next visit how you can best treat dry mouth. You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment.

4 Dental Lessons to Learn From Your Car

Car Maintenance Checklist_Dr. Larry Stone

Now that it’s summertime and our thoughts turn to vacations and road trips, a recent post on the American Dental Association’s website for consumers caught my attention. It discussed how Americans tend to take care of their cars pretty faithfully, and yet, we don’t often perform the same routine maintenance on our teeth.

The following lessons from MouthHealthy.org draw from ways we maintain and preserve our cars to make them dependable. Getting oil changes, stopping for gas and going through the car wash are the things we do without a second thought to keep our car in tip-top shape. The same should be true of our teeth. Prevention is certainly the best medicine when it comes to taking care of the things you depend on most. Be sure you are getting the most mileage out of your mouth by using these strategies in your dental care routine.

Watch What Gets In Your Grill
A grill on a car keeps harmful things from getting under the hood. Think of your own grill, your mouth, as a filter system for your entire body. Everybody’s mouth is full of germs—some good, some bad. The bad ones can cause cavities and gum disease, which can lead to tooth loss. Severe gum disease is also associated with other medical problems, like diabetes, heart disease and stroke.

Keep Your Fuel Tank Full
You wouldn’t put just anything in your fuel tank, so be aware of what you’re putting in your mouth. Keep your engine running with a healthy diet full of fruits and vegetables.

Practice Preventative Maintenance
Your car won’t get very far without fresh oil and proper tire pressure. Your teeth also need regular care. Daily brushing and flossing are the best ways to keep your mouth healthy.

Get a Tune Up
Taking your car in for a tune up can extend the life of your vehicle and catch small repairs before they turn into big fixes. Regular visits to your dentist and good dental habits can prevent many dental diseases and will keep you smiling for years to come.

Be sure to ask us at your next visit how you can best keep tune up your mouth. You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment. We look forward to serving you.

Bucks County Veteran ID Card Discount Program – Helps Veterans Afford Area Services


A recent article by a colleague practicing in central Pennsylvania reminded me of my time in the service. I don’t talk about it that much, but for 2 years after completing my dental education I served as a Senior Assistant Dental  Surgeon with The United States Public Health Service. I was assigned to the U.S. Coast Guard for two years and provided dental care to enlisted personnel at small boat stations throughout the Great Lakes. Most of my patients were young, fairly healthy enlisted men and their dependents.

Being in the service doesn’t pay much and I think we all know how much our veterans have suffered following their service to this great country. It’s estimated that 150 million Americans did not see a dentist last year and that in Pennsylvania alone there are dental health professional shortage areas in 64 of our 67 counties.

I’m proud to say that Bucks County has tried to alleviate some of the inequities experienced by our veterans by Instituting the Bucks County Veteran ID Card Discount Program. By presenting the appropriate paperwork to the Bucks County Recorder of Deeds veterans will be issued an ID card entitling them to discounts at local businesses throughout the county- including my office. In addition, I keep a list of resources in the area that may be able to assist all those less fortunate in accessing dental care.

There’s no reason why our veterans, those who have given so much to this country, should have to go without dental care when they need it the most. If you want to help and have a service or product to offer, call the County Recorder of Deeds to volunteer for this worthy program.

If you are a veteran in need of dental services, Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment. We look forward to serving you.

Summer Travel Alert: Drowsy Driving Can Be as Dangerous as Drunk Driving

Drowsy Driving

As you get ready to hit the road this summer to enjoy your favorite vacation spots, be aware that drowsy driving can lead to serious consequences for you, your family and others on the road. There are many reasons you can become drowsy when driving, the most important of which is lack of proper sleep. It has been reported by the American Academy of Dental Sleep Medicine (AADSM) that drivers are 15 times more likely to be involved in a deadly motor vehicle accident when they have excessive daytime sleepiness, a common symptom of sleep apnea.

AADSM further states that 12-18 million Americans suffer from sleep apnea and snoring, with millions more going undiagnosed – as many as 30-50 million more as claimed by The Institute of Medicine. Certainly sleep apnea and snoring prevent the person suffering with these conditions, and often those sleeping nearby, a good night’s rest. We have spoken in prior blogs about the remedies for sleep apnea, but for those with mild to moderate obstructive sleep apnea, or those who can’t comply with a CPAP, oral appliance therapy may just be the ticket to a good night’s sleep.

Oral appliances look like a sports mouth guard and travel well. Not only are they quiet in comparison to a CPAP, they are very easy to care for. If you think you suffer from primary snoring or obstructive sleep apnea, ask me for a referral to a board-certified sleep physician. Once officially diagnosed, you can determine the best treatment option for you. We will be happy to fit you with an oral appliance should that choice work for you.

In the meantime, look for these telltale signs of drowsiness when driving:

  • Yawning constantly
  • Unable to keep your eyes open
  • Restlessness and irritability
  • Nodding off
  • Daydreaming, wandering thoughts
  • Drifting into other lanes
  • Can’t remember the last few miles
  • Ending up too close to cars in front
  • Missing road signs
  • Driving past turns
  • Moving onto the `rumble strip’ or road shoulder

If any of these present themselves, switch drivers with someone more alert or pull over into a safe place and take a nap. Then walk around to wake up before driving again.

Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule your next visit or schedule an appointment to be fit for your oral appliance to assist you in achieving a good night’s sleep.

Do You Grind Your Teeth at Night?


A comprehensive study reported in the American College of Chest Physicians journal found that more than 8% of the population grind their teeth at night at least once a week. Half of those that grind also experience significant consequences including muscular discomfort on awakening, sleep disturbing tooth grinding and the necessity of extensive dental work. Additional consequences of nighttime grinding (also known as sleep bruxism) can include headaches, jaw joint discomfort, and premature loss of teeth due to excessive attrition and mobility.

Sleep bruxism has also been associated with snoring, moderate daytime sleepiness, heavy alcohol consumption, caffeine drinkers, smoking, a highly stressful lifestyle and those with anxiety. Possibly the most serious association with sleep bruxism, however, is those people suffering from obstructive sleep apnea, a potentially life threatening condition!

If you think you may be grinding your teeth at night or if your sleeping partner tells you that you are grinding or snoring, please let us know the next time you are in the office.

It may just save your life!

Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule your next visit.

Saliva- What Your Spit Can Tell Us About You!


Don’t be surprised if we ask you to spit in a cup at your next dental visit! Salivary diagnostics have been slowly improving as the science grows. Human saliva is now used to diagnose many conditions such as multiple sclerosis; Sjogren’s syndrome; sarcoidosis; metabolic bone disorders; cardiovascular conditions; periodontal disease; genetic disorders; and fungal, bacterial and viral infections.

Our medical colleagues are also using saliva to determine the presence of hypertension, diabetes mellitus, HIV infections, cardiovascular disease, and to monitor drug use.

The advantages of using saliva as a diagnostic aide are numerous. It is non-invasive; it can be self-administered, and because saliva does not clot, samples can be stored and transported more easily. In addition, testing saliva can offer immediate results and is preferable for infants, children, geriatrics and for remotely located populations.

We are currently using salivary diagnostics in dentistry to help identify patients with HPV (Human Papilloma Virus) infections, susceptibility to periodontal disease, Xerostomia (dry mouth) and those with a high caries index. We can then use the results to make intelligent recommendations for treatment and/or prevention. Please don’t hesitate to ask us any questions at your next visit.

So, now you know! Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule your next visit.

Don’t Like Flossing? Some tips to make it easier.

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Well, the good news is you’re not alone. Most people have trouble with flossing, So I’d like to offer a few suggestions that  I’ve found over the years may help.

  1. If you don’t know how to floss properly, then yes, you can hurt yourself and traumatize your gums. Call and stop by or ask the hygienist next time you are in for your “check-up” to make sure your technique is solid!
  2. Try a different kind of floss. If you don’t like what you are using then try something else. There are many different kinds of floss including waxed, un-waxed, tape, glide, flavored, unflavored, etc. Remember, it doesn’t matter what kind you use. The important thing is to remember to do it.
  3. Let’s face it, not everyone has the dexterity of a dental hygienist. II flossing is something you just physically cannot master, then consider using any one of a number of other devices available for getting In between the teeth. Some examples: GUM® Eez-Thru flossers, GUM® Proxabrushes, DenTek Triple Clean Floss Picks, DenTek Floss Threaders, the GUM ® Flossmate Floss Handle and Oral-B Super Floss®. No matter what the issue is, rest assured that there’s something out there to help.
  4. It’s important to floss at least once a day, but if you only floss once, when would be the best time? Night time of course, right before you go to bed. Why you ask? Because night time is the longest period during which you are not feeding the bacteria in dental plaque…those same bugs that cause tooth decay and gum disease.
  5. And finally, don’t forget that flossing, as an integral part of your daily oral hygiene routine, has now been linked to achieving better overall health in many ways. By reducing infection and inflammation, meticulous home care can help reduce the consequences of diabetes, Alzheimer’s disease, heart disease, and possibly pre-term low birth weight babies.

So for all these reasons and more I hope you take your daily flossing seriously.

Please feel free to talk with me at your next visit about your flossing techniques. We will be happy to demonstrate effective flossing techniques. Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to schedule your next visit

Photo demonstrates Dentek Triple Clean Floss Picks in action.