Thursday, December 27, 2012

7 Ways Quitting Smoking Makes You More Beautiful

If you need another reason to quit smoking, here it is: Kicking butts can not only make you healthier, it also noticeably improves your appearance in several ways.

 
By now, it's abundantly clear that quitting smoking can help save your life. The facts don't lie: 80 to 90 percent of lung cancer deaths are due to smoking, and smokers are six times more likely to suffer heart attacks than nonsmokers. Every year, smoking causes almost 450,000 deaths in the United States alone. But if good health isn't enough to entice you to quit smoking, then think about the cosmetic risks of smoking. Smoking negatively affects your skin, your eyes, and your teeth. The good news? Quitting smoking can help you look more vibrant and healthy — which is exactly how you'll feel, too.  

 Brighten Your Eyes

One side effect of smoking is skin damage all over your body, and one area where you will definitely see the damage is around your eyes. "The skin under the eyes is very delicate, and smoking damages this delicate tissue," says Pat Folan, RN, the director of the North Shore-LIJ Center for Tobacco Control in Great Neck, N.Y. "Quitting smoking may have restorative benefits."

 

Put the Brakes on Wrinkles


Smoking can cause wrinkles all over your body, says Jenny A. Van Amburgh, PharmD, associate clinical professor at the Northeastern University Bouve College of Health Sciences in Boston. "The thousands of chemicals in cigarette smoke cause a breakdown in the major structural components of the skin — elastin and collagen," she explains. "When these components are damaged, your skin loses its firmness, elasticity, and strength." Another side effect of smoking is premature aging of the skin from the nicotine, which causes blood vessels to narrow, decreasing blood flow to the skin and resulting in a decrease in the amount of oxygen and nutrients available to skin cells.
 

Perk Up Your Breasts


Smoking doesn't just cause surface wrinkles. Damage to skin cells can cause skin on certain areas of the body to sag. "The chemicals in cigarettes cause skin to sag and lose elasticity and tone, and this can cause sagging of the upper arms and breasts," says Folan. "In addition, studies have linked breast cancer to smoking and secondhand smoke exposure."

 

Reverse Tooth Staining


Not surprisingly, the tar and nicotine passing through your lips and into your lungs have a big impact on the health of your mouth as well. In fact, one of the first easily visible side effects of smoking is yellow teeth. Luckily, quitting smoking can reverse this effect. "Most changes in the mouth due to smoking are reversible, including bad breath and yellowed teeth," says Abinash Achrekar MD, MPH, assistant professor of medicine in the division of cardiology at the University of New Mexico in Albuquerque. "Unfortunately, oral cancers can develop that are not as easily reversible."
 

 

Save Your Lips and Gums


Your teeth aren't the only part of your mouth negatively impacted by smoking. According to the American Academy of Periodontology, the risks from smoking and other tobacco products can also lead to oral cancer, bad breath, discoloration of gums, tooth loss, lost sense of taste, gum recession, and mouth sores. "Smokers usually get burns on their lips or the inside of their cheeks, which can resolve when they quit. People who quit smoking will see an improvement in their breath and sense of taste," says Van Amburgh.

 

Rid Your Nails of Stains


Here's a side effect of smoking that some smokers aren't even aware of: ugly stains on hands and fingers, particularly the fingers that hold all those cigarettes. "After you quit smoking, you will notice a line on your fingernail between the new-growth nail (non-stained) and the stained nail," says Van Amburgh. "Eventually, the new nail will replace the stained nail. In many people, the stains on their fingers will eventually fade."

 

Put a Shine on Your Hair


Even your hair will show more shine and luster, and possibly stay in place longer, when you finally get around to quitting smoking. "The 7,000 chemicals in cigarettes affect every cell in the body, including hair follicles," says Folan. "Smoking has been associated with hair loss." Quitting smoking makes your hair look and smell better as the lingering "ashtray" odor is gone.

 
Make a dental appointment to maintain your health!
 
reference: Healthyaging@everydayhealth.com

 

Wednesday, December 26, 2012

Healthy Smile Series: Oral Health for Diabetics

Physicians and diabetic educators work hard to educate their diabetic patients that diabetes is a serious health condition with many complications. These include heart disease and stroke and vascular disease, skin infections and amputations, kidney failure, blindness, neuropathies, and now gum disease. In fact, the National Institute of Dental Health has published that periodontal disease is now considered the 6th complication of diabetes.

It has long been observed that diabetics (especially poorly controlled diabetics) have more gum infections and periodontal disease. Current research is confirming that diabetics are more susceptible to gum disease.

New research suggests that the relationship between gum disease and diabetes goes both ways. Periodontal disease can make it more difficH ult for diabetics to control their blood glucose levels, and people with diabetes tend to have more gum disease. This means that this disease equation is really a double ended arrow – a veritable “vicious cycle”.

It is widely believed that diabetics have a higher risk for developing infections and experience poor wound healing, generally, especially in uncontrolled or advanced stages.

Signs and symptoms of gum disease include:


·         Gums that bleed

·         Red, swollen and tender gum tissues

·         Bad breath

·         Loose or migrating teeth

·         Elevated C-reactive protein levels

Gum disease is a chronic low-grade infection around the teeth. Infections in diabetics generally impair the ability to process and/or utilize insulin. This can cause blood sugars to be more difficult to manage, and in turn can make the gum infections (or any infection in the body) more severe.

Because gum disease is more common and more serious in people with diabetes, periodontal disease has now been called an “oral complication” of diabetes. In fact, one in three diabetics have chronic gum disease problems. Because gum disease is an infection it represents a significant complication for diabetics.

Physicians are becoming more tuned in to the importance of good periodontal health generally and especially in their diabetic patients. It is important that physicians examine or ask about the oral health of diabetic patients and make a referral to a dentist for an evaluation as necessary. Additionally, dentists should be aware that their diabetic patients require closer supervision. Often dentist and physician must work together to manage the diabetes condition, especially if there is changing or improving oral health conditions which may alter insulin or oral medication needs.

The nature of gum disease is that it is a bacterial infection of the gums and bone around teeth. As such it increases local inflammatory factors producing inflammation in the gums. This also allows bacteria and inflammatory by-products to enter the blood stream and produce systemic inflammation in the body generally. This inflammation is believed to affect the health of blood vessels, tissues and organ systems throughout the body, a condition called “systemic inflammation.”

Increases in inflammation interferes with the body’s natural healing response to infection, of which gum disease is a classic example. Poorly controlled diabetics experience a dysregulation that can contribute to periodontal breakdown and diminished tissue repair capacity. As a consequence, diabetics respond differently to the oral bacterial microfilm that naturally accumulates at the gum line around teeth, compared to non-diabetics.

Effective control of diabetes (good blood sugar control) increases and improves the health of the gum tissues. The improved health of these oral tissues improves the ability to control blood sugars and increasing diabetic control. The good news is that when chronic oral infections are treated and when people have good oral health, the management of diabetes markedly improves. This information should give diabetics and their care-takers another reason to smile, because healthy gums aid in the overall control of diabetes, and vice-versa.

reference : Lee Ostler DDS
(Disclaimer: This information cannot be relied on as medical advice for individual circumstances, nor can it substitute for advice from qualified health professionals. Always consult with your physician, dentist, and/or other health professionals who are experienced with working with diabetic patients.)

Sunday, December 23, 2012

Dental Whitening

Everyone loves a bright white smile and there are a variety of products and procedures available to help you improve the appearance of your smile.

·    In office laser whitening - this procedure can be completed in our dental office during one hour long visit.

·    At home whitening trays - custom trays are constructed in our office, these trays are filled with dental whitening agent and worn for one hour daily until your teeth reach the level of whitening that you desire.

·    Whitening toothpaste - this toothpaste removes extensic staining. This is staining caused by 'outside' or 'external' sources. Like smoking, dark beverages (cola, or coffee) dark foods (red sauce), etc. Whitening toothpaste cannot brighten teeth that are darkened by intrinsic staining such as medications or aging.

If you are interested in teeth whitening, or have questions about which procedure may be best for you let us know. We will be happy to explain the options that will help you to reach your goal of a white, bright, healthy smile.

~ Julie, Dental Assistant


Thursday, December 20, 2012

As I age, what can I do to keep my mouth healthy?


Your mouth is not exempt from the effects of aging. Older people suffer higher rates of gum disease, dental decay, mouth infections and tooth loss. 

Fortunately, you can keep your mouth looking and feeling younger than its years by practicing good oral hygiene. Let’s consider what happens in your mouth as you age. Your teeth are amazingly strong, but a lifetime of crunching, gnawing and grinding wears away the outer layer of enamel, as does exposure to acidic foods.   

Weakened enamel can set the stage for cavities. Cavities can lead to infections of the root of a tooth, requiring a root canal procedure. They also can weaken teeth, causing them to crack.


Along with our teeth, our gums get older too. Gum tissue naturally recedes with age. The gums pull away from the base of the teeth.

This leaves a gap between the gum and the tooth that can become a prime target for tooth decay.

Plaque, a mass of bacteria all embedded in a gel-like substance, often forms in and near the gap between the gum and tooth. The bacteria secrete substances that damage the teeth and gums.

Plaque is constantly forming, and if you don’t remove it by regular brushing and flossing, it will build up and start to attract minerals such as calcium. That’s called tartar, and it’s hard to fully remove with a toothbrush.  


Plaque can cause inflammation of your gums, a condition called gingivitis.

When plaque and tartar start damaging the tooth, the soft tissue around the tooth and the jaw bone, you have periodontal disease.

Periodontal disease is the primary culprit in tooth loss among older adults. Fortunately, your dentist can treat periodontal disease with a combination of scaling to remove the hardened plaque and infected gum tissue, antibiotics, and — in advanced cases — surgery.

 

Make an Appointment

reference: Dr. Anthony Komaroff, practicing physician and Harvard Medical School professor

Wednesday, December 19, 2012

Tooth loss can damage health

A recent national survey of more than 50,000 adults showed that half have at least one missing tooth, according to the American Academy of Implant Dentistry (AAID).

The survey, which was conducted by implant manufacturer Nobel Biocare, also found that only one in three respondents were aware that missing teeth can damage facial contour, and just 25% knew that tooth loss causes bone erosion in the jaw."Many patients who have lost one or more teeth believe the personal impact is strictly aesthetic and, as a result, may not choose to replace a lost tooth," said AAID President Beverly Dunn, D.D.S., in a press release.

"However, just one missing tooth can lead to significant bone loss over time that can alter the jaw structure, cause other teeth to shift, and change the shape of your face."Also, because people with missing teeth have trouble chewing certain foods, such as fruits and vegetables, they often eliminate these dietary staples from their daily regimens, Dr. Dunn added.

Dental implants are one solution for replacing missing teeth, and implant surgery is one of the safest, most precise, and most predictable  procedures in dentistry when performed by skilled implant dentist. Dr. Dunn said.


Reference – Dr. Bicuspid newsletter

Thursday, December 13, 2012

Senior Citizens need good oral health habits too!

 

Brush and floss daily 

Brushing and flossing your teeth is just as important for you as it is for your grandchildren. Even though it may have been years since you’ve had a cavity, your risk of cavities increases with age. One of the reasons is dry mouth — a common side effect of many prescription medications. 

Dr. Tyler Wolf, president of the West Michigan District Dental Society, recommends you brush your teeth twice a day with fluoride toothpaste.

“It’s a good idea to choose a toothbrush with soft bristles and a small head to get to those hard-to-reach areas,” Wolf said.

Another suggestion for those who may have problems with arthritis, or other conditions that limit movement, is to try an electric toothbrush.

It is important to clean between the teeth daily with floss.

“If floss is too difficult to work with, try a floss pick or tiny brushes made to clean between the teeth,” Wolf said. 


Clean dentures daily
 

 Just as bacteria stick to your teeth, it also will stick to your full or partial dentures. Be sure to clean your dentures every day with cleaners made specifically for dentures. Do not use toothpaste for natural teeth or household cleaners, which are too abrasive and can damage dentures that can be expensive to replace. “Take your dentures out  of your mouth for at least four hours every 24 hours to keep the lining of your mouth healthy,” Wol f said. It’s best to remove your full or partial dentures at night. Your dentist will provide you with instructions about how long your dentures should be worn each day. 



Visit your dentist regularly 

Wolf emphasizes it is important to get regular dental checkups and to not wait until you have pain.

“As you age, the nerves inside your teeth become smaller and less sensitive. By the time you feel pain from a cavity, it might be too late to save your tooth,” Wolf said.

Your dentist also will check for more serious conditions such as oral cancer and gum disease, which do not always cause pain until the advanced stages of the disease. By then, it often is more difficult and costly to treat.

When you visit your dentist for a checkup, it’s a good idea to bring the following information: List of all medications,  including vitamins and over-the-counter drugs 

 List of medical conditions and allergies Information and phone  numbers of all health care providers Information about your emergency contacts Dental insurance or Medicaid cards Your dentures or partials, even if you don’t wear them 


Drink water with fluoride
 

No matter what age you are, drinking water with fluoride helps prevent tooth decay. Fluoride is nature’s cavity fighter. In 1945, Grand Rapids became the first community in the country to add fluoride to its public water supply.  




Quit smoking
 

It’s never too late to quit smoking. Smoking increases problems with gum disease, tooth decay and tooth loss. It also slows healing after dental procedures and can decrease the success rate of dental implants.

Talk to your dentist about quitting. There are tobacco cessation programs, overthe- counter products and prescription medications that your dentist can prescribe or recommend to help you quit for good. 

Brought to you by the 600 members of the West Michigan District Dental Society in Kent, Ottawa, Ionia, Mecosta and Montcalm counties. West Michigan District Dental Society dentists also are members of the Michigan Dental Association

Wednesday, December 12, 2012

INVISALIGN - invisable braces

Invisalign invisibly straightens your teeth with a series of custom-molded aligners
Forget everything you’ve heard about teeth straightening. Because now there’s
breakthrough technology that lets you get the smile you always wanted without
bands, brackets, or wires.

A clear alternative
By using a series of clear removable aligners,
Invisalign straightens your teeth right before your eyes.
Change them about every two weeks, and your teeth
will move—little by little, week by week—until they
have moved to the final position your orthodontist or
dentist has prescribed. Comfortable to wear, our
aligners are also removable so you can eat, drink,
brush, and floss as usual.

Less treatment time
A typical Invisalign case takes about a year from start
to finish. You’ll see your doctor every month or two
to see how you’re progressing. Every few visits, you’ll
be given additional aligners to continue your treatment.
Commonly, the number of aligners worn during
treatment is between 18 and 30, but treatment time
and the number of aligners will vary from case to case.

Invisible. And comfortable
Invisalign is a virtually invisible solution. So you won’t
draw undue attention to your mouth while in treatment.
In fact, virtually no one will know you’re wearing them
unless you tell. Comfortable to wear, our aligners are
also removable so you can eat, drink, brush, and floss
as usual.
Is Invisalign for me?
Invisalign can be used to treat the vast majority of common problems for adults and teens.
Whether your smile needs minor improvements or more extensive adjustments, Invisalign
can certainly help. It's successful in treating overly crowded or widely spaced teeth. It can
also relieve more complex issues, including overbites, underbites and even crossbites. In fact,
an Invisalign Certified Orthodontist or Dentist can use Invisalign clear aligners in all or part
of just about any treatment plan.

Look your best during treatment
Invisalign is clear and practically invisible, so nothing gets in the way of your new smile.
No wonder Invisalign is the choice of over half a million people.
* Unobtrusive in business meetings or social gatherings
* No metal wires or bands to irritate your mouth
* Most people won’t notice you’re wearing aligners


Invisalign Aligners from a patients point of view.



Wednesday, December 5, 2012

Healthy Smile Series: The Periodontal Heart Connection

The evidence linking periodontitis to heart disease began in 1989 by a study in Finland, which observed that patients who had heart attacks had more severe oral conditions including periodontal disease and tooth decay. Several studies since have shown that a preexisting periodontal disease results in an increased risk for a heart attack or stroke.

These studies suggest that periodontal disease is not only associated with cardiovascular events like heart attack and stroke, but it is also associated with subclinical evidence of atherosclerosis including thickening of the vessel wall. These controlled studies indicate that periodontitis remains an independent contributor to heart disease. Caution is in order because these associations do not establish causality.

Recent evidence shows the relationship between gum disease and heart disease by demonstrating the presence of periodontal pathogens (bacteria & microorganisms) within the atheromatous plaque lesions of the vessels. We have long known that gum disease is associated with transient exposures of the bacteria into the blood (bacteria) and this is the reason why antibiotics are used as a prophylactic prevention prior to dental treatment for patients with heart murmurs and valve problems. New evidence is suggesting that these organisms can lodge in the vessel walls and persist. Thus the bacteria is associated with the plaques within the vessels themselves.

Other new information links gum disease with systemic inflammation, as measured by the production of liver proteins such as C-reactive protein. This protein has been known to be a risk factor for myocardial infarction or diagnosis of peripheral artery disease in otherwise healthy individuals. Mild elevations in C-reactive protein appear to confer risk for these cardiovascular complications. New research links gum disease as one potential cause for these elevations in this protein, thus suggesting another link between gum disease pathogens and heart disease risk.

There is also an association with known cardiovascular risk factors that are involved in systemic inflammation, and there is also evidence that the organisms are within the plaques. This represents a body of circumstantial evidence suggesting that this may be directly involved in the pathology associated with cardiovascular disease.

Regardless of the root causes for cardiovascular diseases, it stands to reason that good nutrition and good oral hygiene control of bacterial inflammation in the mouth are necessary components to help lower risk factors and prevent heart disease and its complications. Removing the oral bacteria meticulously well on a daily basis, and having regular periodic professional cleanings and dental checkups, as well as providing oneself with a diet high in necessary nutrients, will help reduce unnecessary risk factors that can lead to gum disease, heart disease and stroke.

Reference - Lee Ostler DDS
(Disclaimer: This information cannot be relied on for individual circumstances or substituted for medical advice from qualified health professionals.)


Thursday, November 29, 2012

Dallas Star Larry Hagman (JR Ewing) died of Oral Cancer


Famous TV show star Larry Hagman alias JR Ewing from the Dallas series died a few days ago of oral cancer. This fact triggered the attention of oral health organizations who work now more than ever on raising the awareness upon the importance of regular oral cancer screenings.


Prevention is the best cure, and if people would respect those regular oral cancer screenings, this would save the planet tens of thousands of deaths annually.

On Friday, Larry Hagman, a prominent actor died of tongue cancer. He has been diagnosed with the disease in October 2011.

Oral cancer does not select among patients and in the past few years several important names have been touched by the disease. Just to name a few, there was Michael Douglas, the former cricketer from England Geoffrey Boycott, and Dany Baker, a BBC radio presenter.
 
The best way to stay protected from oral cancer is to get annual oral cancer screenings.    The FDA-approved VELscope® offers dentists another examination tool to help detect oral cancer in its earliest stages. The VELscope® is a blue excitation lamp, which highlights precancerous and cancerous cell changes.
 
Make an appointment for your VELscope oral cancer screening. If not for yourself, then for those you love.
 
~ Kris
Certified and Registered Dental Assistant
Office Administrator
 

Thursday, November 8, 2012

What kind of First Impression are you making?

5 surprising ways others judge you

 When you meet someone for the first time or simply pass a stranger on the street, it’s human nature to make assumptions about them: He’s conceited and lazy, she’s rich and friendly, that little girl is a huge brat. And you may have wondered what people think of you the first time they lay eyes on you.

“When it comes to appearance, how you put yourself together matters more than being conventionally pretty,” says Brandy Mychals, author of How to Read a Client from Across the Room(McGraw-Hill, 2012). “A job interview can be over before you even sit down because the person has already made snap judgments.”

Some of the ways others come to those opinions aren’t what you may expect. Check out these five things people rate you by so you can make that tenth of a second count and wow everyone at first sight.

1. Your Feet Do the Talking

You can never have too many shoes—and people judge you based on every single pair. In a study published in Journal of Research in Personality, researchers found that people could accurately guess a stranger’s age, gender, and income simply by looking at what was on their feet. They also associated certain personality traits with different shoes. More masculine-looking pairs were thought to be worn by less agreeable people, while stylish or attractive shoes were assumed to be donned by rich, conscientious folks. And people rocking those ankle boots that are so in right now came across as aggressive.

 2. Cosmetic Powers

Brushing on a little shadow or blush can not only up your attractiveness factor, it can make you appear more confident. In a 2011 study funded by Proctor & Gamble and performed by Harvard University, people said women wearing a little makeup were more likeable, competent, and trustworthy than those with bare faces.

But don’t use a heavy hand with that eyeliner: Too much makeup still made women attractive, but they also seemed untrustworthy and dishonest, especially when participants only got a quick glimpse of the woman.
 
3. Grin and Bear It
 
Your dentist is about to become your most popular medical practitioner. Earlier this year, Kelton Research conducted a study with Invisalign where more than 1,000 people were shown pictures of men and women’s teeth. Those with straight smiles were perceived to be happier, smarter, and more successful and popular than those with crooked teeth.

Thirty-eight percent also said crooked choppers would kill the chances of a second date, and almost half said that when two job candidates had the same skills and experience, one with straight teeth would be hired over one with crooked teeth.
 


4. The Clothes Make the Woman
 
While Hillary Rodham Clinton rocks the pantsuit—and certainly nobody would doubt her confidence or competence—showing a little leg (tastefully, of course) may work better for you. Women in skirtsuits were thought to earn more money and be more confident than those in pantsuits in a study conducted at the U.K.’s University of Hertfordshire. The researchers say the skirt balances professionalism with attractiveness without being provocative.

Wearing the right outfit can also change your self-perception, researchers at Northwestern University’s Kellogg School of Management found. Students who wore white lab coats while doing a scientific experiment performed better than those in regular clothes.

5. Take Up Space
 
Simply standing tall can speak volumes. According to a 2011 study published in Psychological Science, so-called “posture expansiveness”—where you open up the body and occupy space—not only makes you appear more confident and authoritative, you actually think and act that way. Posture matters even more than your title: It gives you a sense of power, no matter where you line up on the totem pole, researchers say.

reference:  Jene Luciani - Shape Magazine.com

Monday, October 29, 2012

Halloween candy is a treat; not a snack!

For some parents, the scariest thing about Halloween is dealing with all the sugary treats that come home with their little ghosts and goblins. Erin Webley, registered dietitian at Spectrum Health’s Helen DeVo s Children’s Hospital’s Healthy Weight Center, advises parents to view Halloween candy as a treat for their children, not a snack option.

Webley says there are ways parents can help their children prepare for and manage the deluge of candy that comes with trick-or-treating. But, she cautions, parents should not make a big deal of it either way, or it will cause anxiety to both parent and child.

Here are some suggestions for dealing with the Halloween candy deluge: Be consistent with healthy
 
 snacks and meals around Halloween. Make sure you continue to offer the healthy options first, then reward children with a treat.

As soon as you return from
   trick-or-treating, separate out the candy your children don’t like and just throw it in the garbage so there is less temptation. Or, you can donate it to agencies that ship candy overseas to our service men and women. *** Halloween Candy Buy Back***








It’s OK to offer your child one or two pieces a day, but offer it with a healthy snack first. Candy is not nutritionally balanced or even satisfying as a snack.

Think about where you
 
 keep the candy. Out of sight is out of mind, but do not hide it. Candy s hould not be forbidden.

After a few weeks, when
 
children tend to focus less on the candy, you can start to throw it out in the garbage for good.

Increase your child’s level of
 
physical activity to make up for the extra caloric intake. Take more walks or bike rides around this time.

Consider giving out nonfood
 
treats such as dollar store favors, stickers or bags of pretzels and popcorn.

Put your Halloween candy
 in the freezer so it can be enjoyed throughout the year.

Don’t buy candy too far in
 
advance of Halloween or during post-holiday sales or you will be tempted to eat it around non-holiday periods.

You can make better choices
 about candy. Think of miniatures and those with lower fat content (peppermint patties vs. Snickers, for example).




— Information provided by Spectrum Health and the Grand Rapids Press

Thursday, October 25, 2012

An Ounce of prevention is worth a Pound of cure.

If you had a way to reverse a problem or prevent a problem would you try? We have a treatment to help you reverse the beginning stages of tooth demineralization that can lead to tooth decay.

If tooth decay has not reached the inner layer of the tooth (dentin) the enamel can be strengthened and the decay process can be halted using a specialized treatment of MI Paste Plus and custom trays.

First, we make custom trays that will fit onto your teeth. These trays will hold the MI Paste Plus in contact with your teeth. The trays are worn daily at bedtime to strengthen  weakened areas of the tooth. MI Paste Plus has two main components, calcium phosphate and sodium fluoride. These components help strengthen the enamel portion of the tooth. By strengthening the enamel the demineralization process can be stopped and the tooth stabilized.

This minimally invasive technique can help you make your teeth healthier and stronger and possibly prevent you from needing tooth structure removed and replaced with a restoration.

Schedule an appointment for your evaluation.

Val ~ Dental Hygienist