The importance of infectious control procedures at your dentist’s office

submitted by Dr. Michael Spadafora, D.D.S.

While infection control has always been a focus of the American Dental Association and the dental schools, it wasn’t until the early 1980’s that the general public really became aware of the issue.

The 1980’s brought AIDS to the public awareness. And with AIDS came a new term – “universal precautions.”  Universal precautions meant that every patient is treated as if he/she was a carrier of an infectious disease. This was done for the protection of all patients and the health care providers.

Although AIDS brought infection control to the forefront, today it is the hepatitis virus that is very concerning for patients and providers. This is because the hepatitis virus is more virulent and lives longer on surfaces.

So what do universal precautions and infection control mean for us today? In the dental world, it means that the dentists and clinical staff should be wearing fresh gloves to treat each patient. They should also be masked. All instruments that come in contact with the patient should be disposable or sterilized, using heat and/or chemicals. When the patient leaves the treatment room, the room should be thoroughly cleaned, using special chemical agents.

Opening the sterilization bags with the clean instruments in front of the patient in a dentist’s office is a subtle way of showing patients that infection control is a first priority.

As a patient, you have a right to ask about infection control procedures in the office. The dentist or staff should be more than willing to show you the sterilization area and explain what steps they take to protect your health.

If you wonder at all about your dental office’s infection control protocol, be proactive and ask questions. There is one rule of thumb, however, that is a good indicator. A meticulously clean dental office shows the attention to detail that will put your mind at ease. When it comes to infection control, every detail matters!


How do I treat sun damage that is already showing on my skin?

submitted by Brittany Bray, B.A., LMA, Licensed Aesthetician, Aesthetics Director, The Spa at Lifestyle

Sun damage is one of the more easy conditions to treat. It can be lifted to the surface with either a laser or a chemical agent. If you have clearly defined, flat, dark spots on the skin and your skin is significantly lighter than the spots, you’re most likely a candidate for an Alexandrite Laser – Pigmented Lesion Removal Treatment. This laser loves melanin – so the darker the spot the better. Some spots can disappear immediately. If the spots are somewhat lighter, it may take a few treatments to lift the spots safely to the surface. You’ll have only a little downtime, but nothing significant.

Now, if your spots are more like freckles and appear all over, like a mask, you’re probably a better candidate for chemical peels or a fractional laser.

Chemical peels will address pigmented areas by lifting the damaged cells to the surface. It’s crucial to be using your retinols, lightening ingredients and antioxidants at home, and to stay committed to an every 2-4 week program, for at least six months. An ideal combination chemical peel for sun-damaged skin is a blend of Kojic and Lactic acids, both of which are designed to exfoliate and lighten skin. You won’t shed much skin, but that’s not necessarily the goal.

If you’re looking for a more expedited treatment, the Clear + Brilliant Perméa Laser is the latest technology. This is a fractional laser for rejuvenation and pigmentation. The Clear + Brilliant Perméa is designed to address early signs of aging, melasma and sun damage. It is optimized to bring you a brighter, more even skin tone and enhances your skins permeability. Results are desirable and there is a minimal downtime period.


Real estate market bounces back

submitted by Lynne Kelleher, Realtor, Berkshire Hathaway Home Services Fox & Roach, Realtors – Newtown Office

Well…It’s official. The real estate market is finally back. Not to pre-crash levels of course, but firmly on solid ground and gaining. After nearly a decade of despair reminiscent of the Great Depression, 2013 has seen real estate change from being a ball and chain around the neck of millions of Americans to an asset that has been one of the few bright lights helping to move this stubbornly sluggish economy forward.

While the housing market is still somewhat volatile, the “experts” are calling for increases in 2014 ranging from 5% over 2013 levels to 10-15% higher. In Bucks County, the number of units sold increased 20% over 2012 totals.

Nationally, home prices continue to rise faster than they have since the housing boom. The average sale price in Bucks County of $322,592 was up 2.3% and it took an average of 77 days for a house to sell, down 19% over the previous year.

Another key factor on the rise is mortgage interest rates, which have come up almost a point in 2013 and are now hovering around 4.5%. Expect them to rise even higher in 2014, possibly close to the 6% mark by the end of the year. Also expect to be put through the wringer if you’re applying for a mortgage this year. Lenders and underwriters are still re-living the horrors of the mortgage debacle and even immensely qualified buyers are paying the price through excessive documentation, explanation and all around hoop jumping.

We’ve returned to a “normal” real estate market, where neither party should consider themselves in the driver’s seat.


Ice dams – The silent home wrecker

submitted by Gary Selleck, owner, C & C Family Roofing

After a moderate snowfall it’s always fun to look out the window and see the winter landscape. Snow blankets the ground and icicles glisten from the trees and overhangs. But don’t let the serene landscape fool you. There is a thief lurking in the snow.

The formation of icicles over the gutters can be a result of the gutters being full of debris, snow and ice. It can also be the result of warm air escaping out of your heated space into the attic. This accelerates the melting and freezing process on the roof. This ice build-up over the front edge of the gutter may also be restricting the water coming off the roof. This blockage is called an “Ice Dam.”

As a result, this water restriction will begin to find gaps and openings in the exterior roof covering and may penetrate your attic space. From there this water could leak through exterior walls, into ceiling insulation and through your finished ceiling. The result of this moisture entering the home from ice dams can lead to the growth of mold and mildew. These things may lead to respiratory problems.

Here are a few simple steps that can help prevent ice dams from occurring:

  • Have your gutters cleaned out prior to the first snowfall to improve water flow;
  • Seal all openings that would allow warm air vapors to rise into the attic space (access panels, ceiling mount light fixtures and ceiling fans, etc.);
  • Have your attic properly insulated;
  • Provide good attic ventilation to ensure proper air circulation;
  • Consult a professional for the best ways to avoid ice dams and water damage.

Don’t let winter ruin your holiday season.


Laser hair removal the latest weapon in centuries-old battle

submitted by Brittany Bray, B.A, LMA, Aesthetics Director, Licensed Medical Aesthetician at The Spa at Lifestyle

For cosmetic and medical reasons, hair removal methods have been around for hundreds of years. While uncommon ways of removing hair have come and gone, the conventional ways have stuck around. The popular methods include shaving, waxing, tweezing, threading, and depilatory creams.

For some, these routines can be tedious and expensive over time and not all of these practices are desirable for those with coarse hair. Individuals who struggle with coarse hair can agree that these methods may not only be a nuisance, but irritating and painful. And none of them make an impact on the hair growth forever. This is when laser hair removal becomes ideal.

Laser hair removal can be a rewarding treatment for anyone who has excess hair growth. The technology has advanced to where lighter hair can also be treated, rather than just dark, coarse hair. Additionally, darker skin types can now safely be treated as well.

There are a few things to know before receiving laser hair removal. Having a detailed consultation is crucial, and it is important to know that medications, sun exposure, pain tolerance and expectations are necessary topics to discuss. 

Laser hair removal is not a one-treatment-process. It can take between six months to a year to treat the growth and sometimes more if there is a hormonal imbalance. Also, you may see hair growth just a few days after your first treatment. It is not permanent hair removal, but rather permanent hair reduction. Typically 95% of growth is reduced if compliancy is maintained and treatments are performed every four to six weeks, for at least six treatments.

This treatment can have an extremely beneficial impact on one’s self-esteem and seeing the progress is incredible. It also helps to have a compassionate technician by your side along the way.

The days of shaving, waxing and tweezing may be far behind you, so interview several places, make sure you feel comfortable and safe, and don’t be afraid to ask questions!


‘Tis the season for gifting

submitted by E. Garrett Gummer, III, Esquire and Maureen L. Anderson, Esquire,

At this time of year we think about gifting for the holiday season. While gift giving is considered an act of kindness, it can also be an important estate-planning tool.

You may wish to give away assets during your life, so they are not included in your estate and subject to tax upon your death. However, you need to consider the tax laws that may apply.

According to the IRS code, a gift is a voluntary transfer of property from a donor to a donee without full and adequate consideration. An individual may give gifts up to $14,000 each year to as many individuals as they wish without incurring any gift tax. A married couple can make joint gifts up to $28,000 each year. This $14,000 exclusion does not apply to gifts to charities or gifts between spouses. There is no limit to how much an individual may give their spouse or charities each year. Also, any medical expenses or school tuition of another is excluded.

If you give an individual $20,000 during the year, which exceeds the $14,000 limit, you will have to file a Federal Gift Tax Return for the year, but will probably not have to pay any tax.

The IRS code allows a $5,250,000 exemption from Federal Estate/Gift taxes. Therefore, until the $5,250,000 is exhausted, no Federal Gift Tax is due. If you do not exhaust your federal exemption during your lifetime, you will be able to use it as an exemption for federal estate taxes after your death. 

In addition to Federal Gift Tax, one must think about Pennsylvania Inheritance Tax when contemplating gift giving. If you transfer an asset to another individual during your life for the purpose of avoiding inheritance tax, you must live for one year following the transfer, or the asset will be counted as part of your estate at death. 

During this busy season, take the time to consider gift planning for you and your family. 


Relief from TMD

submitted by Dr. Michael Spadafora, D.D.S.

Last month’s column was about Temperomandibular joint disorder (referred to as TMD) and some of the symptoms that occur in dental patients. It is a topic of such interest that more discussion was warranted.

When a patient arrives in the dental office complaining of symptoms indicative of TMD (such as headaches, jaw pain, locked jaws, swelling), the doctor will take a detailed health history. In the health history, the dentist is looking for recent traumas, increases in stress, the presence of arthritis in other areas of the body and other factors that may contribute to TMD. He is also listening for complaints from the patient (for example, the jaw locks open when the patient yawns, eating is difficult).

A physical exam follows the health history. In the exam, the dentist is listening for sounds from the jaw – clicking, popping, and grating sounds. He will feel the jaw as it opens and closes to determine if the movement is smooth. He will observe the jaw and mouth to determine the range of motion. Finally, the dentist will palpitate the areas around the jaw to identify the specific sites of pain. Occasionally, the dentist will recommend x-rays of the jaw or an MRI.

A good and careful diagnosis of TMD is important because the symptoms are so wide-ranging and can be indicative of other issues (sinus and dental infections).

The diagnosis is the first step in treating TMD. The protocol for treating TMD suggests starting with the most conservative treatments. Lifestyle changes, such as eating softer foods, taking smaller bites, and purposefully keeping the jaw unclenched are recommended.  Medication is sometimes prescribed, ranging from NSAIDs (non steroidal anti-inflammatory drugs such as Advil and Naproxen), muscle relaxants, and low dose antidepressants.

Custom fitted night guards often will provide relief from TMD, as well as ice and moist heat.

Finally, treatment options can include physical therapy, corticosteroid injections, and, as a last resort, surgery. Relief is almost always available for patients suffering from TMD.  The patient must take the first step and visit his dentist or physician.


House drafts are a constant battle

submitted by Gary Selleck, owner, C & C Family Roofing

Did you ever walk past a window or a door and feel a draft that sends shivers up your spine? As if Death himself has laid his hand on you. Often this is a result of improper insulation in your home. The hot air from your heating system escapes through the inadequate insulation areas and thus your heating system needs to run more often to compensate. This air infiltration can lead to increased heating costs, moisture build up on the wood framing and could possibly lead to mold.  The same thing could be said during the summer.

There are many areas in older homes that lack the proper insulation. The attic is the most common area. Older homes rarely meet the minimum recommended R-value for insulation. The U.S. Department of Energy recommends the northeast region to have a minimum R-38 insulation to maximum R-60 insulation in your attic space (bat insulation or blown-in insulation). An easy way to determine whether a home has an insulation issue is during the winter months. Snow accumulation normally melts during the daylight hours.

Some other areas on a house where poor insulation is found are around windows and doors. When windows and doors are installed properly there is a minimal gap that should be insulated. Many houses have larger openings and the insulation sags or misses altogether.

Like many things in life, people would rather not know and just presume things are fine, all while their heating and cooling bills are unreasonably high or they’re suffering with an uncomfortable home. Have your home insulation checked by a professional insulation company before the winter really sets in. Don’t get left out in the cold!


When it rains it pours

submitted by Gary Selleck, owner, C & C Family Roofing

Nobody likes to get wet when it’s unexpected. Have you had a glass of water spilled on your lap at a restaurant, gotten caught in a sudden rainfall, or had a car splash puddle water at you while walking? All these situations make for a miserable day.

But have you ever had unexpected water in your home. Wet clothes are a lot less stressful than a wet carpet, furniture, drywall or basement. Often these sudden water penetration issues are a result of clogged or defective gutters. Defective or loosely secured gutters can be a result of snow and ice creating downward pressure on the old hanger of the gutters causing them to fall out of alignment.

When gutters don’t perform the way they are supposed to they can cause all kinds of problems. Water will spill over the edge of the gutter and splash against windows, in the landscaping or against the foundation. Gutters are intended to control or manage the removal of rainwater from off the roof and direct it to areas on the ground that will cause the least amount of trouble.

Here are some ways that homeowners can prevent these unexpected water issues from occurring. Have your gutters cleaned out two times a year (in the spring when the trees bloom and in the fall when the leaves fall). Have your gutters and downspouts secured to the house and aligned properly. If the gutters are in total disrepair have them replaced. Make sure that the size of the gutters matches the amount of water that is being managed. Have a good gutter guard screen installed on your gutters to prevent leaves and debris from causing future problems.


How much should I eat each day?

submitted by Solomon Brenner, Zen-10, 10 week fitness challenge

The answer to this question is different for everybody. How many calories you should consume each day depends on a variety of factors such as sex, height, weight, age, and physical activity. There is a widely used formula to determine your BMR, or basic metabolic rate, which is the number of calories your body needs to function at your current weight without exercise. Below is a formula to figure out your BMR (you can also find BMR calculators online).


Step One:

For women – 655 + (4.35 x weight in lbs) + (4.7 x height in inches) – (4.7 x age in years);

For men – 66 + (6.23 x weight in lbs) + (12.7 x height in inches) – (6.8 x age in years).

Step Two:

Multiply your number from Step 1 by the appropriate activity factor listed below to get your specific BMR (number of calories needed without exercise).

Sedentary (desk jobs, etc).  Multiply by 1.1

Mildly active (teachers, retail sales people, housewives, etc).  Multiply by 1.2

Active (physical trainer, plumber, electrician, etc).  Multiply by 1.3

Extremely physically active (construction workers, athletes, etc).  Multiply by 1.4

Step Three:

Write down your BMR. By writing it down, you ensure that you remember that number.

Your BMR is a great number to stick to if you’d like to maintain your current weight. If weight loss is one of your goals, eat fewer calories than your BMR indicates. By burning more calories than you put in, you force your body to use stored fat as an energy source.

If this all seems like a lot of math to you, remember this: the LEAST amount of calories you should eat is 1200 for women and 1600 for men. It’s also important to eat the right kinds of food. Look for foods that are relatively low in calories compared to their high value of nutrients.