Q: I experience numbness and tingling in my toes when I wear certain shoes. I have been told I have a neuroma, are there any new breakthroughs for this problem?

A: The quick answer is yes.

Let’s review what a neuroma is. A neuroma is the pinching of the nerve in the foot usually found between the third and forth toes.

The symptoms are: burning pain, pins and needles, and numbness or cramping of the toes. Often times the cramping will cause the person to take their shoe off and massage the cramp out.

Historically, the treatment for neuromas would be the injection of a steroid and if this failed to relieve the symptoms, which was often the case, then surgery was required.

Today we have a new treatment called Chemical Neurolysis: whereby a podiatrist injects a diluted alcohol solution into the nerve which essentially shrinks and kills the nerve. The injections are relatively painless and are given weekly until the symptoms resolve, usually requiring 3-7 injections.

The results I see in my practice are similar to those in the current literature which is to say the procedure is roughly 85% effective. By comparison, steroid injections are less than 30% effective.

So yes, this is great news! I have been performing this technique over the last year and have found it so effective that in no case was surgery required.

Q: My child has flat feet do they need to be treated?

A: This depends on many factors.

I generally recommend that a child with flat feet be professionally evaluated beginning at two years of age. From my experience, most physicians and parents take the feet for granted. What is forgotten is that when children complain of tired feet or knee pain this is a cry for help.

A major misunderstanding in the medical community and with parents is that flat feet (pronation) is not a benign problem and may lead to different types of structural complaints such as: lower back pain, knee problems, and potential major foot deformities that can and do occur later on in life.

These foot problems can be quite disabling and may require major foot surgeries if left untreated, yet most are preventable if diagnosed and treated early. Early treatment generally consists of prefabricated or custom orthotics.

My advice to parents is to have your children’s feet examined routinely by a qualified podiatrist so that corrective action can be taken at the first sign of a problem. Early prevention and care are the keys to healthy feet!

Jack R. Landry has worked as a podiatrist and foot surgeon for the past 14 years and written hundreds of articles about various foot conditions. He recommends (http://www.DrRoths.com) for products to help with plantar fasciitis.

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Long boarding is a sport that is gaining popularity very quickly. The longer board and the ability to get going at very high speeds make this form of “land surfing” a very unique experience.

If you have been interested in longboarding but you have not mustered the courage to go out and try it, now is the time. With more and more longboarders entering the skating scene, you will have a lot of support and there are many experienced riders to learn from.

Watching the experienced riders ride is always a treat. Seeing their new moves and innovative tricks gives longboarding a very unique feel.

When you first learn to longboard you will want to learn how to skog. Skogging is the combination of skating and jogging.

When you are running or jogging there is no distinction between left or right legs to stay balanced. This same phenomena occurs when you are rollerskating or rollerblading.

You just simple point your body forward and swing your legs from your hips. You develop a similar movement when you skog.

Many long distance riders utilize skogging out of necessity. The leg you are standing on the board with and the leg you are pushing yourself forward with will need to alternate if you are riding for a long amount of time.

Even if you are only going a short distance, skogging can turn a simple skate session into a fun cardio work out. There are not many other sports out there that can give you a cardio experience that is fun and addicting.

When you are first learning to switch legs it is important that you start on flatland. You begin by working at standing on one leg.

You need to be able to stand on one leg and gently bend at the knee and waist while imagining rolling. Make sure you can do this on both legs.

It is mandatory that every beginner can balanced on the board. You should be at least able to stand stationary on one leg while making twisting motions and gently bending at the knee.

Next, take your board and set it on the carpet. Make sure that if you fall the board is not going to shoot out and damage something or hurt you.

Now, go through the same visualizations as in step one. Do not roll.

It may take days or a week for you to get comfortable enough with feeling your balance evenly. Knowing that you can balance on the board with only one leg at a time is crucial to being able to do this exercise.

The next step is to find a surface that will not allow your board to roll at its full capacity. A golf green or a carpet are ideal for this step.

Once you have found the proper surface, you must then begin to push with both legs for 10-20ft. Alternate and feel the required balance as if you were on a smooth surface.

Practice on the restrictive surface for a few hours a day. It is also helpful to watch others that can do this exercise so that you can understand the rhythm of the exercise when done properly.

Finally it’s time to take it to the boardwalk or to the streets. You will eventually get to the point that instead of just alternating your legs, you will have the ability to glide on either leg while alternating pushing legs.

Eventually you will be able to gain speed and feel the effects of the workout. Skogging is a great alternative to jogging and running because it is so much easier on your knees.

Remember as you go out to always be conscious of your safety. Wearing elbow, knee and wrist guards along with a helmet is very highly recommended.

You will take some tumbles and some falls as you are learning to skog. Learning how to fall without hurting yourself may be very beneficial.

Look for surfaces that have minimal amounts of cracks. A crack on a boardwalk or on a sidewalk can easily throw a riders balance off and make him or her wipe out.

If you are skogging in an area with cracks it is important to pay attention to where the cracks are. When you are approaching a crack, attempt to shift weight up to “hop” over and hit the cracks at an angle.

Be very aware of the rules and regulations that are in place where you are going to skog. If you are successful in your skogging endeavors you will not ever want to go back to jogging and running.

Jack R. Landry has been skating since he could tie his own shoes. He loves riding various models of skateboards and longboards. He recommends (http://bbsdistribution.com) for longboard completes.

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What is it? Gingivitis is an inflammation of the gums surrounding the teeth.

Gingivitis is one of many periodontal diseases that affect the health of the periodontium The periodontium are those tissues that surround the teeth and include the gums, soft tissues, and bone.

Periodontal diseases are often classified according to their severity. They range from mild gingivitis, to more severe periodontitis, and finally acute necrotizing ulcerative gingivitis, which can be life threatening.

Bacteria can cause inflammation of the gums. Although bacteria are normally found in our bodies and provide protective effects most of the time, bacteria can be harmful. The mouth is a great place for bacteria to live.

The warm, moist environment and constant food supply are everything bacteria need to thrive. If not for a healthy immune system, bacteria in the mouth would rapidly reproduce out of control, overwhelming the body’s defense system.

An infection begins when the body’s immune system is overwhelmed. Gingivitis is an infection that occurs when bacteria invade soft tissues, bone, and other places that bacteria should not be.

At the moment of infection, bacteria no longer help us, they begin to harm us. Infections, like other diseases, range from mild to severe or life threatening.

Gingivitis is considered to be a bacterial infection of the gums. The exact reason why gingivitis develops has not been proven, but several theories exist.

For gingivitis to develop, plaque must accumulate in the areas between the teeth. This plaque contains large numbers of bacteria thought to be responsible for gingivitis.

But it is not simply plaque that causes gingivitis.

Almost everyone has plaque on their teeth, but only a few develop gingivitis.

It is usually necessary for the person to have an underlying illness or take a particular medication that renders their immune system susceptible to gingivitis.

For example, people with leukemia and have changes in the blood vessels of their gums that allow gingivitis to develop.

Other people with diabetes, HIV, and other immune system diseases lack the ability to fight bacteria invading the gums.

Sometimes hormonal changes in the body during pregnancy, puberty, and steroid therapy leave the gums vulnerable to bacterial infection.

A number of medications used for seizures, high blood pressure, and organ transplants can suppress the immune system and change the structure of the gums enough to permit bacterial infection.

The symptoms of gingivitis include:

Swelling, redness, pain, and bleeding of the gums are signs of gingivitis.

The breath begins to take on a foul odor.

The gums begin to lose their normal structure and color. The gums, which were once strong and pink, begin to recede and take on a beefy red, inflamed color.

Inflammation-a complex system by which bacteria-fighting cells of the body are recruited to an area of bacterial infection-plays a major role in gingivitis.

It is this inflammation of the gums that accounts for most of the symptoms of gingivitis.

When bacteria first begin to invade the gums, proteins present in the saliva and soft tissues called antibodies coat the bacteria and weaken it, making it an easy target for the body’s immune system.

The cells that encounter the bacteria first attempt to kill it and, in the mean time, release chemicals into the bloodstream to call other cells to their aid.

One particular cell called a macrophage is responsible for ingesting the bacteria and dissolving it with chemicals. This system works nicely, but it is not terribly efficient.

While the invading bacteria are destroyed, chemicals used by the immune system cells to kill them are spilled into the surrounding tissues.

This not only kills the bacteria but damages the nearby connective tissues and cells of the gums as well. The body sees this inflammation as a small price to pay for stopping the bacteria. This process will continue until the source of the infection is removed.

Gingivitis is a clinical diagnosis. This means that the physician or dentist can arrive at the diagnosis by listening to the person’s medical and dental history and performing a good oral exam.

Blood work, x-rays, and tissue samples are checked for cases not responding to initial therapy. The person should, however, be evaluated for underlying disease.

Jack R. Landry is a former dental assistant and has authored hundreds of articles relating to general and cosmetic dentistry. He recommends (http://www.TrueDentistry.com) as a dentist in Las Vegas.

Our society is dependent on the outputs of heavy machinery. From the machines used to build cars to the machines used to compress the trash at the local dump, heavy machinery plays a huge role in our society.

This reality also means that the men and women trained to use this heavy machinery are vital. Our economic and industrial markets depend on people to operate heavy machinery every day.

These men and women that are helping our world turn ’round care often working in situations that have the potential to be very dangerous. They are trained to take all of the necessary precautions around the machinery they work with.

In our economic situation some people that never expected to work with heavy machinery are accepting jobs in which working with this equipment will be part of their everyday task. It is important to remember how to be safe around machinery in case ever find yourself in the position requiring you to run the equipment.

First off and foremost it is important to know exactly how the heavy machinery functions. The machine was build to get a job done correctly and efficiently.

There are different schools that can educate you in very specific machines. Acquiring the knowledge to work with different types of heavy duty machines will make you very valuable in the job market.

Before attending a school for training there are some simple safety precautions that you should be aware of. Knowing these safety tips beforehand will give you a slight advantage as you learn more about the machinery you will be working with.

First, the way you dress is crucial. You need to be wearing sturdy clothes that are snug-fitting. In many cases you will be wearing overalls with reinforced cut retardant to prevent you from cutting yourself on the machinery.

At all costs, avoid wearing loose fitting jackets, scarves, neckties, jewelry, flared or cuffed pants and even long hair. All of these items could easily become entangled in the machine.

If an article of your clothing becomes entangled in the machine, you may not have adequate time to react and save yourself. Even if you live, you may have severed limbs or serious damage done to you.

If you are going to experience prolonged exposure to heavy machinery, you may also experience vibrations that may have a negative effect on you. Many machine operators develop carpal tunnel syndrome from the effect of the vibrations on their wrists.

In some cases carpal tunnel is not severe, but in others it can be very painful. It may cause numbness and burning sensations in the hand if nerve or circulation damage has been incurred.

Another common symptom of carpal tunnel syndrome is the hands loss of ability to feel and regulate temperature. It is very important to protect your hands from this type of condition.

One way to avoid this condition is to have a good grip on the machine. The best way to improve your grip on the equipment is to buy sturdy, heavy-duty, non-slip gloves.

Some employers will tell you that because the handle to the machine you are using is heated or has an anti-vibration system you will not ever have carpal tunnel syndrome. All though these efforts do make a difference, and are greatly appreciated, carpal tunnel syndrome can still develop.

Keep watch on your hands for any of the above mentioned symptoms. If you begin to feel the symptoms seek medical attention right away.

There are many considerations to be taken when choosing what footwear you are going to wear. If you are working in sawing, you should heave heady duty nonslip shoes and the majority of the men have a steel toe.

Wearing protective goggles is the best thing you can do for your eyes. There are many different forms of facial protection that businesses will educate you about.

When advised to wear protective clothing, heed the advice. Some machines require that you wear protective eyewear.

Wearing the protective eyewear is never a bad idea. Even if your boss does not require you to wear protective eyewear, it will never hurt you.

Sometimes the machinery is extremely loud. The deafening noises will be far too painful to function without earplugs.

Taking the time to put on your earplugs and protective eyewear will prove to be a very wise decision.

The last piece of safety clothing we will mention is the safety harness. A tool designed to make it impossible for the worker to fall into a machine, the safety harness has been utilized all over the world.

Jack R. Landry has used metalworking equipment for the last 11 years and written hundreds of articles about machinery. He recommends (http://www.jorgensonmachinetools.com) for Durma machinery and tools

There are all kinds of cosmetic dentistry procedures out there. The shape of your jaw, the placement of your teeth and your oral health can all have an effect on what procedures are better for you.

Here we talk about the different kinds of procedures to help you determine what to talk to your dentist about.

Tooth contouring:

Using a polishing instrument, your dentist removes small amounts of enamel to contour the tooth. It’s a relatively inexpensive, painless and quick procedure.

Too much tooth enamel could be removed but this is rare. The cost for this procedure can be anywhere from $600 to $1000 per session.

Full mouth reconstruction:

Using advanced technology, the dentist measures the jaw’s muscle function in both stressed and relaxed positions by running computerized scans. With an imbalance, the dentist will use an orthotic appliance.

The orthotic is a removable or fixed appliance that artificially builds up the patient’s bite to a comfortable resting position. For patients that wish to eliminate the orthotic, full mouth restoration is often required.

After the orthotic has been worn for several weeks to several months, the jaw naturally drops into its most comfortable position. Only then can the doctor begin to restore the bite.

Inlays and Onlays:

If a cavity is detected in a dental exam, or if you have a failing metal filling, and the decay is inside the cusp of the tooth, an inlay can be used to restore the tooth to health. The dentist will first take an impression of the tooth then send the impression to an outside lab.

The lab will custom build the inlay to fit the patient’s tooth exactly. The patient will be fitted with a temporary inlay in the interim.

When the lab returns the inlay to the dentist, he or she will remove the temporary restoration, and bond the permanent inlay to the tooth. The inlay becomes part of the tooth, splinting it together and making it stronger.

There is no space between the inlay and the tooth, ensuring that bacteria can not enter and cause a cavity. The color and shading of the inlay should make the restoration invisible to the naked eye.

The cost for an inlay varies with the doctor’s training and the cost of the laboratory, but typically ranges from $650 to $1,200.

Bridges:

The dentist will first administer an anesthetic to numb the area. Then, a minimal amount of tooth structure will be removed from the teeth on either side of the space to be filled by the new tooth or teeth.

This material is removed to provide the needed space for the new crowns. An impression of the area will be made.

This impression will be sent to a dental laboratory, serving as a model from which the bridge will be created. The patient will then be fitted with a temporary bridge.

At the next visit, when the permanent bridge is ready, the temporary bridge will be removed. The new bridge will be fitted and adjusted for perfect fit and comfort.

The new bridge will then be bonded to the teeth. Typically there is a fee per tooth, including the anchoring teeth on each side.

For example, if a patient needed a three unit bridge (one missing tooth, two anchoring teeth), and the cost per tooth was $1,000, then the bridge cost would be $3,000. The cost per tooth depends on the lab fees, skill, training and location of the dentist.

Gum recontouring:

Gum recontouring is a safe, comfortable procedure. The dentist will first numb the gums with anesthetic.

Then, with a duo laser, he or she will gently re-shape the gum line, sculpting excessive and uneven tissue. The laser immediately seals the tissue, promoting a fast, comfortable recuperation.

Typically gum recontouring is included as part of a larger treatment plan, so the procedure cost will be included in the overall fee.

Jack R. Landry is a former dental assistant and has authored hundreds of articles relating to general and cosmetic dentistry. He recommends (http://www.BakersfieldSmileDesign.com) as a dentist in Bakersfield, CA.

Why do my teeth become discolored? Tooth discoloration is a normal part of aging. As people age, enamel wears down, and teeth take on a duller appearance.

Teeth can also become discolored from smoking and heavy consumption of coffee or tea. Other causes of tooth discoloration include side effects of medications (specifically certain antibiotics) used during the developmental phase of the teeth, an individual’s genetic makeup, and excessive fluoride consumption (fluorosis, seen in both children and adults).

Teeth whitening and veneers offer a cosmetic dentistry solution for people with discolored or dull-looking teeth.

What are the side effects to teeth whitening?
Dentists take protective measures to prevent discomfort during teeth whitening procedures.

Typically, a protective gel or rubber shield is used to prevent bleaching agents from damaging gum tissue.
The most common bleaching agents used by dentists are approved for use by the American Dental Association, ensuring safety and effectiveness.

After the whitening procedure, you may experience minimal tooth sensitivity for a short period of time
Does teeth whitening work for everyone?

In cases involving severe discoloration, teeth whitening may not result in a bright, white smile. Individuals with severe tooth discoloration should consider other options, such as porcelain veneers or composite bonding.

Are there special considerations for dental veneers?
The factors to consider when evaluating a veneer procedure from an aesthetic point of view include:
Your goals – what you want your mouth to look/feel like.

The color of your teeth. For example, most veneers are ultra-thin and therefore translucent, so discolored teeth underneath may show through.

Your dentist may recommend teeth whitening first to reduce discoloration. Veneers are fabricated to have a natural tooth-like appearance.

Veneer color must match that of any remaining teeth, and texturing may be applied to veneer surfaces for a natural look.

The impact of your lifestyle and habits. For example, teeth grinding and clenching may make the veneer more susceptible to chips, cracks, and breaking.

You should also consider the artistry of the dentist who designs the specifications and ultimately places the veneers. Veneer materials are universal, but the artistic skill of the dentist, as well as that of the lab technician who crafts the veneers, plays a major role in the esthetic appeal of the final product.

Are veneers my only option if I want a smile makeover?
Your cosmetic dentist will determine the cosmetic dentistry procedures that would be the best for you.

The dentist’s suggestions will be based on your desires and a thorough examination to determine the condition of your teeth and what problems, if any, may require dental treatment.

Therefore, your smile makeover could involve teeth whitening, crowns, composite bonding, gingival sculpting, inlays and onlays or any other combination of cosmetic dental procedures that your dentist determines is right for your cosmetic treatment plan.
How do I know whether a cosmetic dentist is good or not?

One of the first questions you should ask is what type of training he or she has for the particular procedures you’re interested in. Not all dentists know and perform all cosmetic dentistry procedures.

Some cosmetic dentists even have portfolios for you to look at. These include before and after pictures of their work.

As such, cosmetic dentists often involve other specialists (orthodontist, endodontist, lab techs, etc.) in treatment planning and execution. It is important to know exactly who will be involved in your treatment and what they will be doing.

You should also ask to see before-and-after photos of patients who underwent those procedures. Ask questions about their cases and the strategies the dentist used to improve their smiles.

Additionally, ask if the dentist is an accredited member of the American Academy of Cosmetic Dentistry (AACD). Accredited members undergo extensive continuing education and rigorous testing to ensure that their skills using composite bonding, porcelain veneers and other cosmetic restorations and procedures are exemplary and worthy of accreditation status.

Jack R. Landry is a former dental assistant and has authored hundreds of articles relating to general and cosmetic dentistry. He recommends (http://www.BakersfieldSmileDesign.com) as a dentist in Bakersfield, CA.