Cosmetic, or aesthetic, dentistry focuses on improving appearance and facial self-image by correcting the alignment, shape, and color of teeth. Dental professionals who offer cosmetic options can improve the appearance of stained, chipped, and misshapen teeth, and correct uneven gums and replace old fillings with nearly invisible filling materials. Cosmetic dentistry procedures are elective and, therefore, often not covered by insurance.
Description

The most popular option in cosmetic dentistry is tooth bleaching, an area that is experiencing a 15 to 20% growth a year. Most dental practices offer tooth bleaching, which involves the use of at-home and in-office supervised whitening systems that brighten stained, discolored, or dull-looking teeth.

Veneers are the second most popular cosmetic dentistry option. Used to correct chipped, cracked or worn teeth, veneers are ultra thin tooth coverings, sometimes made of porcelain or composite materials. Bonding is another process also used to correct chipped, cracked, or worn teeth.

Crowns, dental bridges, and dental implants can be used to replace missing teeth or correct bite dysfunction. Today’s newer technology includes porcelain and ceramic tooth replacements that look real and blend with existing teeth.

Cosmetic dentists can correct excessive or uneven gums with cosmetic surgery. Many patients with old or unsightly fillings also can opt to have them replaced by a dentist, who can use resin and porcelain filling materials or crowns to eliminate the look of the previous fillings.

Causes and symptoms

Anyone who is unhappy with his or her smile is a candidate for cosmetic dentistry. The reason might be a general displeasure with the look of one’s teeth or a specific aesthetic dental concern. While the reasons for improvement vary, the most common causes are staining due to aging, tobacco use, coffee intake, fluorosis, and tetracycline use. Patients also often want to improve the shape and position of their teeth. Diastemas (spaces between teeth), slight rotations, and malformation of the teeth (e.g., peg laterals, barrel shape teeth) are common reasons for correcting the shape and the position of the teeth.
Diagnosis

The diagnosis of an aesthetic problem involves looking at the entire face; the color of the eyes, skin, and lips often influence the appearance of teeth. The face evaluation is usually divided into imaginary thirds: the first section goes from the hairline to eyebrows, the second from eyebrows to the base of the nose, and the third from the

base of the nose to the lower border of chin. Aesthetic smiles are diagnosed by the dentist, who looks for asymmetry and mobility of the upper and lower lips; midline in relation to the front teeth; gumline; tooth and gum contours; tooth color; tooth to length proportion and relationships; and, finally, restorations. Several factors must be taken into account when assessing these variables, including age, gender, race, and personality.

When examining the tooth shade, specifically, certain factors should be considered, such as the light source and surrounding colors. Bleaching of teeth will change the shade of the tooth structure only, which can pose a problem if the patient has several tooth-colored restorations.

The recent economic woes in the U.S. have led to an increased accounts of DIYers perfoming their own dentistry at home. A recent survey of dentists points to an increase in this type of behavior. So, perhaps it is not a surprise that the most popular technique involves Super Glue.

As amusing as it sounds, I see patients using many dangerous methods to save themselves a trip the to the dentist, from emery boards to power tools (i.e. dremel tools). I was told by a patient the other day that Super Glue worked better than Krazy Glue. Obviously he’s had some experience in differentiating between the two in their effectiveness.

It is true that cyanocrylate, the generic name for Super Glue and Krazy Glue, which contains acrylic resins methyl-2-cyanocacrylate or 2-octal cyanoacrylate, is used by physicians for wound repair. In fact, cyancrylate bonds very well to surfaces that are moist and non-porous. Sounds perfect for that dental crown that keeps coming out, right?

Unfortunately, that notion is wrong and here’s why. The crown is a non-porous surface and can be moistened, but the tooth, despite being very moist, is also very porous. Therefore, the adhesion between the two is negligible and will not last. But the real danger is forcing the cyanocrylate down into the tubules of the tooth and killing the tooth. This will ultimately lead to the need for a root canal or even the loss of the tooth due to resorbtion.

What most people may not know is that a dental crown does not stay in place via adhesion. It remains in place for years merely by mechanical retention.

Mechanical retention is best explained like this: Imagine placing an identical glass over another identical glass. Pick up the upper glass and the one below comes with it, and the two “stick” together as you lift the top glass.

Now try that with two identical bowls stacked face down on top of each other. It’s impossible to pick the bottom bowl by lifting the one placed on top. This is an illustration of the effects (and success) of mechanical retention.

So if that crown keeps falling off, it’s not due to a lack of adhesion - it’s due to the shape of the prepared tooth lacking in retentive features. Dentists typically don’t actually use glues, we use cements to prevent saliva from seeping between the crown and tooth, which prevents tooth decay. In this light, I hope you see the futility of using a product like Super Glue in your mouth.

It’s not at all about stickiness - it’s about the shape of the tooth and the tightness of the fit - that keeps the crown from falling off.

And because the human body has a high moisture content, cyanoacrylate adhesives will bond very effectively to the skin and other body parts. Ask me if I have seen a patient come in with his (yep, sorry guys, it was a guy) lips glued together. I think after reading this article, you know what the answer is!

Mark Burhenne DDS

Arthritis is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. There are over 100 different types of arthritis.

See also: Joint pain
Alternative Names

Joint inflammation
Causes, incidence, and risk factors

Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.

You may have joint inflammation for a variety of reasons, including:

* An autoimmune disease (the body attacks itself because the immune system believes a body part is foreign)
* Broken bone
* General “wear and tear” on joints
* Infection (usually caused by bacteria or viruses)

Often, the inflammation goes away after the injury has healed, the disease is treated, or the infection has been cleared.

With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers. Risk factors for osteoarthritis include:

* Being overweight
* Previously injuring the affected joint
* Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers, and construction workers are all at risk)

Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people.

Other types or cause of arthritis include:

* Adult Still’s disease
* Ankylosing spondylitis
* Fungal infections such as blastomycosis
* Gonococcal arthritis
* Gout
* Juvenile rheumatoid arthritis (in children)
* Other bacterial infections (nongonococcal bacterial arthritis)
* Psoriatic arthritis
* Reactive arthritis (Reiter syndrome)
* Rheumatoid arthritis (in adults)
* Scleroderma
* Systemic lupus erythematosus (SLE)
* Tertiary Lyme disease
* Tuberculous arthritis
* Viral arthritis

Symptoms

If you have arthritis, you may experience:

* Joint pain
* Joint swelling
* Reduced ability to move the joint
* Redness of the skin around a joint
* Stiffness, especially in the morning
* Warmth around a joint

Signs and tests

First, your doctor will take a detailed medical history to see if arthritis or another musculoskeletal problem is the likely cause of your symptoms.

Next, a thorough physical examination may show that fluid is collecting in the joint. (This is called an “effusion.”) The joint may be tender when it is gently pressed, and may be warm and red (especially in infectious arthritis and autoimmune arthritis). It may be painful or difficult to rotate the joints in some directions. This is known as “limited range-of-motion.”

In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated. Such joint deformities are the hallmarks of severe, untreated rheumatoid arthritis.

Tests vary depending on the suspected cause. They often include blood tests and joint x-rays. To check for infection and other causes of arthritis (like gout caused by crystals), joint fluid is removed from the joint with a needle and examined under a microscope. See the specific types of arthritis for further information.
Treatment

Treatment of arthritis depends on the particular cause, which joints are affected, severity, and how the condition affects your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan.

If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, the cause is NOT necessarily curable, as with osteoarthritis and rheumatoid arthritis. Treatment, therefore, aims at reducing your pain and discomfort and preventing further disability.

It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications. In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.

Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your exercise program should be tailored to you as an individual. Work with a physical therapist to design an individualized program, which should include:

* Low-impact aerobic activity (also called endurance exercise)
* Range of motion exercises for flexibility
* Strength training for muscle tone

A physical therapist can apply heat and cold treatments as needed and fit you for splints or orthotic (straightening) devices to support and align joints. This may be particularly necessary for rheumatoid arthritis. Your physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS).

Rest is just as important as exercise. Sleeping 8 to 10 hours per night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent exacerbations. You should also:

* Avoid holding one position for too long.
* Avoid positions or movements that place extra stress on your affected joints.
* Modify your home to make activities easier. For example, have grab bars in the shower, the tub, and near the toilet.
* Reduce stress, which can aggravate your symptoms. Try meditation or guided imagery. And talk to your physical therapist about yoga or tai chi.

Other measures to try include:

* Apply capsaicin cream (derived from hot chili peppers) to the skin over your painful joints. You may feel improvement after applying the cream for 3-7 days.
* Eat a diet rich in vitamins and minerals, especially antioxidants like vitamin E. These are found in fruits and vegetables. Get selenium from Brewer’s yeast, wheat germ, garlic, whole grains, sunflower seeds, and Brazil nuts. Get omega-3 fatty acids from cold water fish (like salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
* Taking glucosamine and chondroitin — these form the building blocks of cartilage, the substance that lines joints. These supplements are available at health food stores or supermarkets. While some studies show such supplements may reduce osteoarthritis symptoms, others show no benefit. However, since these products are regarded as safe, they are reasonable to try and many patients find their symptoms improve.

MEDICATIONS

Your doctor will choose from a variety of medications as needed. Generally, the first drugs to try are available without a prescription. These include:

* Acetaminophen (Tylenol) — recommended by the American College of Rheumatology and the American Geriatrics Society as first-line treatment for osteoarthritis. Take up to 4 grams a day (two arthritis-strength Tylenol every 8 hours). This can provide significant relief of arthritis pain without many of the side effects of prescription drugs. DO NOT exceed the recommended doses of acetaminophen or take the drug in combination with large amounts of alcohol. These actions may damage your liver.
* Aspirin, ibuprofen, or naproxen — these nonsteroidal anti-inflammatory drugs (NSAIDs) are often effective in combating arthritis pain. However, they have many potential risks, especially if used for a long time. They should not be taken in any amount without consulting your doctor. Potential side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage. In 2005, the U.S. Food and Drug Administration (FDA) asked makers of NSAIDs to include a warning label on their product that alerts users of an increased risk for heart attack, stroke, and gastrointestinal bleeding. If you have kidney or liver disease, or a history of gastrointestinal bleeding, you should not take these medicines unless your doctor specifically recommends them.

Prescription medicines include:

* Biologics– these are the most recent breakthrough for the treatment of rheumatoid arthritis. Such medications, including etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira), are administered by injection and can dramatically improve your quality of life. Newer biologics include Orencia (abatacept) and Rituxan (rituximab).
* Corticosteroids (”steroids”) — these are medications that suppress the immune system and symptoms of inflammation. They are often injected into painful osteoarthritic joints. Steroids are used to treat autoimmune forms of arthritis but should be avoided in infectious arthritis. Steroids have multiple side effects, including upset stomach and gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and increased infections. The risks are most pronounced when steroids are taken for long periods of time or at high doses. Close supervision by a physician is essential.
* Cyclooxygenase-2 (COX-2) inhibitors — These drugs block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Celecoxib (Celebrex) is still available, but labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest duration possible. Talk to your doctor about whether COX-2s are right for you.
* Disease-modifying anti-rheumatic drugs — these have been used traditionally to treat rheumatoid arthritis and other autoimmune causes of arthritis. These drugs include gold salts, penicillamine, sulfasalazine, and hydroxychloroquine. More recently, methotrexate has been shown to slow the progression of rheumatoid arthritis and improve your quality of life. Methotrexate itself can be highly toxic and requires frequent blood tests for patients on the medication.
* Immunosuppressants — these drugs, like azathioprine or cyclophosphamide, are used for serious cases of rheumatoid arthritis when other medications have failed.

It is very important to take your medications as directed by your doctor. If you are having difficulty doing so (for example, due to intolerable side effects), you should talk to your doctor.

SURGERY AND OTHER APPROACHES

In some cases, surgery to rebuild the joint (arthroplasty) or to replace the joint (such as a total knee joint replacement) may help maintain a more normal lifestyle. The decision to perform joint replacement surgery is normally made when other alternatives, such as lifestyle changes and medications, are no longer effective.

Normal joints contain a lubricant called synovial fluid. In joints with arthritis, this fluid is not produced in adequate amounts. In some cases, a doctor may inject the arthritic joint with a manmade version of joint fluid. The synthetic fluid may postpone the need for surgery at least temporarily and improve the quality of life for persons with arthritis.
Expectations (prognosis)

A few arthritis-related disorders can be completely cured with treatment. Most are chronic (long-term) conditions, however, and the goal of treatment is to control the pain and minimize joint damage. Chronic arthritis frequently goes in and out of remission.
Complications

* Chronic pain
* Lifestyle restrictions or disability

Calling your health care provider

Call your doctor if:

* Your joint pain persists beyond 3 days.
* You have severe unexplained joint pain.
* The affected joint is significantly swollen.
* You have a hard time moving the joint.
* Your skin around the joint is red or hot to the touch.
* You have a fever or have lost weight unintentionally.

Prevention

If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms.

Osteoarthritis may be more likely to develop if you abuse your joints (injure them many times or over-use them while injured). Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions.

Excess weight also increases the risk for developing osteoarthritis in the knees and possibly in the hips. See the article on body mass index to learn whether your weight is healthy.

White House health reform director Nancy-Ann DeParle says that while the Virginia judge struck down the law, the administration is encouraged by two other federal judges that have upheld the law.

U.S. District Judge Henry E. Hudson rejected the government’s argument that it has the power under the Constitution to require individuals to buy health insurance, a provision that was set to take effect in 2014.

DeParle told The Associated Press that the Justice Department is reviewing Hudson’s ruling. The case is expected to ultimately be decided in the Supreme Court.

An allergy is an exaggerated immune response or reaction to substances that are generally not harmful.

Allergic conjunctivitis

Allergic reactions

Allergy testing

Allergy to mold, dander, dust

Atopic dermatitis (eczema)

Contact dermatitis

Drug allergies

Food allergies

Hay fever (allergic rhinitis)

Causes, incidence, and risk factors

Allergies are relatively common. Both genetics and environmental factors play a role.

The immune system normally protects the body against harmful substances, such as bacteria and viruses. It also reacts to foreign substances called allergens, which are generally harmless and in most people do not cause a problem.

But in a person with allergies, the immune response is oversensitive. When it recognizes an allergen, it releases chemicals such as histamines. which fight off the allergen. This causes itching, swelling, mucus production, muscle spasms, hives, rashes, and other symptoms, which vary from person to person.

Common allergens include pollen, mold, pet dander, and dust. Food and drug allergies are common. Allergic reactions can also be caused by insect bites, jewelry, cosmetics, spices, and other substances.

Some people have allergy-like reactions to hot or cold temperatures, sunlight, or other environmental triggers. Sometimes, friction (rubbing or roughly stroking the skin) will cause symptoms.

A specific allergy is not usually passed down through families (inherited). However, if both your parents have allergies, you are likely to have allergies. The chance is greater if your mother has allergies.

Allergies may make certain medical conditions such as sinus problems, eczema, and asthma worse.

Symptoms

Allergy symptoms vary, but may include:

Breathing problems

Burning, tearing, or itchy eyes

Conjunctivitis (red, swollen eyes)

Coughing

Diarrhea

Headache

Hives

Itching of the nose, mouth, throat, skin, or any other area

Runny nose

Skin rashes

Stomach cramps

Vomiting

Wheezing

What part of the body is contacted by the allergen plays a role in the symptoms you develop. For example:

Allergens that are breathed in often cause a stuffy nose, itchy nose and throat, mucus production, cough, or wheezing

Allergens that touch the eyes may cause itchy, watery, red, swollen eyes.

Eating something you are allergic to can cause nausea, vomiting, abdominal pain, cramping, diarrhea, or a severe, life-threatening reaction

Allergens that touch the skin can cause a skin rash, hives, itching, blisters, or even skin peeling

Drug allergies usually involve the whole body and can lead to a variety of symptoms

Signs and tests

The health care provider will perform a physical exam and ask questions such as when the allergy occurs.

Allergy testing may be needed to determine if the symptoms are an actual allergy or caused by other problems. For example, eating contaminated food (food poisoning) may cause symptoms similar to food allergies. Some medications (such as aspirin and ampicillin) can produce non-allergic reactions, including rashes. A runny nose or cough may actually be due to an infection.

Skin testing is the most common method of allergy testing. One type of skin testing is the prick test. It involves placing a small amount of the suspected allergy-causing substances on the skin, and then slightly pricking the area so the substance moves under the skin. The skin is closely watched for signs of a reaction, which include swelling and redness. Skin testing may be an option for some young children and infants.

Other types of skin tests include patch testing and intradermal testing. For detailed information, see:Allergy testing

Blood tests can measure the levels of specific allergy-related substances, especially one called immunoglobulin E (IgE).

A complete blood count (CBC), specifically the eosinophil white blood cell count, may also help reveal allergies.

In some cases, the doctor may tell you to avoid certain items to see if you get better, or to use suspected items to see if you feel worse. This is called “use or elimination testing.” This is often used to check for food or medication allergies.

The doctor may also check your reaction to physical triggers by apply heat, cold, or other stimulation to your body and watching for an allergic response.

Sometimes, a suspected allergen is dissolved and dropped into the lower eyelid to check for an allergic reaction. This should only be done by a health care provider.

Treatment

Severe allergic reactions (anaphylaxis) require treatment with a medicine called epinephrine, which can be life saving when immediately given.

The best way to reduce symptoms is to try and avoid what causes your allergies in the first place. This is especially important for food and drug allergies.

There are several types of medications available to prevent and treat allergies. Which medicine your doctor recommends depends on the type and severity of your symptoms, your age, and overall health.

Specific illnesses that are caused by allergies (such as asthma, hay fever, and eczema) may require other treatments.

Medications that can be used to treat allergies include:

ANTIHISTAMINES

Antihistamines are available over-the-counter and by prescription. They are available in many forms, including:

Capsules and pills

Eye drops

Injection

Liquid

Nasal spray

CORTICOSTEROIDS

Anti-inflammatory medications (corticosteroids) are available in many forms, including:

Creams and ointment for the skin

Eye drops

Nasal spray

Lung inhaler

Patients with severe allergic symptoms may be prescribed corticosteroid pills or injections for short periods of time.

DECONGESTANTS

Decongestants can help relieve a stuffy nose. Decongestant nasal spray should not be used for more than several days, because they can cause a “rebound” effect and make the congestion worse. Decongestants in pill form do not cause this problem.

OTHER MEDICINES

Leukotriene inhibitors are medicines that specifically block the substances that trigger allergies. Zafirlukast (Accolate) and montelukast (Singulair) are approved for those with asthma and indoor and outdoor allergies.

ALLERGY SHOTS

Allergy shots (immunotherapy) are occasionally recommended if the allergen cannot be avoided and symptoms are hard to control. Allergy shots keep your body from over-reacting to the allergen. Regular injections of the allergen are given, with each dose slightly larger than the previous dose until a maximum dose is reached. They do not work for everybody and require frequent doctor’s visits.

Support Groups

See: Asthma and allergy support group

Expectations (prognosis)

Most allergies can be easily treated with medication.

Some children may outgrow an allergy. This is particularly true of food allergies. However, as a general rule, once a substance has triggered an allergic reaction, it continues to affect the person.

Allergy shots are most effective when used to treat those with hay fever symptoms and severe insect sting allergies. They are not used to treat food allergies because of the danger of a severe reaction. Allergy shots may require years of treatment, but they work in most cases. However, they may cause uncomfortable side effects (such as hives and rash) and dangerous outcomes (such as anaphylaxis).

Complications

Anaphylaxis (life-threatening allergic reaction)

Breathing problems and discomfort during the allergic reaction

Drowsiness and other side effects of medicines

Calling your health care provider

Call for an appointment with your health care provider if:

Severe symptoms of allergy occur

Treatment for allergies no longer works

Prevention

Breast-feeding children for at least 4 months or more may help prevent atopic dermatitis cow milk allergy, and wheezing in early childhood.

However, changing a mother’s diet during pregnancy or while breast-feeding does not seem to help prevent allergy-related conditions.

For most children, changing diet or special formulas does not seem to prevent these problems. If there is a family history of eczema and allergies in a parent, brother, or sister, discuss the infant feeding with your child’s doctor. The timing of introduction of solid foods in general, as well as use of several specific foods, can help prevent some allergies.

There is also evidence that infants exposed to certain airborne allergens (such as dust mites and cat dander) may be less likely to develop related allergies. This is called the “hygiene hypothesis” and sprang from observations that infants on farms tend to have fewer allergies than those who grow up in environments that are more sterile.

Once allergies have developed, treating the allergies and carefully avoiding those things that cause reactions can prevent allergies in the future.

References

Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug:122(2).

Kurowski K, Boxer RW. Food allergies: detection and management. American Family Physician. 2008 June:77(12).

Bielory L, Friedlaender MH. Allergic conjunctivitis. Immunol Allergy Clin North Am. 2008 Feb;28(1):43-58, vi.

High, full brows look youthful and help define all your features, says Los Angeles makeup artist Brett Freedman. Use a brow powder or pencil a shade lighter than your hair color to fill in sparse areas, then sweep a fine line right above the top of the arch. Try Wet n Wild Eyebrow/Eyeliner Pencil ($1; drugstores).

How to shop like a dermatologist.

2. Camouflage crow’s feet.

Nix heavy cover-up, which makes lines more obvious, says Matin Maulawizada of Laura Mercier Cosmetics. Instead, brighten the area with concealer under the outer third of your lower lashes and a creamy highlighter such as Benefit Ooh La Lift ($22; benefit cosmetics.com) just below any lines.

The Best beauty products of 2010.

3. Reduce “parentheses.”

To diminish the lines that run from your nose to your mouth, apply concealer one shade lighter than your skin over the shadow below the fold only, not over the entire crease, says Maulawizada. This pro trick reduces the appearance of a defined edge. Try Laura Mercier Secret Camouflage ($28; lauramercier.com).

4. Pep up your pout.

“The sides of the mouth tend to droop with age,” says Joanna Schlip, makeup artist for Physicians Formula. “To lessen the effect, brush highlighter on the corners and concealer just below the outer edges of your lower lip to minimize shadows.” Try Sonia Kashuk Multi-Purpose Nylon Brush ($6; Target).

100 Ways to look younger—instantly!.

5. Slim a double chin.

Apply a light layer of foundation or matte bronzer two shades darker than your skin under your chin, shading over any jowl, suggests Maulawizada. Try Rimmel London Natural Bronzer ($5; drugstores). Blend toward your neck, using a sponge or brush.

Reverse the aging process!

Walk toward the (right) light. Sunshine raises your levels of serotonin, a neurotransmitter linked with happy feelings. And studies show most fluorescent lights increase cortisol and irritability. Stressing at work? Throw on your coat and head outside for a midafternoon walk, or if it’s too cold out there, curl up next to a window with a good book.

Breathe slowly for 60 seconds. “Your diaphragm connects to many of the important organ systems throughout your body,” says Sasha Loring, a therapist at Duke Integrative Medicine. “Actively moving it is like giving these organs a relaxing massage from the inside.”

Get crafty. The repetitive nature of knitting, crochet or needle point triggers a relaxation response in the body, research from Harvard Medical School has shown. Bonus benefit: Whatever you craft could become the perfect, personal Christmas gift!

Snuggle. A 20-second hug has been shown to decrease levels of stress hormones in research at the University of North Carolina School of Medicine. Hugs are free, so solicit them whenever you can—remember, you’re returning the stress-busting benefits!

Catch a few winks. People who take naps three times a week are less likely to die of heart disease, a sign that shut-eye helps relieve stress, according to a study from Harvard University. So go ahead and catch some zzz’s when you can!

Play with your pet. Don’t have one? Adopt, or borrow a pal’s! Pets are proven to help ease stress, plus daily walks with a pup are a great way to get more exercise—another proven stress reducer. Log on to PetFinder.com if you’re ready to bring home a new furry friend; if not, find a local shelter that might need volunteers.

Pop some peppermint. Keep gum or herbal sticks in your purse or pocket. “The action of chewing can be calming,” says Albers. “Plus, mint and cinnamon are both relaxing scents.” Not to mention, if your mouth’s already occupied, you might be less tempted to try to keep it busy with high-calorie treats.

Write a bucket list. Don’t dwell on what’s making you unhappy; instead, imagine all of the fun things you’d love to do in your lifetime and jot them down. Always dreamed of riding an elephant in Thailand? Start saving for and planning your special someday trip!

About 2.8 million children and 2 million people ageD 65 and older are treated each year at U.S. hospital emergency rooms for accidental falls, the AANS says.

The AANS offers the following tips for preventing falls during the holidays and yearround:

Secure loose electrical cords and pick up toys and other items that may be on the floor.

Use safety gates and install window guards. Keep chairs, cribs and other furniture away from windows.

Make sure you have adequate lighting in your home. Dim lighting increases the risk of falls. Install night lights in halls and bathrooms and keep a flashlight near your bed.

Keep items in easy-to-reach places. Use step stools/ladders only when absolutely necessary.

Make sure ladders are stable and secure before using them.

Wear proper shoes with slip-resistant soles. Do not walk on slippery, freshly washed floors. Don’t use floor waxes.

Remove debris and ice from walkways, driveways, porches and yards.

Buy bath mats and rugs with slip-resistant backing and secure them.

Install grab bars and indoor and outdoor handrails if you are elderly or frail.

Do not allow children to take part in activities that are inappropriate for their age.

On the other hand, women diagnosed with locally advanced breast cancer will need chemotherapy to help ensure that they will survive the disease.

For most women today, however, chemotherapy can neither be so clearly ruled out nor clearly recommended. These patients will need the input and advice of their medical oncologist when making the tough decision about whether to have chemo or not.

Every day, I see women struggling with this decision. And to make matters worse, they only have a few weeks to make their choice before the window of opportunity will close (and, potentially, the window of regret will open).

Certain pathology tests in use today can help some women decide whether or not to get chemo. If these tests reveal the presence of favorable prognostic factors, for example, such positive results can help an oncologist predict whether chemo would be of benefit from a survival perspective. Such encouraging factors would include cancers that are either hormone-receptor positive or HER2-negative, as well as tumors that are small and invasive or lymph-node negative.

But even some women who could potentially benefit from such laboratory tests still might learn that their specific breast-cancer results fall within a gray area, and so the decision needs to be based on her gut feelings, not on statistics. The decision ultimately remains with the patient.

So how do women decide? Some look at the statistics. I’ve seen women opt to do chemo if there’s a 1 percent chance it will be of benefit. I’ve seen others refuse to do chemo despite a 15 percent statistical benefit.

Family members can drive the decision, too, as when husbands and children ask her to please take the chemo so that they can all feel more reassured that she will become a long-term survivor. Though she may have been somewhat comfortable not doing this form of systemic treatment, her family isn’t, and if she doesn’t do it they might drive her nuts worrying her every day about it.

In such a case, a woman might embark on chemo so that in the event the disease does return she’ll be able to say, “Well, I did the chemo like they told me to do, so I can’t kick myself now for the disease returning.”

If you have had breast cancer, how did you decide whether or not to do chemotherapy? In retrospect, are you still happy with your decision?

One of the challenges health professionals have is that we don’t know right away if chemo is working . We are relying on a negative–the absence of recurrence–to measure the success of the treatment. Doesn’t sound very scientific, does it? Experts predict that in the future more women, including those with smaller tumors, might get their chemotherapy before they have surgery. In so doing, her doctors will be able to see if the drugs she is receiving are in fact working. If the tumor in her breast is shrinking, then we believe that the drugs are benefitting her and that the chemo is probably also destroying any cancer cells that have traveled to distant parts of her body that we don’t know about but in fact do exist. If the tumor doesn’t start to shrink, then we might try other chemo agents to test their effect.

If you are so inclined, please write in to share what you experienced during this sometimes grueling decision-making process. Was it difficult or easy for you to make the decision?

2. Wash your hands thoroughly. Use lots of soap and hot water. Then hold a paper towel as protection when you turn off the water, so you don’t have to touch the tap.

6 Doctor-Tested Ways to Keep a Cold Away

3. Buy a big bottle of water. Now that you’ve gotten through security, go get a big bottle, start guzzling, and bring it with you on the plane.

4. Moisturize your nose. Use a saline nasal spray to irrigate and moisturize the mucous membranes inside your nose. Some frequent fliers also swear by applying a bit of Neosporin or Vaseline to the insides of the nostrils. This is an old tip for preventing nosebleeds, but it can work to protect against dry cabin air as well.

5. Eat yogurt. According to some nutrition research, the beneficial bacteria in yogurt have a protective effect on your immune system. One study found that eating a daily cup of low-fat yogurt reduced susceptibility to colds by 25 percent. Researchers think the beneficial bacteria may kick the immune system into high gear to fight off viruses.

6. Remove contact lenses before you fly. If you don’t like to wear your lenses while you fly, plan to remove them ahead of time in the airport bathroom. Touching your eyes is one of the primary means of transmission for cold and flu viruses, which can make their way through the tear ducts to the nasopharynx — the “sweet spot” for cold viruses, where nasal passages meet the mouth at the back of the throat. Avoid touching your eyes with germy hands by washing hands first, then removing lenses before you fly.

7. Take immune-boosting supplements. There’s still little scientific evidence to support the effectiveness of supplements such as vitamin C, Airborne, echinacea, and zinc lozenges. In fact, Airborne was recently required to settle a lawsuit for falsely making such claims. But it’s also true that with the exception of Zicam, a zinc supplement that’s been accused of damaging users’ sense of smell, there’s little harm that can come from arming your immune system with extra nutrients. Vitamin C is the least supported by science at this point; echinacea and the other herbal ingredients in Airborne have the most likelihood of being proven effective.