Smog Linked to Heart Disease in Seniors

TUESDAY, Dec. 1, 2015 (HealthDay News) — Older people living in cities with high levels of a particular type of air pollution are more likely to be hospitalized for heart disease, a new study reveals.

The type of air pollution in question is known as coarse particulate matter. Increased levels of this kind of air pollution have been linked to construction projects, desert winds and farming, according to the researchers.

These microscopic particles are larger than the air pollutants released by cars and power plants. Scientists say they can have a significant impact on people’s health.

“We suspected that there was an association between coarse particles and health outcomes, but we didn’t have the research to back that up before,” said study leader Roger Peng. He is an associate professor of biostatistics at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

“This work provides the evidence, at least for cardiovascular disease outcomes. I don’t feel like we need another study to convince us. Now it’s time for action,” Peng said in a university news release.

But, although the study found a strong link between coarse particle air pollution and heart disease hospitalizations, it wasn’t designed to prove cause-and-effect.

The findings were published in the November issue of Environmental Health Perspectives.

The study involved data collected from an air-monitoring network established by the U.S. Environmental Protection Agency in 110 large urban areas. This information was linked to Medicare data on hospitalizations among people aged 65 and older in these regions between 1999 and 2010.

During the study, there were more than 6 million heart-related emergency hospital admissions and 2.5 million respiratory admissions. Respiratory diseases were not linked to high levels of coarse particles. However, admissions for heart-related emergencies were higher on days when levels of these air pollutants were elevated, the study revealed.

Where the participants lived affected hospital admission rates for heart problems. There were higher concentrations of coarse particles in the western United States, but heart-related hospitalizations were higher in the East, suggesting some particles are more harmful than others.

“Just because the particles are the same size doesn’t mean they are made of the same material,” Peng explained. “It’s possible that the chemical composition of the particles in the east could make them more toxic.”

Under the Clean Air Act, the EPA monitors finer particles, and states have taken steps to limit these pollutants with measures, such as stronger car emissions standards. Coarse particles may be more difficult to control since they often come from natural sources, the researchers noted.

How these airborne particles lead to health problems throughout the body isn’t clear. The study’s authors suggested a national monitoring network for these larger particles may be necessary.

“It’s worth revisiting, given this new data,” said Peng.

More information

The U.S. Centers for Disease Control and Prevention has more on the health effects of air pollution.

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There’s a Pill That Prevents HIV, So Why Aren’t People Taking It?

Photo: Getty Images

A highly effective once-a-day pill for preventing HIV has been available in the United States since 2012—but you’ve probably never heard of it.

That’s because just 1% of people who could benefit from the medication are actually taking it, and a third of primary care doctors and nurses don’t know about it, according to the U.S. Centers for Disease Control and Prevention (CDC).

The medication, Truvada, is a “huge” step in the fight against AIDS, according to Susan Buchbinder, MD, the director of Bridge HIV, an arm of the San Francisco Department of Public Health dedicated to HIV prevention, research, and education.

RELATED: 16 Signs You May Have HIV

“It’s a highly effective tool and we really do need to get it out to the people who most need it,” Dr. Buchbinder says. Here are the facts about this breakthrough drug.

How does Truvada work?

Truvada is a combination of two HIV drugs, emtricitabine and tenofovir, which block an enzyme that the virus needs to make copies of itself. Taking the medication daily will flood the mucosal membranes with these HIV-fighting molecules, preventing the virus from spreading through sexual contact. (Researchers have looked into whether other approaches to dosing—for example, only taking the pills before and after sexual contact—are equally effective, but for now the jury is still out.)

Who should be taking it?

The drug is an option for people with a very high risk of HIV infection due to their sexual activity or drug use. For example, a person with an HIV-positive partner or someone who uses injection drugs can reduce their risk of contracting the virus by 70% to 90% if they take Truvada daily. The CDC reckons that one in four sexually active men who have sex with men, one in five injection drug users, and one in 200 sexually active heterosexual adults are candidates for the treatment, also known as pre-exposure prophylaxis (PrEP).

Are there any risks?

“We talk about PrEP not being a lifelong preventive approach, but rather it’s used during what we call ‘seasons of risk,’” like when you’re dating an HIV-positive person, or perhaps you’re newly single, Dr. Buchbinder explains. People who are on Truvada need to visit their health care provider every three months, in part so that they can be tested for HIV. An HIV-positive person should not be on Truvada, because taking the drug can lead to resistance. It’s also recommended that people also use other HIV prevention methods, including condoms, while taking the drug.

“The other big concern with this drug is really about kidney function,” Dr. Buchbinder explains. “It can’t be taken by people who have pretty severely impaired kidney function, and also kidney function needs to be monitored over time.”

RELATED: 20 New Things You Need to Know About HIV

How much does it cost?

A year’s worth of Truvada costs about $10,000, and expenses for the required quarterly medical visits and lab tests also add up—another part of the reason why few people take it.  But many insurers help cover these costs, and Gilead (the company that manufactures the drug) offers a patient assistance program to help people who can’t afford the medication.

Many experts say the expense is worth it if you have high risks. “We know if we prevent an infection, it saves $350,000 over a lifetime for a person in health costs, so it’s definitely an economically sound approach,” Anthony Fauci, MD, the director of the National Institute on Allergy and Infectious Diseases, told Time earlier this year.

As Dr. Buchbinder put it, at the end of the day, what’s most important is “for people to know that if they’re at-risk now we have something that’s very highly effective and that they should talk to their provider or doctor about.”

RELATED: Top 10 Myths About Safe Sex and Sexual Health

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Delayed Clamping of Umbilical Cord May Be Better for Preemies

TUESDAY, Dec. 1, 2015 (HealthDay News) — Delayed clamping of a preterm infant’s umbilical cord leads to better motor function development, a new study suggests.

“If you can wait 45 seconds before clamping the cord, and that delay has a chance of improving your baby’s motor function, wouldn’t you make that choice to delay?” researcher Debra Erickson-Owens, an associate professor of nursing at the University of Rhode Island, said in a university news release.

“It makes us consider what other positive things occur with delaying that could result in a long-term impact on infant well-being,” Erickson-Owens added.

The study included 161 infants born before 32 weeks of pregnancy. Researchers assessed them when they were 18 months old. They found that just 13 percent of babies whose umbilical cord clamping was delayed for 30 to 45 seconds had below normal motor development, compared with 28 percent of those whose cords were clamped immediately.

“Motor development is so critical for babies because it is how they learn, how they experience the world. When you see a baby, he or she is always reaching out, touching, grasping things and even putting things in their mouths,” researcher Judith Mercer, a professor emeritus of nursing at the university, said in the news release.

Delayed cord clamping and cord milking allow more of the infant’s blood to return from the placenta and increases iron-rich red blood cells, stem cells and blood volume, the researchers said.

The study findings were published recently in the Journal of Pediatrics.

More information

The U.S. National Institute of Child Health and Human Development has more about preterm birth.

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Planned Cesareans Tied to Slight Increase in Asthma Risk for Kids

By Steven Reinberg
HealthDay Reporter

TUESDAY, Dec. 1, 2015 (HealthDay News) — Children born by planned cesarean delivery appear to have a slightly higher chance of developing asthma than those born through vaginal delivery, researchers report.

The difference in risk was small, with 3.73 percent of those born through planned C-section hospitalized by age 5 for asthma, compared to 3.41 percent of kids who were born through vaginal delivery. And those who had a cesarean delivery had a 10.3 percent risk of needing an asthma inhaler at age 5, compared to 9.6 percent for those born vaginally, the researchers found.

“C-section may play a part in explaining global increases in asthma, but overall this study provides some reassurance that children delivered by planned C-section are not at substantially higher risk of childhood illness,” said lead researcher Dr. Mairead Black. Black is a clinical lecturer and research fellow in obstetrics at the University of Aberdeen, in Scotland.

“This is an observational study, so we cannot definitively say that the planned C-section is the cause of the small increase in risk of asthma,” she said.

“The absolute difference in risk to children delivered by planned C-section was very low. So, while C-section may play a part in explaining global increases in asthma, it is unlikely to be important enough to influence individual delivery decisions,” Black added.

The report was published Dec. 1 in the Journal of the American Medical Association.

For the study, Black and her colleagues collected data on more than 321,000 firstborns in Scotland between 1993 and 2007, and followed them until February 2015.

The investigators found that, compared with children born by emergency cesarean delivery, those born by planned cesarean delivery were not at a significantly increased risk for asthma requiring hospitalization, asthma inhaler prescription at age 5, obesity at age 5, inflammatory bowel disease, cancer or death. But they were at increased risk of type 1 diabetes, the findings showed.

Dr. Mitchell Maiman, chairman of the department of obstetrics and gynecology at Staten Island University Hospital in New York City, said, “C-section can be a disadvantage for babies.”

The process of going through the birth canal may be a benefit to the infant’s immune system, he suggested. “There’s something about going through the birth canal — the most difficult trip the child will have in its entire life — that has a competitive advantage,” Maiman said.

Maiman said having a C-section, unless it is medically necessary, is not recommended. For mothers, a C-section can increase the risks of bleeding, dying and having problems delivering the placenta. “A C-section is much less safe than a vaginal delivery,” he added.

Another study in the same journal looked at C-section rates around the world, and found higher cesarean rates correlated with lower death rates among infants and new mothers. The rates of cesarean delivery vary widely from country to country, from as low as 2 percent to more than 50 percent, the researchers found.

“In countries that provide very low rates of C-sections, there are very high rates of maternal and neonatal deaths,” said lead researcher Dr. Thomas Weiser, an assistant professor of surgery at Stanford University School of Medicine, in Stanford, Calif.

As the number of C-sections increases, the rates of maternal and neonatal deaths decrease, he said. But when the rate of C-sections reaches about 19 per 100 births, there are no further reductions in deaths, Weiser added.

“Countries that are trying to improve outcomes are going to have to consider C-section as part of comprehensive maternal care,” he said. “Countries that have very low rates of C-sections are going to have to improve that in the context of overall health care.”

But, “on that flip side, countries that have high rates of C-sections may have rates that are excessive,” Weiser added.

More information

Visit the U.S. Office on Women’s Health for more about C-sections and labor and delivery.

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Doctor Burnout Rates on the Rise

TUESDAY, Dec. 1, 2015 (HealthDay News) — Burnout is a growing problem among American doctors, a new study indicates.

Analyzing the results of 2011 and 2014 surveys of more than 6,000 doctors across the United States, researchers found that the number who met the criteria for burnout rose from 45 percent to 54 percent over that time.

Burnout rates rose in nearly all specialties, but the highest rates of burnout were among those in general internal medicine, family medicine and emergency medicine. There was no increase in work hours or in rates of depression among doctors.

Doctors’ satisfaction with work-life balance fell between the two surveys, according to the study, which was published Dec. 1 in the journal Mayo Clinic Proceedings and conducted by Mayo Clinic researchers in partnership with the American Medical Association.

“Burnout manifests as emotional exhaustion, loss of meaning in work, and feelings of ineffectiveness,” study author Dr. Tait Shanafelt said in a Mayo news release. “What we found is that more physicians in almost every specialty are feeling this way, and that’s not good for them, their families, the medical profession or patients.”

Research has shown that doctor burnout can lead to poor patient care, higher doctor turnover and a decrease in the overall quality of the health care system.

The study authors said there are a number of ways health care organizations can help reduce doctors’ risk of burnout, including giving doctors greater flexibility and control over work.

More information

Helpguide.org has more about burnout.

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Sleep Apnea Devices Lower Blood Pressure

By Steven Reinberg
HealthDay Reporter

TUESDAY, Dec. 1, 2015 (HealthDay News) — For those suffering from sleep apnea, the disrupted sleep and reduction of oxygen getting to the brain can contribute to high blood pressure, but the two common treatments for the condition both lower blood pressure, Swiss researchers report.

A comparison of the treatments — continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) — showed that each produces a modest reduction in both systolic and diastolic blood pressure rates, the researchers found.

“CPAP and MADs not only reduce symptoms of obstructive sleep apnea such as sleepiness, but also lower blood pressure,” said lead researcher Dr. Malcolm Kohler, chair of respiratory medicine at the University Hospital of Zurich.

“Both treatments have similar positive effects on blood pressure, but the treatment effect of CPAP seems to be larger in patients who have more hours of sleep,” he said.

According to the U.S. National Heart, Lung, and Blood Institute, sleep apnea is a common and chronic condition in which breathing stops or becomes shallow during sleep. Breathing pauses can last from a few seconds to minutes and can occur 30 or more times an hour.

Sleep apnea is the leading cause of excessive daytime sleepiness, and can cause high blood pressure, which raises heart disease risk, the agency says.

Mandibular advancement devices work by pushing the jaw and tongue forward to keep the airway open during sleep. In continuous positive airway pressure, patients wear a face mask hooked up to a device that produces mild air pressure to keep the airway open.

Some patients find it difficult to adapt to CPAP, Kohler said. Some have problems wearing the face mask, others can’t get used to the noise of the compressor and some can’t abide either.

“MADs are to be considered as an alternative treatment to the more widely used CPAP, especially in patients who fail to adapt to CPAP treatment,” Kohler added.

The report was published Dec. 1 in the Journal of the American Medical Association.

For the study, Kohler and colleagues looked at the ability of CPAP and MADs to lower blood pressure in 51 previously published studies that included a total of nearly 5,000 patients.

In this type of study, called a meta-analysis, researchers use previously published data to try to find consistent patterns across all the reports.

They found that CPAP was associated with a reduction in systolic blood pressure (top number of a reading) of 2.5 mm Hg and a reduction of 2.0 mm Hg in diastolic blood pressure (bottom number).

MADs were associated with a reduction in systolic blood pressure of 2.1 mm Hg and 1.9 mm Hg in diastolic blood pressure, the researchers reported.

Although no statistically significant difference between CPAP and MADs in lowering blood pressure was found, CPAP was more likely to have a strong association with lowering systolic blood pressure, Kohler said.

Dr. Preethi Rajan, an attending physician in the department of pulmonary, critical care and sleep medicine at North Shore-LIJ Health System in Great Neck, N.Y., said the new study “confirms what we know — that both treatments can reduce blood pressure.”

Even though CPAP appears more effective, MADs can be a good alternative for some patients, she said.

“CPAP is the tried-and-true method of treating sleep apnea and it’s effective across the whole spectrum of severity,” Rajan said. “MADs tend to work better in mild to moderate sleep apnea. They may not be good enough for severe sleep apnea.”

Rajan said that the reductions in blood pressure seen with both devices were modest. Patients with high blood pressure and sleep apnea will need to have their blood pressure controlled with medication, she said.

More information

For more information on sleep apnea, visit the U.S. National Heart, Lung and Blood Institute.

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Ebola Blood Level May Predict Odds of Death, Study Says

TUESDAY, Dec. 1, 2015 (HealthDay News) — The levels of Ebola virus in a patient’s blood can strongly predict the risk of death, a new study finds.

Researchers evaluated data on nearly 700 people in the West African nation of Guinea who were hospitalized with Ebola between March 2014 and February 2015.

A better understanding of the link between blood levels of Ebola and death risk will help researchers better assess the effectiveness of treatments, the study authors said.

They found that death rates were 21 percent among those with low blood levels of the virus, 53 percent among those with medium levels, and 81 percent among those with high levels.

When patients’ average levels of Ebola in the blood increased 10-fold in July 2014, the death rate rose 14 percent, according to researchers led by Amadou Alpha Sall of the Pasteur Institute of Dakar, Senegal, and Simon Cauchemez of the Pasteur Institute in Paris, France.

The 2014 Ebola epidemic, the largest in history, caused more than 11,000 deaths in West Africa.

The study, published Dec. 1 in the journal PLOS Medicine, also found a link between age and mortality. Those younger than 5 and older than 45 had higher death rates compared to patients ages 15 to 44. Children ages 5 to 14 had lower death rates than the 15- to 44-year-olds, the researchers said.

They cautioned, however, that the results might not apply outside a hospital setting.

More information

The U.S. Centers for Disease Control and Prevention has more about Ebola.

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Metformin May Not Help Obese Teens With Type 1 Diabetes

TUESDAY, Dec. 1, 2015 (HealthDay News) — Metformin is the standby drug for millions of people with type 2 diabetes, but a new study finds that adding it to insulin therapy won’t boost blood sugar control for overweight teens with type 1 diabetes.

In type 1 diabetes, which comprises about 5 percent of diabetes cases, the body is unable to produce the insulin it needs. So, supplemental insulin is a must for people with the disease.

The new study was led by Kellee Miller of the Jaeb Center for Health Research in Tampa, Fla. As her team explained, young people with type 1 diabetes are at even higher metabolic risk if they become overweight or obese, especially in adolescence.

That’s because both obesity and puberty may cause the patient to require higher levels of supplemental insulin, complicating blood sugar control, the researchers said.

Metformin — a pill taken to help lower blood sugar — is widely used to treat type 2 diabetes. However, prior studies of how it might affect blood sugar control in teens with type 1 diabetes have been inconclusive, Miller’s team noted.

The new study involved 140 overweight and obese patients ages 12 to 19 with type 1 diabetes. Each was randomly assigned to take either metformin or a placebo, along with their insulin, for six months.

The result: Patients taking metformin showed no improvement in blood sugar (glycemic) control over those taking the placebo. A small beneficial effect from the metformin was seen early on in the study, but it disappeared as the weeks went on.

Furthermore, patients who took metformin had more gastrointestinal side effects than those who didn’t take the drug, Miller’s team said.

“These results do not support prescribing metformin to adolescents to improve glycemic control,” the researchers wrote in the Dec. 1 issue of the Journal of the American Medical Association.

One expert in diabetes care said there could still be a role for metformin for these patients, however.

Dr. Spyros Mezitis is an endocrinologist at Lenox Hill Hospital in New York City. He pointed out that the addition of metformin did seem to offer patients some benefits.

“Metformin did decrease the amount of insulin used and was associated with weight loss,” Mezitis said, although it “did not reduce blood pressure or cholesterol profiles.”

Metformin is also known to cut glucose production by the liver, curb harmful insulin resistance and reduce appetite, he added.

So, “I think more randomized trials are needed before practicing physicians change their practice of using metformin in adolescent overweight type 1 diabetic patients,” Mezitis concluded.

More information

The American Diabetes Association has more about type 1 diabetes.

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5 Reasons Why Some Women Go Through Early Menopause

Photo: Getty Images

Maybe you wake up at night drenched in sweat. Or you’re struggling to concentrate, and oh yeah, your period has been MIA. These symptoms are enough to freak any woman out, even when she’s at the right age for menopause, the natural transition to infertility that most women experience around 50. But when these symptoms begin in your 30s, they can be downright scary.

For some women, early menopause is brought on by surgery that removes the ovaries. A woman who carries a BRCA gene mutation, for example, may opt to have her ovaries and fallopian tubes taken out in a preventative salpingo-oopherectomy. (This is the procedure Angelina Jolie had last March, after blood tests revealed possible indicators of early cancer.) The result? Levels of estrogen and other female hormones drop dramatically, which may lead to hot flashes, vaginal dryness, and other telltale signs of menopause.

But one in 100 women will experience these symptoms by the age of 40 for other reasons—which are often hard to pin down. In fact, for about 90 percent of cases a woman never learns the reason why. The technical term for this medical condition is primary ovarian insufficiency (POI). “Basically the ovaries poop out early,” explains Shawn Tassone, MD, an ob-gyn who specializes in integrative medicine at Austin Area Obstetrics, Gynecology, and Fertility.

RELATED: 8 Reasons Sex Is Better After 50

One key sign for diagnosis: skipped or irregular periods for four months. Women with POI (also known as premature ovarian failure) may face more than mood swings and low libido. If they want to have children, they will likely struggle with infertility, and that can be the first sign that something is not right. (That said, some women do continue to have occasional periods for years after a POI diagnosis, and between 5% and 10% do manage to get pregnant.)

Although most of the time POI happens without an obvious cause, there are quite a few things that are known to bring it on—yet many women are unaware of them. Below are the top factors that put you at risk.

Your mom went through early menopause

Or your sister, or your grandmother. POI seems to be genetic: “You tend to see it run in families,” Dr. Tassone says. “It can come from either side.” A 2011 review of studies found that in up to 20 percent of cases, the woman has a family history of the condition.

RELATED: Soothing Yoga Moves for the Menopause Blues

Genetic disorders

FMR1 is a gene that causes Fragile X syndrome, the most common form of inherited intellectual impairment; even if you don’t have the syndrome you can have a mutation on that same gene that causes problems with your ovaries, leading to fragile X-associated primary ovarian insufficiency. According to a report by the National Institutes of Health, this is the case for one in 33 women with POI.

Turner Syndrome (in which a woman has only one X chromosome) is another genetic disorder associated with POI.

Autoimmune disorders

The autoimmune disorder thyroiditis (inflammation of the thyroid gland) has been linked to POI. So has Addison’s Disease, in which the adrenal glands don’t produce enough hormones. In the case of either of these diseases, it’s possible your own immune system may begin to attack the follicles in your ovaries, the small sacs where eggs mature and grow, interfering with their ability to function.

Smoking or other toxin exposure

“Some toxins can bring on premature ovarian failure,” Dr. Tassone says. “Things like cigarettes and pesticides.” Normally we are born with enough primordial follicles (aka the tiny seeds that grow into follicles) to last us until the natural age of menopause, around 50. But exposure to harmful chemicals is thought to cause a woman to run out of follicles sooner rather than later.

Chemotherapy or radiation

Similar to environmental toxins, these cancer treatments can damage the genetic material in ovarian cells. But the damage depends on various factors, like the type of drug and dose of radiation, your age at the time of treatment, and the area of your body that was radiated. Some women may not develop POI until years after undergoing cancer treatment. And some won’t ever get it.

RELATED: 15 Factors That Affect a Woman’s Fertility

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The Easiest Way to Prevent Red Wine-Stained Teeth

Photo: Gettym

After stumbling home from a summer happy hour, I caught a glimpse of myself in the mirror and was immediately horrified. The four glasses of red wine I drank turned my teeth a burgundy red, it was a disaster. I brushed and brushed, but the damage was done. Everyone I had interacted with that night had seen my wine-stained teeth—so embarrassing. What’s a red-wine obsessed girl to do? Am I supposed to order vodka sodas on dates? Drink beer at the office holiday party? Have white wine on a cold winter’s night? In the wise and timeless words of Cher Horowitz “I don’t think so.” In honor of my love of red wine, I’ve made it my mission to find the best tricks to keeping my teeth their utmost white, while still enjoying my glass of Cabernet.

According to New York City Cosmetic Dentist, Lauren Becker, the best way to avoid a red smile is to make sure your teeth are plaque free. “Routine cleanings at your dentist office in conjunction with brushing and flossing (best with an electric toothbrush, twice a day) are surefire ways to keep your teeth sparkling, no matter what you drink or eat. When you know you’ll be drinking red wine, try to brush no more than an hour before indulging. Brushing too close to drinking wine can alter the taste (think: OJ in the morning after brushing!), but brushing too soon afterwards can cause the acidic wine to penetrate the pores in your teeth and can actually erode the enamel,” Dr. Becker advised.

Naturally, I immediately went out and bought an electric toothbrush, the ISSA Mini ($119; net-a-porter.com), and one hour before drinking I brushed. Then, in the name of research, I split a bottle of Cabernet with my roommate. A few hours later, I looked in the mirror and noticed that my teeth were still white—the red wine hadn’t stained them the way it did before.

I decided to also test some hacks for when brushing before or after isn’t a possibility. Here’s what I found:

Drink sparkling water.

I used this trick on a first date and made sure to order a glass of Pinot noir AND a sparkling water. I may have aggressively swished the sparkling water around like mouthwash at first, but I’m happy to say this trick worked. The hardest part is remembering to drink the sparkling water the whole time, but if you do, this can also help avoid a red-wine hangover.

Drink wine out of a straw.

This idea comes courtesy of the Real Housewives. I chose to test this on my couch and found that while using a straw worked, I felt a little ridiculous drinking this way. I would say this is one of the least practical hacks, but could be useful during a pregame with close friends or a night in with a significant other who promises to love you no matter how you look.

Suck on a lime after drinking wine.

While effective in removing wine stains, I’m not sure this should be your new go -to. According to Dr. Becker, “Limes, like wine, are also very acidic and can erode away the outer enamel layer of your teeth. Definitely a DON’T!”

Pairing wine with cheese.

This hardly felt like a trick since wine and cheese are a dream team, but eating cheese while drinking red wine actually did help to prevent stains. Dr. Becker explains how cheese is even more beneficial than just keeping teeth white, “Cheese is high in calcium (especially the harder ones) and calcium helps strengthen the teeth. It also helps heal the pores of the tooth because of its waxy consistency, and can act as a defense barrier from the red wine staining.” Proving just how perfect wine and cheese truly are together.

Wine teeth wipes.

These convenient little wipes are magical. They come in a little pack that can fit easily into a purse—perfect for dating scenarios or special occasions. Dr. Becker says to watch out though; these wipes can be a bit abrasive. Sometimes even a cocktail napkin can get the job done in a bind. (Wine Wipes, $8; amazon.com)

 

This article originally appeared on MIMIchatter.com.

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