Habit Shift: Teeth Grinding

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.


We all have habits and tendencies. I’d be the first to admit that some of them are not good – such as always needing to eat a sliver of dessert after dinner, or never drying our good knives after washing them. I have a history of even worse habits during my teen years, such as chewing my nails, or chewing on the caps of pens, neither of which are good for my teeth. But like most habits, these I have direct control over, and I can change them whenever I so please, like when chewing on your nails turned from cool to gross. Unfortunately, there are some habits that are subconscious, and therefore much more difficult to break. An example of such a habit is teeth grinding, otherwise known as bruxism.

I am a heavy bruxor, meaning that I have the tendency to grind my teeth at night. Like so many others, it was undiagnosed until I landed myself in a dental chair due to a painful ache on my lower left tooth. I was prepared for a root canal and a crown, convinced that something this painful must be caused by a severe infection involving hateful bacterial species. So I was surprised when my co-worker showed me the x-ray and there was an absence of any signs of decay. Wait, then was going on?

Bruxism!

Bruxism is the subconscious habit of grinding your teeth. It is also considered a sleep-movement disorder. It is not uncommon for people who have other sleep disorders (such as snoring or sleep apnea) to grind their teeth as well. While some people grind their teeth from side to side, others chomp and chew, and yet others, like myself, clench really, really hard. It has even been reported by loved ones that their partner’s grinding habits are so loud it keeps them up at night! However, most people who grind their teeth are undiagnosed until they start to experience pain. The pain can be anything from mild to severe, and can be persistent or transient. Sometimes, bruxism is so severe that it causes to the teeth to fracture! This can then cause you to lose your tooth, depending on how it breaks. In order to prevent this from happening to you, it’s important to be aware of the most common signs and symptoms, as well as to try and protect your teeth from the effects of heavy grinding.

Bruxism

Signs and Symptoms

There are many signs and symptoms for bruxism, and they are different for every person. The severity depends on the frequency, duration, and weight of your bruxing habits.

Common sign and symptoms include:

  • Abfraction Lesions – These look like little chipping of your teeth around the gum line. Teeth are anchored in the jaw, and when we clench and grind, we are causing these teeth to flex in all sorts of directions. As they flex, the part of the tooth closest to the gumline (where it is most tightly anchored) experiences the most stress, causing these areas to be prone to chipping.
  • Flat Occlusion – As we grind our teeth, we are slowly grinding away at the top portion of the enamel. Eventually, heavy bruxism may lead to completely flat teeth.
  • Fractured Teeth – Under the stresses of grinding and clenching, part of the tooth itself can give way and fracture. Teeth with large existing fillings are more prone to fracturing than a complete tooth or a tooth with a crown. When we start to see the first signs of cracking or microfracture, we want to take precaution and monitor the tooth closely. Sometimes, it may be beneficial to remove the cracked portion and place a crown, to help prevent any unpredictable and unfavorable fractures in the future.
  • White Lines Inside the Cheeks – Look inside your cheek to see if there is a white striation. These are formed from the repetitive sucking motion related to teeth clenching and grinding.
  • Tight or Tired Jaw Muscles – It may be that you are spending the entire night working your jaw left and right. Your jaw joints may then get tired, or feel very tight. If you ever wake up in the morning with a soreness in your jaws, you may have just experienced a night of heavy grinding!
  • Tooth Pain or Sensitivity – Teeth can experience sensitivity to hot, cold, or pressure if they are continually experiencing trauma from bruxism. There are nerves running to each tooth, and repetitive trauma to the tooth can cause these nerves to become hypersensitive. If treated right away, the hypersensitivity can be reversible.
  • Migraines and earaches – The nerves that innervate your teeth run up along the sides of your head. If they are hypersensitive, they can also cause migraines and earaches.
  • Sleep Disruption – Some people wake up in the middle of the night due to the sounds of bruxism. Others awaken due to aches and pains. Untreated bruxism can definitely take away a good night’s rest!

Causes of Teeth Grinding

The exact cause of bruxism is difficult to pinpoint. It could be a myriad of factors, so it’s important to evaluate whether any of the following apply to you.

  • Stress or Anxiety – The most common cause of teeth grinding is stress. I will always ask my patients if they are experiencing any stressful events in their lives lately when they report bruxism. Most people identify a difficult time at home, or a job change, or a recent move. Identifying the cause of stress and trying to manage or decrease it is really helpful in treating bruxism!
  • Abnormal Bite – Children often time experience grinding when their teeth first erupt and again when their adult teeth start to erupt. Sometimes they outgrow it, and sometimes they don’t. I have also noticed that bruxism is more common when people are missing teeth. A theory would be that an abnormal bite or a bad occlusion can lead to grinding.
  • Side Effects of Medications – Some medications are known to cause grinding. If you have recently started taking a new medication, ask your doctor whether grinding could be a possible side effect. Antidepressants, for example, have been shown to cause grinding.
  • Weight Gain and Sleep Disorders – Recent weight gain can make breathing more difficult when one is sleeping. Soft tissues around the neck and throat tends to push downward when we are lying down, thus obstructing the airway. This can lead to a number of sleep disorders, including snoring, sleep apnea, and grinding!

How to Protect Your Teeth from Grinding

There are many ways to protect our teeth! Unfortunately, since grinding is subconscious, eliminating the habit can be very near impossible to do. Therefore, we must find other ways to help prevent further wear and tear on our pearly whites!

  • Wear a Night Guard

Getting a night-guard is the best way to protect your teeth from the effects of bruxism. Since bruxism is a subconscious habit, it can be difficult to catch yourself doing it, let alone to stop yourself from grinding or clenching. A night guard is a protective plastic piece that sits on either your upper teeth or on your lower teeth. The plastic piece acts as a barrier between upper and lower teeth while you are grinding, so that you are not placing as much forces on your teeth and you aren’t wearing them down. The upper night guard works really well, but can feel very bulky for some. The lower night guard is a much more comfortable fit for first time users. You have the option of either buying universal night guards over-the-counter or making a custom-fit night guard with your dentist. Off course, the custom-fit night guard will protect your teeth better, but I can understand if you don’t want to spend that much money until you’ve tried an over-the-counter one to see if you can tolerate sleeping with a night guard. It will take awhile for you to get used to! It took me about two weeks. One thing is for sure: Once I started wearing my night guard, the pain went away. And if I ever forget, the pain will come back, which shows me that the night guard is doing its job!

  • Reduce Stress

There are many ways to reduce stress. I was first diagnosed with bruxism during dental school, which no doubt was a very stressful time. I find that I clench my teeth while I work or concentrate on something. When I involve myself in stress-reducing practices, I find that I clench less. Below are some ways to alleviate stress or anxiety.

    • Avoid stressful activities an hour before bed.
    • Drink caffeine-free tea in the evening after dinner.
    • Avoid screens in the last hour before bed. Try reading a book instead, or listening to calming music.
    • Choose exercises such as yoga in the late evenings, rather than hitting the gym and working out.
    • Write positive events or affirmations down. Gratitude has been shown to decrease stress and anxiety levels greatly. Try a 5-minute journal.
    • Spend time with your family, friends, or pet.
    • Practice deep breathing, and letting thoughts go.
  • Lose Weight

If you’ve recently gained weight and have noticed that you started grinding your teeth, try to get back to your previous weight. As mentioned above, weight gain is a common cause of grinding. Many patients have found success in decreasing bruxism by simply losing weight.

  • Regular Dental Visits

Regular dental visits are important when you grind your teeth. Make sure your dentist knows of your bruxism. They will be able to detect early signs of tooth fracture. When you start to see a hairline fracture, it shows that your tooth is giving way underneath all those chewing forces. You want to treat a small fracture with caution. It may be that a crown will be needed in the near future to cover the tooth and help protect it. A small crack can grow into a big one, and there is never any telling when and how a tooth will break. Sometimes, a tooth breaks and we can save it with a filling, a crown, and/or a root canal. However, other times, it breaks in a completely unfavorable way, and you may end up losing your teeth. Speak with your dentist about the best preventative practices you can engage in to save your teeth!

A Parent’s Guide: The First Dental Visit

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.


Child raising is no easy task, especially if you’re a first-time parent. Despite all the advice that friends, family, and well-wishers throw at you, it seems that none of them actually work in terms of making the job easier. I’m sure you’re frantically trying to find space in your hectic schedule to get a bathroom break in peace, let alone a wink of sleep! So of course, I understand the look you’re going to give me when I tell you that somewhere in between the baby bottle juggling and the diaper toss, you’ve got to schedule your child’s first dental visit, too. A look that’s mixed between, “Can you not see I’m busy drowning in to do lists?” and “Why don’t you try your hand at this?” As if you don’t already have enough advice being thrown at you left and right, a few words on a child’s first dental visit:

When:

A child’s first baby tooth appears around 6 months old. Typically, it will be one of the lower two front teeth. Look out for it, although I am sure your little one will let you know it’s coming as they’re gnawing away at all those teething toys, or in some cases, whatever they can get their mouths on. Some might wail as a precautionary measure to warn you that it’s teething time! If the tooth comes earlier or later than 6 months, don’t be alarmed! It is considered normal to be within 3 months of the scheduled timeline. It is important to remember that some babies have a head start, and others are late bloomers. The eruption of the first baby tooth is the first sign that your child should see their dentist. It is recommended that a child establishes their “dental home” no later than a year after their birth. The sooner, the better – here’s why!

Why:

When it comes to teeth, we can get behind creating good dental habits early on. It is best if a child establishes a dental home at a young age for multiple reasons.

  • To check and maintain a healthy oral cavity: It’s obvious that there is tooth decay when a tooth has turned black. Anyone can diagnose that. Unfortunately, by that point, it may be too late! Most tooth decay detected by our eyes have already been present for a long time! We recommend seeing your child every six months as soon as the first tooth erupts, so that we can spot problems early on! Maybe our exams will be limited until your child is old enough to take radiographs, but an exam is still better than nothing at all! Let’s be proactive with our dental care!
  • To develop good oral hygiene habits: When your little one is six months old, the people dentists really want to talk to are the parents. As parents, you will have to guide your child toward good, daily oral hygiene habits. Sometimes, that means holding their hand and doing the brushing for them until they are five years old! We know that they will want to grow up fast but we want them to grow up WITH TEETH! So don’t let them go on their own too early. If your child insists, maybe give them time to brush on their own, and then immediately afterwards, follow up by re-brushing their teeth. Your dentist should be willing to go over some tips if you’re having difficulty with your child’s brushing tendencies. I am sure you have a lot of questions, so do not hesitate to ask your dentist on these visits. Plus, the more times your child gets their cleanings, the more opportunities the dentist has to inform them on ways they can improve, too!
  • To become familiar with the family dentist and dental procedures: Dental procedures can be seen as scary to kids, no thanks to the bright lights, loud sounds, and perception in the media. But they shouldn’t be! We want kids to be familiar with going to the dentist. We want appointments to be fun! And we want to make check-ups easy for them. You know the saying: practice makes perfect. The more times they see the dentist, the more comfortable they will be.
  • To avoid fear of the dentist: Humans, especially little ones, fear the unknown. By developing a dental home early on, a child can become more comfortable with the dentist and will start to see check-ups as part of a routine. When you start to brush your child’s teeth, at first they will resist. But after many practice runs, much resistance, and possibly battle scars, they will soon accept it as a part of life. That’s the same with the dental visit (minus the battle scars!).

Things to Expect:

The first dental visit is not going to be perfect. But it establishes the start of what will be a great relationship between your child and their dentist. Here are some things that you might need to prepare yourself for.

  • The first dental visit will be a visual exam. At six months old, we are not going to take radiographs, a fact you probably already knew. “So what’s the point?”, you may ask. The first visit is usually a visual exam. Meaning, we have your child open their mouth and take a peek at their brand new chompers. If we can get a dental instrument in there to feel the surfaces for any ‘holes’ or ‘soft spots’ that might indicate a cavity, then great! If not, then there is always the next visit. What we really want to accomplish is the familiarity of going to the dentist. Good habits are easier developed early on.
  • Your child may cry. Let’s face it. Everything at the dental office is completely alien to your little one. There’s a lot of stimulation going on and your child may not like it. So, they cry. Well, crying is actually good, because I can stick my head in their tiny mouths and peer at their teeth, mid-cry. Sometimes, that’s better than fighting with a child to open their mouth. If your child cries, do not immediately assume it’s related to trauma or pain. And please do not stop coming to the dentist. As mentioned before, the more they get used to coming in, the more cooperative they’ll be in future visits.
  • Nothing may get done. If the baby or child is not cooperative AND does not cry, then it’d be pretty difficult to take a look at their teeth. No worries! Let’s just call this an introductory visit! “Here’s the dentist, your new friend!” “Nice to meet you, little one! Next time, you are going to do so great, we just know it!”
  • We have to be patient: We don’t want your child to have a traumatic experience, because that can affect their perception of dental procedures and can keep them away from their six month check ups when they grow older. We want the experience to be positive, therefore, forcing a child to cooperate is not the best way to go. We can always try again next time. If there IS treatment that needs to be done, but your child stops cooperating, there are also other things we can do, such as refer to a pediatric dentist (also known as a pedodontist) who specializes in working with children!

So there you have it! Now you are equipped with the to-dos and the whys and the hows. If you can find time to establish a dental home for your child early on, you and your child will have an easier time as your child gets older. Hopefully this advice helps you sleep soundly at night too, knowing that their teeth are in good hands!

On Trends: Charcoal Toothpaste

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.


Charcoal sure is getting quite the attention these days. It seems that this granulated, activated, ashy celebrity has stolen the spotlight. Instagram posts are covered with picture-worthy activated charcoal-containing foods, such as black scoops of ice-cream atop waffle cones, and seeded black hamburger buns on either side of a beef patty. This ‘coconut ash’ has also been praised to bind toxic drugs and chemicals in the body due to its negative charge, thus pulling out toxins before the stomach can digest them. (Someone has yet to start an all-charcoal diet.) For similar reasons, bits of charcoal are also being integrated into beauty products in the effort to bind dirt and oils, and I’ve seen humans who look like panda bears, mid-exfoliation. Pretty cute. And don’t think I didn’t consider for a moment the use of charcoal sticks in lieu of a water filtration system. In a crazed effort to eliminate plastic use completely while not being open to drinking unfiltered water, I myself fell down a charcoal-obsessed rabbit hole internet search. Drop a stick of charcoal in a jug of water, wait a few hours, and voila! Perfectly delicious drinking water advertised. While I have nothing at all to say about any of these aforementioned things, except maybe to note that charcoal ice cream temporarily stains your teeth the same color as the pint, I do have a few things to say when it comes to this much celebrated charcoal entering our toothpaste.

Why Put Charcoal in Toothpaste?

Have you seen videos of people brushing their teeth with black globs of sticky stuff and wondered to yourself, “Why put charcoal in toothpaste?” Especially after divulging the fact that a first date may be complicated by stained teeth as a result of trying charcoal ice cream with a potential future life partner. Along the same lines of the previous train of thought that activated charcoal can bind to things due to its micro-porous nature, it seems that some are of the mind that it can also bind plaque and bacteria and tartar. There is the added benefit of whiter teeth, as well. So, why don’t we dig deeper about these two topics?

Does Charcoal Like Bacteria?

Not any more than we do! Activated charcoal is porous in nature. The thinking behind removing bacteria with activated charcoal is that plaque and micro-organisms will be caught in the pores of the charcoal particles, and thus be removed. Possible, but it seems that it does this at a similar rate as regular old toothpaste would. So, no, there is no special binding relationship between the new celeb and our bacteria.

Does Charcoal Toothpaste Detoxify?

There isn’t much to say about the detoxifying nature of charcoal toothpaste that so many people claim. The gums and teeth are not at all similar to your liver and kidneys, which take on the job of clearing your body of toxins. Because of this, the charcoal is not exactly detoxifying your body of anything. Of the same token, for those who are using charcoal toothpaste and are concerned about the charcoal affecting your current medications, rest assured that the charcoal is not in contact with the medications in your digestive tract and therefore has no effect. Unless, off course, you are swallowing the toothpaste rather than spitting it out.

Does Charcoal Actually Make Teeth Whiter?

The simple answer is, “Yes it does”. Bizarre, that you can brush with black to make them white! Charcoal is effective in removing surface stains, which isn’t exactly equated to whitening teeth. Surface stains are extrinsic staining on the teeth due to a coffee drinking habit, or the occasional red wine indulgence. These stains reside on the enamel layer which happens to also be the outermost layer of your tooth. Typically, other ‘whitening’ toothpastes remove these stains as well.

However, your teeth can also have intrinsic stains, either caused by trauma, certain medications, weak enamel, or excess fluoride use. These intrinsic stains can not be removed by toothpaste, with or without charcoal, primarily because the toothpaste will never reach these stains. Whitening of intrinsic staining can only occur from bleaching treatments (whether that’s in-office or over-the-counter) that penetrate past the enamel. But if you wish to use charcoal toothpaste to help reduce stains due to a cold brew habit, then charcoal toothpaste will suffice.

Should We Be Wary of Charcoal Toothpaste?

Unfortunately, charcoal is abrasive. Part of what makes it so good at removing extrinsic stains is the fact that it is rough and can rub off discolorations that are stuck in the pores of your teeth (teeth are porous too!). However, the concern is that charcoal acts like sand paper. Anyone who has consumed or brushed with charcoal will know the grainy feeling it leaves in your mouth. Like sandpaper, repetitive use of the stuff can abrade parts of the outer enamel layer. The enamel is the strongest part of our bodies (stronger than bone!) and our teeth need it as protection. Removal of the enamel layer will weaken the tooth and cause hypersensitivity. You know those ‘Zings’ you feel after a tooth whitening session? Well imagine a permanent version of that, if the enamel is removed. Yikes! Ironically, too, the removal of enamel makes the teeth even more prone to staining for future years to come. Enamel is definitely something we want to protect. If you are planning on using charcoal toothpaste, then consider brushing lightly and gently.

Also, before you declutter your regular toothpaste, may I suggest alternating your charcoal toothpaste with the regular one? Who knows? Like all trends, charcoal coolness may fade, and you may be reaching for your trusty familiar toothpaste brand, once again. At the very least, the alternation will help reduce abrasion to your beautiful, pearly whites. Plus, most charcoal toothpastes do not have fluoride, a good protector of teeth. Fluoride is what helps fight dental decay, and as much as we want white teeth, I am sure you would agree that we want to KEEP our teeth even more. Since charcoal is a recent celebrity, it is too early to tell what charcoal is really about. Better to wait until the tabloids (and research) unearth its true qualities before we fall head over heels for this new star.

Cocofloss: Join the Party!

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Much to the bereavement of all of society, flossing is absolutely necessary and cannot be replaced by things such as water-flossers or, say, prayers. All at once now, *collective sigh*. I get it. But there is a new hero in town, one that’s got me (and soon enough, you, too) cheering. I would like to introduce you to a new best friend and awesome travel partner, Cocofloss!

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It would be difficult to argue against the fact that  the hardest part about flossing is the motivation to actually do it. Cocofloss is a creative solution to making flossing (dare we say it?) an inspiring act looked forward to by all. Imagined and brought to life by two sisters, Chrystle and Cat, Cocofloss is all the right sorts of trendy. Chrystle is a dentist and is a flossing-pro. Cat is an artist and a bit more lazier on the flossing front. But together, they make a dynamic duo, saving the world, one tooth at a time.

Cocofloss is not just string in a box. It’s an experience, and I challenge you not to become completely enamored and transformed into a flossing fanatic once you’ve tried it out. Does it sound like I’m a crazed dentist? Maybe a little. I still dare you to try it! Scented with different fruity aromas, flossing transports you elsewhere. A sandy beach at the Caribbean, perhaps? The four standard flavors include Fresh Coconut, Cara Cara Orange, Pure Strawberries, and Delicious Mint. Currently, there is the seasonal Summer Watermelon flavor for post-BBQ hangouts. Once you open the box, delicious scents waft to your nose. Try not to get addicted!

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Now it isn’t just all fun and games. There’s lot to love on the dental front too. Firstly, the string is blue. That isn’t just to make it engaging to look at. The blue string actually makes the plaque that you remove visible. There is a sort of satisfaction in seeing the plaque that you are actively prohibiting from staying in your mouth. Crazed dentist, indeed! Take THAT, plaque!

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Advertised as a loofah for your smile, there is another feature that I absolutely love. The floss is made of multiple, soft, polyester filaments and is coated in vegan wax. The waxy material is easy to glide in between tight contacts. Once you pass the floss through the contact, the fibers seem to spread. In other words, they poof out ever so slightly, filling that gap underneath the contact and covering more surface area while massaging the gums. At the same time, the fibers are very gentle which protects the gums from trauma. Plus, we all know there is strength in numbers! The fibers are even strong enough to remove chunks of calculus and tartar! Off course, there’s a technique for that. For the non-queasy, here’s a video. Viewer discretion advised.

Also, remember how you floss vigorously before your six-month cleaning because you suddenly remembered that flossing was important? Don’t you deny it! Heaven forbid the dentist ever notice. As much as I love holding you accountable for flossing, Cocofloss can do that for you too. Each container has an indicator for how long the floss should last you. The regular packages are a two month’s supply. Once two months are up, you should be finished with your flossing container. If the indicator is not motivation enough, sign up for the six month plan on their website to make sure you are on track between dental visits. Under the six month plan, Cocofloss will ship you a new flavor of your choice every two months, for a total of three flavors, over the course of six months. If you receive your new Cocofloss before you have finished the old one, then maybe that’s an indication that you’ve skipped a day or two (or three or four).

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Lastly, the floss is infused with coconut oil. Which I think is a cool concept, especially considering all the rave about the benefits of oil pulling. However, I would not necessarily say that the coconut oil does much of anything, considering the amount of time it’s in contact with the teeth. Remember that oil pulling requires you to swish coconut oil around your mouth for 20 – 30 minutes! You only floss for a few minutes. The floss itself does a majority of the heavy lifting, but if coconut oil grooves with you, and it gets you to floss, then there you go!

Two things worth noting that could be improved. The floss is housed in a plastic container, although I would like to note that it is advertised as vegan, animal cruelty-free, and is a completely recyclable product. But still, more plastic being circulated around the world. I’m as crazy about plastic packaging as I am about teeth (maybe even more) so for that, I apologize. And secondly, it does come at a bit higher price than other floss. You can find these babies at $8 a piece, although if you buy a package of 3 or more, you will receive a discount. Regardless, if it is the only thing that’ll get you to want to floss every day, I say it’s worth it. Preventative care is the number one most important thing for oral health, and the fact exists that, for most people, flossing just ain’t fun. Cocofloss tries to bridge that gap. We need to make preventative oral health care cool, just like we made smoking cigarettes uncool. Consider it a changing of times, if you will.

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If you’d like to give Cocofloss a try, ordering is easy! This product lines the shelves of Sephora, Nordstrom, and Urban Outfitters, but you can also order here, from the comforts of your home. I have personally tried all five flavors, and I’ve got to tell you that Pure Strawberries is my absolute favorite. Reminds me of farmers markets and strawberry shortcakes! I recommend this product to all my patients, especially kids and younger teens who have yet to develop a flossing habit. Challenge them (or yourself) to floss for 21 days straight (the number of days it takes to form a habit). Let’s introduce a new flossophy to younger generations by teaching them that flossing is actually cool.

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