Posts for category: Oral Health
October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.
This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.
In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.
In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.
The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.
It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.
Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.
You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.
Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.
If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.
There are few things sweeter to hear than for your dentist to tell you your periodontal (gum) disease is under control. Depending on how deep the infection may have advanced, your treatment journey may have been a long one.
Unfortunately, while the battle may be over, the threat still lingers—once you've experienced a gum infection, you're at higher risk for a recurrence. To minimize that risk, you may need to undergo dental cleanings on a more frequent basis than before.
The average patient typically sees their dentist for cleanings every six months. The aim of these visits is to remove dental plaque, a thin film of bacterial-laden particles that is the prime source for gum disease. These cleanings are meant to supplement a daily habit of brushing and flossing, which should remove the bulk of plaque that builds up throughout the day.
After gum disease treatment, though, you may need to have these cleanings more frequently, and of a more involved nature than the normal cleaning. For patients who've overcome advanced gum disease, that frequency could initially be every other week, every couple of months or every three months. This frequency may change depending on the status of your gum health.
Besides a thorough cleaning, a specialized periodontal maintenance visit may include other interventions. For example, your dentist may apply topical antibiotics or other anti-bacterial products to keep bacterial growth under control.
Protecting you from further gum infection isn't totally on your dentist's shoulders—you also have a role to play. You'll need to brush and floss your teeth thoroughly every day, along with using any other hygiene products prescribed or recommended by your dentist. Daily hygiene will help prevent the buildup of dental plaque and subsequent bacterial growth.
You'll also need to keep a watchful eye on your gums for any emerging signs of infection. If you begin to notice swelling, pain or bleeding, contact your dentist as soon as possible to initiate remedial treatment.
Gum disease treatment can bring your gums back to a reasonable state of good health. But that state could be reversed with a returning gum infection. Only vigilance practiced by both you and your dentist can stop that from happening.
Preventing tooth decay from developing in your child's teeth requires a strong commitment to daily oral hygiene. But if you have a child with a chronic physical or behavioral condition, you might find it difficult to keep that commitment in the light of other pressing health needs.
But tooth decay is just as important a health issue as the others with which you may contend. Because primary teeth guide incoming permanent teeth to erupt properly, losing them prematurely can lead to a poor bite and other associated problems. This could further diminish their quality of life already compromised by their chronic condition.
Helping your special needs child avoid tooth decay isn't easy—but it can be done. Here's how!
Brush and floss for them. Normally, a parent's goal is to help their children learn to care for their teeth on their own. But depending on the nature of your child's chronic disease, that may not be possible. Instead, you may need to take an active role in their daily hygiene for the foreseeable future, even brushing and flossing for them if necessary.
Model proper dental care. Even so, it's still a good idea to guide them toward performing oral hygiene tasks without assistance, according to their abilities. This could be a long road, though, one that requires your active participation. You can ease this process by continuously modeling good dental care behavior for them through brushing and flossing together.
See an understanding dentist. Although caring for a special needs child can be isolating, you don't have to go at it alone. That includes taking care of their teeth and gums: A dentist who has both training and experience in treating children with chronic health conditions can become an important partner in your efforts to fight tooth decay.
Communicate between all care providers. Likewise, having everyone involved in your child's care on the same page can make decay prevention a much easier process. Be sure then to share your concerns about your child's needs, including dental care, with attending physicians, therapists and, of course, dentists.
If you would like more information on dental care for special needs children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Managing Tooth Decay in Children With Chronic Diseases.”
Although Santa Claus has Christmas and the Easter Bunny has Easter, neither of these mythical characters has a day just for them (unless you count the Feast of Saint Nicholas in early December). Not so the Tooth Fairy: According to NationalToday.com, August 22nd is National Tooth Fairy Day, in celebration of this favorite sprite of children.
And, there's good reason for the love—he (or she, if you prefer) comes bearing gifts. Well, not technically a gift: the deal is a tooth in exchange for a treat. Now, what the Tooth Fairy does with all the millions of teeth obtained, no one knows. But that he/she has a huge potential supply is undeniable.
The teeth sought are a specific kind—primary ("baby") teeth that start showing up on the jaw a few months after birth and then gradually fall out by adolescence. Kids have around twenty of these teeth for the potential under-the-pillow exchange.
Here's how it happens: The roots slowly begin to dissolve and the gum tissues holding the tooth in place detach. The sure sign this is occurring is the tooth's noticeable looseness. The process continues naturally, and with no help from us, until the tooth falls out.
But children especially can grow impatient—a wiggly tooth becomes annoying, not to mention all that "earning potential" just hanging there. And so, there's an understandable urge to help it along. But some methods for doing so are problematic—tying a string to the tooth and yanking, for example. Trying to remove a tooth not quite ready can result in excessive bleeding or damage to the tooth socket.
Depending on a tooth's degree of looseness, there is a way to take it out safely. You can do this by draping a piece of gauze pad over the tooth and grasping it firmly between your fingers. Then, gently give the tooth a gentle downward pinch or squeeze. If it's loose enough, it should come out. If not, simply wait another day or two and try again.
A tooth ready to come out doesn't normally bleed much. If it does, have the child bite down on a clean piece of gauze or a wet tea bag for a few minutes until the bleeding stops. They might also eat softer foods for a few days to avoid a resumption of bleeding.
Of course, the tooth inevitably comes out whether you help it along or not. In the event it does away from home, make up some kind of small container your child can carry with them to secure the lost tooth. It's a fun project—and we wouldn't want to lose the opportunity for that profitable encounter with You-Know-Who.
Parents will do just about anything to relieve their children's discomfort when they're in pain. When a toddler is suffering through a teething episode, it's tempting to turn to a topical numbing ointment to soothe their gums.
But there can be a hidden danger for kids if you use certain over-the-counter products used by adults for gum or teeth pain. Many of these topical ointments contain a pain reliever called benzocaine. While it's relatively safe for adults, benzocaine can be hazardous for infants and young children.
Studies have found that benzocaine contributes to a disease called methemoglobinemia, in which a protein in the blood called methemoglobin increases to abnormal levels. Too much of this protein inhibits the transport of oxygen throughout the body. For young children, this can cause shortness of breath, fatigue and dizziness. In extreme cases, it could lead to seizures, coma or even death.
Parents are urged to avoid using any product containing benzocaine to ease gum or teething pain in children. Instead, the American Academy of Pediatric Dentistry recommends providing a child a chilled (not frozen) teething ring, pacifier or a damp clean cloth to chew on. The chewing action helps relieve gum swelling pressure and the cold will help numb the pain. Massaging the gums with a clean finger may also help.
If the pain persists, parents should consult a doctor or pharmacist about giving their child pain medication. Drugs like ibuprofen or acetaminophen (never aspirin) administered in the proper dosage for a child's age can help ease teething discomfort. Medications should always be given orally—you should never rub substances like aspirin or alcohol directly on the gums, which can further irritate already inflamed tissues.
Teething episodes come and go during a child's early dental development—they are like storms that swell and abate before they finally pass. Except when accompanied by fever or diarrhea, there's no need for concern. Your main goal is to help ease their discomfort as much—and as safely—as possible.