Posts for category: Oral Health
Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.
Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.
Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax, and denosumab or Prolia. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.
In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.
The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.
Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.
Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.
If you would like more information on the effect of osteoporosis treatment on dental health, 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 “Osteoporosis Drugs & Dental Treatment.”
‘Tis the season to be merry—and with plenty of edible goodies! During the holidays, families fill their homes with all sorts of delectable treats for friends and loved ones. But there can be unintended consequences with all this joyous feasting, and not just added pounds come January: eating more sugar could increase your risk for dental disease.
We’re not here to throw a wet blanket on your holiday fun. Instead, we have 4 commonsense tips to help you keep your holiday snacking from ultimately causing tooth and gum woes.
Blend in healthier choices. The problem with sugar is that it’s a prime food source of disease-causing oral bacteria. The more sugar available in the mouth, the more these bacteria multiply and increase the disease threat to your teeth and gums. So, try reducing sugar by adding savory treats like nuts or flavored popcorn to your sweeter offerings. And don’t forget cheese and other dairy—eating dairy products along with sweets can help blunt some of sugar’s effect on bacteria.
Avoid “grazing.” While it’s tempting to do so during the holidays, continuous snacking increases the mouth’s acidity, which is like Superman’s kryptonite to your tooth enamel. The longer acid directly contacts your enamel, the more it can soften it and open the door to tooth decay. Saliva neutralizes after-meal acid; but if you’re constantly snacking, you could prevent saliva from completely buffering the acid present. So, limit your snacking time—or better yet, reserve your sweet treats for mealtime.
Don’t neglect your hygiene. The hectic pace of the holidays can interfere with people’s normal routines. Don’t let that happen to your daily practice of brushing and flossing. These essential hygiene tasks clean your teeth of a disease-causing biofilm called dental plaque. Miss a few days and the accumulated plaque could trigger an infection that could damage your gums and ultimately your teeth. You can help avoid this by brushing and flossing every day.
Don’t brush right after eating. The mouth’s acidity naturally increases during and just after eating. As we alluded to earlier, saliva’s on the job getting the mouth back to a more neutral state and reducing the effect of acid on enamel. That takes about an hour, though, and in the meantime your enamel may be in a slightly softened state. If you brush right after eating, you might inadvertently brush tiny bits of enamel. So, wait an hour or so after eating before you brush.
The holidays are all about enjoying friends and family and ringing in the new year. Follow these tips to ensure it’s a healthy and happy one for your teeth and gums.
If you would like more information about dental care during the holidays, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
While the effectiveness of chemotherapy and radiation have contributed to rising cancer survival rates, they can still have an adverse effect on the rest of the body. That includes the mouth: these treatments can damage healthy tissues like the salivary glands. The decrease in saliva flow increases the risk of tooth decay or periodontal (gum) disease.
While overcoming cancer is certainly the patient’s main health priority, it’s important for them to tend to their oral health. The best approach often involves a three-way partnership between patient, dentist and family caregivers all doing their part to keep the patient’s teeth, gums and mouth healthy during cancer treatment.
Here’s what each “partner” can do to protect a cancer patient’s oral health during treatment.
The dentist. To minimize dental disease odds, patients should enter cancer treatment with their teeth and gums in the best shape possible. Before beginning treatment, then, the dentist can assess their oral health status and recommend a treatment plan for any existing disease or condition. The dentist can also monitor a patient’s oral health during the treatment period.
The patient. Patients can do the most to protect their oral health by removing disease-causing plaque buildup with daily brushing and flossing, as well as maintaining their regular schedule of dental cleanings (if possible). They should also attempt to reduce dry mouth, a potential consequence of cancer treatment, by consuming more water and using saliva boosters like Xylitol-sweetened gums and mints. A nutritious diet is also important for protecting oral health.
The caregiver. Many cancer patients depend on family or friends to aid them during treatment. One of the best things a caregiver can do is act as a liaison between the patient and their medical and dental providers. When it comes to oral health, caregivers should be on the alert for any mouth changes including tooth pain, gum swelling or bleeding, foul breath and other signs of disease.
Focusing on oral health can be a daunting challenge for patients during their fight with cancer. But with help from their other partners, they can come out of this fight with their teeth, gums and mouth in good health.
If you would like more information on oral care during cancer treatment, 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 “Oral Health During Cancer Treatment.”
If you suffer frequent sinus infections, you might want to talk with your dentist about it. It could be your chronic sinus problems stem from a deeply decayed or infected tooth.
Sinuses are hollow, air-filled spaces in the front of the skull associated with nasal passages. The largest, the maxillary sinuses, are located just behind the cheekbones and above and to the rear of the upper jaw on either side of the face. These sinuses can become painfully congested when infected.
One possible cause for an infection in the maxillary sinus can occur in certain people whose upper back teeth (the molars and premolars) have roots that are close to or even protrude into the sinus. This is normally a minor anatomical feature, unless such a tooth becomes infected.
An infection in teeth with advancing decay or whose nerve tissue has died will eventually reach the root tip through tiny passageways called root canals. If the roots are close to or penetrating the maxillary sinus, the infection could move into the sinus. This is known as Maxillary Sinusitis of Endodontic Origin (MSEO).
A case of MSEO could potentially go on for years with occasional flare-ups of sinus congestion or post-nasal drip. Because of the nature of the infection within the sinus, the affected tooth itself may not show the normal signs of infection like sensitivity or pain. Doctors may attempt to treat the sinus infection with antibiotics, but because the actual source of the infection is within the tooth, this therapy is often ineffective.
If your doctor or dentist suspects MSEO, they may refer you to an endodontist, a specialist in root canals and interior tooth problems. With their advanced diagnostic capabilities, endodontists may have a better chance of accurately diagnosing and locating the source of a tooth-related infection.
As with any non-vital tooth, the likely treatment will be root canal therapy in which the infected tissue within the tooth is removed and the empty spaces filled to prevent future infection. For MSEO, the treatment not only preserves the tooth but may also relieve the infection within the sinus.
Visiting the dentist for regular cleanings and needed dental work can do wonders for keeping your teeth and gums in tip-top shape. But if you’ve seen or heard about infections occurring in healthcare facilities, you might be a little concerned that your trip to the dentist might expose you to one. Don’t be! You and your family will be out of harm’s way because your dental team has made protection from viruses, bacteria and other infectious agents a top priority. To highlight this effort, the American Academy of Oral Medicine commemorates each September as “National Dental Infection Control Awareness Month.”
As a healthcare provider, dentists have a legal, moral and ethical obligation to protect patients (and staff members too) from infection through what are known as “standard precautions.” These include barrier protection, disinfection and sterilization practices, and safe disposal of contaminated items.
But dentists and their professional organizations don’t stop with the minimum requirements—they’re committed to a higher standard when it comes to infection control. The bedrock for this commitment is adherence to an infection control checklist developed by the U.S. Centers for Disease Control (CDC), updated regularly. This in-depth checklist recommends several best practices and protocols, including:
- Creating a written infection control plan that outlines all practices and procedures to be followed by the provider and staff;
- Barrier protection, including the wearing of disposable gloves, face shields or gowns by providers as appropriate;
- Proper disposal methods for used items;
- Proper hand washing and other hygiene practices before and after treatment procedures;
- Proper disinfection and sterilization of instruments and equipment;
Most licensing bodies also require that dentists and their staff undergo continuing education in infection control, usually every two years.
Because you as a patient have a right to know the details about your medical and dental care, you have public access to infection control guidelines and requirements. You can also ask your dental provider about what steps they take to protect you and your family from infectious disease. They’ll be glad to answer any questions you have to put your mind at ease about your safety.
The dental profession’s commitment to patient and staff safety has drastically reduced the risk of any infection. Rest assured, your dental visit will be beneficial for your oral health—and safe for your general health too.
If you would like more information about infection control in the dental office, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Infection Control in the Dental Office” and “Shingles, Herpes Zoster: A One-Sided Facial Rash.”