What one should do first – Brushing or flossing and how many times a day? Either flossing or brushing first is okay as long as you do them both. You must brush at least two times a day and floss … Continue reading
General
Dental Fillings Need Checked By Your Dentist
When was the last time you had your dental fillings checked? Dental fillings may last years before they need to be replaced, but once a filling becomes worn, chipped, or cracked, it will need to be replaced. If you do … Continue reading
Salt Lake City Dentist Provides Information About Periodontal Disease
If left untreated, periodontal disease will lead to the loss of teeth. On the pathway to losing teeth, you may notice gums that bleed easily, teeth that are loose, and persistant bad breath. Periodontal disease is caused by an infection of the gums and the bodies response to that infection.
There is space between the tooth and gums. Plaque or a collection of bacteria accumulates in that space. If the plaque or bacteria are not removed each day, the body responds with inflammation to prevent the infection from spreading. This is often manifest by gums that bleed easily. We call this early periodontal disease gingivitis.
2 other things happen when the plaque is left in this space. The space gets bigger making it even harder to remove the bacteria. The plaque hardens and forms tartar or calculus. Once hardened, this bacteria can only be removed with a professional dental cleaning. As the space gets deeper and deeper, the gum tissue dies, and the bone is destroyed. Once more than 50% of the bone is missing the tooth often becomes loose. A loose tooth will often move leaving gaps between your teeth.
Once more than 75% of the bone is missing oftentimes the tooth will get so loose that it can fall out while eating. Once the space has been enlarged and the bone is destroyed it will never go back to being completely healthy. It is best to prevent periodontal disease or to treat it as soon as possible.
The best way to prevent periodontal disease is to see your dentist regulary for check-ups and cleanings. Professional dental cleanings will prevent gingivitis from turning into periodontal disease. You should have your teeth cleaned professionally at least once a year, and possibly as often as every few months.
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Jonathan Campbell, DDS is a Salt Lake City dentist. He practices at Legacy Dental. He provides treatment for periodontal disease using antibiotic therapy, laser therapy, and conventional deep cleanings. Dr. Campbell uses Previser to help monitor the health of his patients and to improve their outcomes.
Dental Care and Osteoporosis, Osteopenia, and Bisphosphonates
Many people suffer from osteoporosis and increased risk for fracture of bones. This condition is often treated by medications, mostly in the bisphosphonate class, that slow down the process of decreasing bone density. These medications can increase a patients risk for osteonecrosis of the jaw (ONJ) following invasive dental procedures. ONJ is a condition where the bone in the area of the treatment remains exposed, fails to heal, and areas of the exposed bone become necrotic and die. This condition is very difficult to treat. Because it is difficult to treat, many physicians, dentists, and patients are unsure regarding dental treatment if the patient is taking this medicaton.
In the Journal of the American Dental Association’s November 2011 issue, authors, Hellstein, Adler, Edwards, et al. wrote an article entitled, “Managing the Care of Patients Receiveing Antiresorptive Therapy for Prevention and Treatment of Osteoporosis”. The aim of their efforts was to provide a summary of the current research, and provide guidelines for the treatment of patients undergoing antiresorptive therapy.
The risk for ONJ is 0.1%. Risk seems to increase with time that a patient has taken the medication. Risk does not seem to decrease if the patient discontinues taking the medication. Risk is also higher the more involved the planned procedures. Risk is also higher for overweight patients, and patients with diabetes.
Millions of people are taking these medications and all will require dental treatment. It is recommended that the following things be done to decrease risk.
- Have a dental examination and have your dentist complete any necessary treatment, especially the removal of any questionable teeth, prior to beginning these medications.
- Have regular dental check-ups to prevent and detect small problems before becoming big problems.
- Keep your mouth clean to prevent dental disease. Ask your dentist and hygienist to evaluate your technique and provide instruction how to improve. Ask your dentist about the use of fluoride, xylitol, MI paste, to lower your risk.
- Improve your diet. Avoid the frequent consumption of soda, energy and sports drinks, sweetened coffee and tea, and juice. Avoid other sugary and other starchy foods especially between meals. Be especially careful with lozenges, candies, and gums that contain sugar.
- If you’ve already started the medication, have an examination and treatment as soon as possible the longer you are on the medication, the higher your risk.
- Do not discontinue the medication unless advised by your physician. Discontinuing the medication will not lower your risk for ONJ, but may increase your risk for a fracture.
- Take an antibiotic prescribed by your dentist one day prior to your planned procedure and continue the antibiotic for 4 days after the procedure. Your dentist can tell you if your planned procedure warrants this measure. Generally you do not need to take an antibiotic for cleanings, fillings, root canals, and crowns or bridges.
- Rinse with a chlorhexidine 2 times a day for 4 weeks after any surgical procedure. Chlorhexidine is a prescription mouthrinse provided by your dentist.
- Be careful with surgical procedures performed in multiple areas of the mouth. It may be best to limit treatment to one area at a time.
Here’s some good news a patient taking these bisphosphonates and other antiresorptive medications can expect similar rates of success for any dental procedure as a person not taking those medications. This includes dental implants.
Together you, your physician, and dentist can work together to slow the progression of osteoporosis while enjoying good dental health.
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Article written by Jonathan G. Campbell, DDS. Dr. Campbell is a dentist in Salt Lake City.
All I Do is Smile and Take Pics!
Hello my name is Marcia Rayford and for at least the past 37 years I’ve have been afraid of dentists until visiting Sala Family Dentistry. Five of my lower teeth were crocked; my two front teeth protruded and had a gap. Almost all of my upper and lower teeth had been extracted. I made it […]