Our bodies wage a continuous war against enemies too small to be seen with the naked eye. If we’re healthy, our immune system will stop the vast majority of these microbial agents.
But some of them, viruses in particular, are so small and with certain characteristics that they can slip past our immune systems. Prevention — removing the opportunity for these viruses to gain entry into our bodies in the first place — is a key component in controlling infection.
Healthcare facilities, including dental offices, are primary battlegrounds in this war. In recent years, the stakes have increased as viral infections that cause the liver disease hepatitis (B and C) and HIV that causes the auto-immune disorder AIDS are on the rise. Although different in effect, these viruses spread in much the same way — when the blood of an infected person comes in contact with the bloodstream of another person.
The risk for this exposure is higher in situations when there’s a break in the skin. Blood transfusion, surgery centers and similar facilities with invasive procedures require high standards of protection to prevent viral transmission between people.Â This includes dental clinics — even a routine hygienic cleaning can become a conduit for viral infection.
As a result, the more than 170,000 dental providers across the country have adopted strict infection control standards that conform to the National Center for Disease Control (CDC) guidelines, as well as state and local regulations. These standards detail such issues as wearing protective equipment and clothing (like disposable gloves, gowns or facemasks), cleaning and sterilizing instruments, or disposing of bio-hazardous waste.
High infection control standards are also promoted by the professional boards and organizations of dental providers, like the American Dental Association, and are a requirement for continued membership.Â As a result, infection occurrences from dental visits or procedures are extremely rare.
We understand you may have concerns. We’re glad to discuss with you our procedures for infection control and how we’re following the highest standards to keep you and our staff safe. We’re making sure the care you receive for your teeth and gums doesn’t lead to another health problem.
If you would like more information on dental infection control practices, 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 “Infection Control in the Dental Office.”
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
Millions of Americans regularly use ibuprofen to manage minor pain and swelling. As with other fields in healthcare, the drug is a mainstay in dentistry especially for post-procedural discomfort. But ibuprofen and similar drugs also have side effects that can lead to serious health problems. So, should you be concerned about its safety?
For most people, ibuprofen is safe and effective — but only if used properly. Like aspirin, ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation by blocking the effect of substances called prostaglandins, released by injured or damaged tissues. NSAIDs differ in mechanism from pain relievers like steroids or narcotics and don’t have the same side effects, especially the addictive qualities and impaired consciousness potential of narcotics like morphine or codeine. While these more potent drugs are usually reserved for serious injuries or illnesses, NSAIDs like ibuprofen are ideal for mild to moderate pain following routine dental work.
The biggest concern for the use of an NSAID is its tendency to thin the blood, especially if used continuously over several weeks; this can make bleeding control more difficult after an injury. Prolonged overuse has also been linked to erosion of the stomach lining leading to ulcers or bleeding, kidney failure, early miscarriage and repeat heart attacks for patients with cardiovascular disease.
With this in mind, we recommend that adults take no more than 2,400 milligrams of ibuprofen during one twenty-four hour period for short-term pain relief unless otherwise recommended by a doctor. Research has shown that a single 400-milligram dose of ibuprofen is safe and effective for relieving even severe post-operative pain for about five hours in most people. On the other hand, we don’t recommend a NSAID during pregnancy or for people with a history of intestinal bleeding or heart attacks.
Taking into account your medical history and the procedure you’ll be undergoing, we will recommend the best pain management medication for your situation. In most cases, ibuprofen will be an effective means to reduce your discomfort level and, taken properly, will not pose a danger to your overall health.
If you would like more information on dental pain management, 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 “Treating Pain with Ibuprofen.”
There are a lot of reasons (including a blow to the mouth) why one of your permanent teeth might become loose. The most common: advanced periodontal (gum) disease that has weakened the gum attachment to the tooth.
There's also another, less common reason: you have a grinding habit that's producing higher than normal biting forces. Besides accelerating tooth wear, the constant jaw movement and teeth clenching can stretch periodontal ligaments and loosen their attachment to a tooth.
If the gums are disease-free, teeth grinding is most likely the main culprit for the damage, what we call primary occlusal trauma. Our treatment goal here is to reduce the effect of the grinding habit and, if necessary, secure the teeth with splinting while the ligaments heal. We can often reduce the grinding effect with a custom bite guard worn while you sleep. We may also prescribe minor muscle relaxants and mild pain medication like aspirin or ibuprofen.
Sometimes we may need to perform other measures like re-shaping your teeth's biting surfaces so they don't generate as much biting force. You may also benefit from counseling or other psychological treatment to help you address and cope with stress, a prime driver for teeth grinding.
Even if you don't have a grinding habit, biting forces may still contribute to tooth looseness if you have advanced gum disease. Advanced disease results in excessive bone loss, which in turn reduces the remaining amount of ligaments attached to the tooth. This type of damage, known as secondary occlusal trauma, and ensuing tooth looseness can occur even when your biting forces are normal.
It's necessary in these cases to treat the gum disease, primarily by manually removing plaque and calculus (hardened plaque deposits), which causes and sustains the infection. Once removed, the gums can begin to heal and strengthen their attachment. We may also need to apply splinting or perform surgical procedures to encourage gum and bone reattachment.
Whatever has caused your loose tooth, our goal is to remove the cause or lessen its effects. With your tooth secure and the gums regaining their healthy attachment, we have a good chance of saving it.
If you would like more information on teeth grinding and other potentially damaging oral habits, 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 “Loose Teeth: Biting Forces can Loosen Teeth.”
Now that we’re into the New Year, it’s a good time to look over your list of resolutions. Did you remember to include dental health on your list? Here’s one simple resolution that can help keep your smile bright and healthy through the New Year and beyond: Floss every day!
Your oral hygiene routine at home is your first line of defense against tooth decay and gum disease. While brushing your teeth twice a day effectively removes much of the food debris and dental plaque from your teeth, brushing alone is not sufficient to remove all the plaque that forms on your teeth and around your gums. For optimal oral health, flossing once a day is also necessary.
Which teeth do you need to floss? Any dentist will tell you, “Only the ones you want to keep!” And yet according to a national survey of over 9,000 U.S. adults age 30 and older, nearly 70% don’t floss every day, and nearly one third admit that they don’t floss their teeth at all. Unfortunately, if you don’t floss, you’ll miss cleaning about a third of your tooth surfaces. When plaque is not removed, this sticky film of bacteria releases acids that cause cavities and gum disease. With dental floss, however, you can clean between the teeth and around the gums where a toothbrush can’t reach.
Flossing is an essential component of good oral hygiene. Still, daily flossing seems to be a harder habit to get into than brushing. Some people tense up their cheek muscles while flossing, making it harder to comfortably reach the back teeth, so remember to relax as you floss. If unwaxed floss doesn’t glide easily between teeth, try waxed floss. If you have trouble using traditional dental floss, you can try threader floss, which has a rigid tip, interdental brushes, floss picks, or a water flosser, which cleans by way of pressurized water.
It’s not too late to add one more resolution to your list, and flossing is a habit that will go a long way toward keeping you in the best oral health. And along with good dental hygiene at home, regular professional dental cleanings and checkups are key to a healthy smile. If you would like more information about maintaining excellent dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Flossing—A New Technique.”
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