Posts for: November, 2013
When Giuliana Rancic, long-time host of E! News, first saw her new son, she said it was “the best single moment of my life.” Recently, on the eve of Duke's first birthday, the TV personality and reality star spoke to Dear Doctor magazine about her growing family, her battle with cancer — and the importance of starting her child off with good oral health.
“Duke will have his first visit with the dentist very soon, and since he is still a baby, we will make his visit as comfortable as possible,” Giuliana said. That's a good thought — as is the timing of her son's office visit. Her husband Bill (co-star of the couple's Style Network show) agrees. “I think the earlier you can start the checkups, the better,” he said.
The American Academy of Pediatric Dentistry concurs. In order to prevent dental problems, the AAPD states, your child should see a dentist when the first tooth appears, or no later than his or her first birthday. But since a child will lose the primary (baby) teeth anyway, is this visit really so important?
“Baby” Teeth Have a Vital Role
An age one dental visit is very important because primary teeth have several important roles: Kids rely on them for proper nutrition and speech, and don't usually begin losing them until around age 6. And since they aren't completely gone until around age 12, kids will depend on those “baby teeth” through much of childhood. Plus, they serve as guides for the proper position of the permanent teeth, and are vital to their health. That's why it's so important to care for them properly.
One major goal for the age one dental visit is to identify potential dental issues and prevent them from becoming serious problems. For example, your child will be examined for early signs of dental diseases, including baby bottle tooth decay which is a major cause of early childhood caries. Controlling these problems early can help youngsters start on the road to a lifetime of good oral health.
Besides screening your child for a number of other dental conditions or developmental problems, and assessing his or her risk for cavities, the age one visit also gives you the opportunity to ask any questions you may have about dental health in these early years. Plus, you can learn the best techniques for effectively cleaning baby's mouth and maintaining peak oral hygiene.
Breezing Through the Age-One Visit
To ease your child's way through his or her first dental visit, it helps if you're calm yourself. Try to relax, allow plenty of time, and bring along lots of activities — some favorite toys, games or stuffed animals will add to everyone's comfort level. A healthy snack, drink, and spare diapers (of course) won't go unappreciated.
“We'll probably bring some toys and snacks as reinforcements,” said Giuliana of her son's upcoming visit. So take a tip from the Rancics: The age one dental visit is a great way to start your child off right.
If you would like more information on pediatric dental care, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”
If you have certain health conditions, your medical doctor may prescribe an antibiotic for you to take prior to a dental visit. The reason why is a story that dates back to the mid-20th Century.
In the early part of the last century, a theory became popular that bacteria in the mouth could migrate to other parts of the body and cause systemic illness or disease. During the 1930s and 1940s evidence arose that indicated a connection between dental procedures that caused bleeding and two serious health conditions: bacteremia (the presence of bacteria in the bloodstream) and infective endocartitis. The latter is the inflammation of inner tissues of the heart (including the valves) caused by infectious agents, most notably bacteria. It became common then to prescribe antibiotics to patients susceptible to these conditions as a preventive measure. Later, patients with prosthetic joints or poor immune systems were added for this kind of treatment.
For many years, the American Heart Association (AHA) recommended pre-visit antibiotic treatment for a wide array of heart patients. After several years of research that indicated the treatment wasn't necessary for most people and might even be detrimental, they updated their guidelines in 2007 and reduced their recommendation list to just a few conditions. They now recommend the antibiotic treatment for patients with artificial heart valves, a history of infective endocartitis, heart transplant recipients with valve problems, and certain congenital (inherited) heart conditions.
If you have a condition that calls for a pre-visit antibiotic treatment, all the providers involved with your care will need to communicate. Your medical doctor will most likely prescribe two grams of amoxicillin (or a similar antibiotic if you are allergic to amoxicillin) that you would take an hour before the dental procedure. We in turn would communicate with your medical doctor concerning the dental procedures you're scheduled to undergo (including regular cleanings), in case your doctor would like to make adjustments in your medication.
Your health and well-being is of utmost importance to all your healthcare providers, medical and dental. Working together, we can ensure the dental procedures you need for oral health won't have an adverse impact your general health.
If you would like more information on antibiotic treatment before a dental visit, 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 “Antibiotics for Dental Visits.”
Maybe you had braces as a child, or you are thinking of having your own (it's never too late) or your child's teeth straightened through orthodontia. But how much do you really know about this branch of dentistry? Here are six questions people often ask about orthodontia.
Q. How did the word “orthodontia” originate?
A. From Latin roots meaning “straight” and “teeth”
Q. Teeth are anchored in bone. How is it possible to move them?
A. Living bone is not unchanging. The bone, ligament, and the outer layer of a tooth's root (called cementum) react to the stresses of biting and chewing. Due to this stimulation the bone is constantly being resorbed (broken down) and rebuilt as it is pushed from one side of a tooth and pulled from the other. Under normal conditions, there is a balance resulting in a steady state. Orthodontia takes advantage of this process to slowly change the teeth's position in the desired way.
Q. My dentist talks about the periodontal ligament. What does this mean?
A. The ligament is a fibrous tissue that connects the teeth to their bone and takes part in the dynamic process of resorption and rebuilding of the bone.
Q. What kinds of conditions can orthodontia correct?
A. Treatment can improve the teeth's position and relations to each other (being too crowded or badly spaced) and the way the upper and lower jaws relate. It can enhance the appearance of a person's teeth and face, and can also improve the teeth's function in biting and chewing.
Q. What is the best first step to orthodontic treatment?
A. Talk to your general dentist about your concerns. If you are referred to an orthodontist, the next step is to assess your situation using molds of your teeth that show the way the upper and lower teeth meet (your bite). Special x-rays will be taken to show the locations of your teeth and relation of your upper and lower jaw. Your dental team may also use photographs of your smile and computer imaging to get a clear view of how your teeth are now and how they may be moved.
Q. What are some of the methods of treatment?
A. In the traditional method, small metal brackets are attached to the crowns of the teeth. Thin wires, called arch wires, are strung through attachments on the brackets. These wires are used to apply controlled force to direct the teeth in the desired direction. Another method is to use removable clear plastic aligners. A series of aligners is designed by a computer, to be changed from one to the next as the positions of the teeth slowly change.
Contact us today to schedule an appointment to discuss your questions about braces and orthodontia. You can also learn more by reading the Dear Doctor magazine articles “Moving Teeth with Orthodontics” and “The Magic of Orthodontics.”
My forty-five years of dentistry have taught me that, without a doubt, the most important service I can render to my patients is to teach them proper oral hygiene and to somehow have the ability to convince them how important it is. Without good oral hygiene, all dental treatment will fail. The patients leave themselves open for the dental bacteria to travel to other parts of their body…the infection does not stop suddenly at the neck. One cannot be totally healthy if he has a chronic low grade infection present in his mouth. The accomplishment that I am the most proud of in my dental career is the large number of patients who have listened to my oral hygiene instructions and now have healthy mouths. I am proud of my restorations but they can only be successful if the patients maintain them adequately. I also have contributed very much to these patients systemic health.
In 1967, I was introduced to the research of Dr. Surrindar Bhaskar, the commanding General of the U.S. Army Dental Corps. He was adapting the water irrigation principals that the Army Medical Corps was using to clean wounds inflicted by combat rifles. Dr. Bhaskar was a brilliant researcher and teacher. Two important points need to be made here. They are: 1. All of his research can and has been duplicated over and over. 2. He did not do this research for his own personal gain.
When I first started my own practice, in January of 1972, I referred the periodontal patients to the periodontist upon diagnosis of the condition and was met by a very high failure rate. After about six months I realized that unless I had successfully taught proper home care and the patients were completely compliant, the periodontist and I were going to fail and the patient would have undergone a painful and expensive treatment for no gain. After insisting that the patient modify their home care before any other treatment was rendered, I came to the conclusion that once the patients were doing the home care procedure that Dr. Bhaskar had developed, at least 70% of them no longer needed care by a periodontist.
The following pictures are of actual patients of Mendelson Family Dentistry. These are not in any way “touched up” and they are typical of the results of good oral hygiene.
Dental plaque and the resulting dental infection are very obvious in this picture. The plaque which causes dental disease is a biofilm which has the consistency of Elmer’s glue and cannot be adequately removed by flossing and brushing. Oral Irrigation, along with brushing, is the best way to remove this. Please note that this patient has no bone loss she has gingivitis. Her bone is very resistant to periodontal disease. If she continues to have poor oral hygiene, she will develop full blown periodontal disease and will lose her teeth. She has had cardiac bypass surgery. When she was informed on her March 13thappointment that dental disease plays a big role in heart disease, she was eager to learn just how to take care of her mouth and quite ready to do this on a DAILY BASIS.
March 13, 2007 March 20, 2007
The dental plaque is the white substance with that can be seen between her teeth. If one were to look at this plaque under a microscope, he or she would see that it is made up of living bacteria and their waste products. See how swollen and red the tissue is. At her March 13th appointment her teeth were cleaned and she was given oral hygiene instructions. She agreed to use oral irrigation along with brushing (water-pik appliance) twice a day and return to the office in one week for a follow up cleaning and photographs. You can easily see how much healing has taken place in just one week. She has continued to practice good oral hygiene and her tissue is now very healthy.
August 23, 2005 July 18, 2007
This patient is a young lady who has had several unsuccessful periodontal surgeries. She was referred to us by her mother. She has been a very compliant patient and has followed our instructions. She uses oral irrigation at night and regular tooth brushing. This has allowed her to bring her gums to maximum health without any surgeries or treatments by us except regular 6 month cleanings and exams. As you can see from these pictures taken two years apart, she has been well rewarded for her good oral hygiene.
HOW TO USE THE ORAL IRRIGATION DEVICE
Oral Irrigation devices such as the Water-Pik products and the Conair-Interplak products can be found at many local retail outlets.
- Fill the reservoir of the device with warm water. Do not use cold water. If you desire, add mouthwash (i.e. Listerine, Cepacol or Peridex).
- The power on the device should be set to a low number. It is not desirable to use it at maximum power.
- Place the tip in the mouth before turning the device on and turn it off before taking it out of your mouth.
- Shoot the water jet at right angles to the teeth, holding it in place for 5 seconds between each tooth.
- The best time to use this device is at bedtime. When you use it at other times of the day, try to not eat for at least 30 minutes following the procedure.
- In order for oral irrigation to be effective, it must be done on a daily basis.
- The best way to clean the irrigation device is to run apple cider vinegar through the appliance once every two to four weeks. Let it sit overnight with the vinegar in it. Rinse the appliance in the morning with cold water.
We urge out patients to use oral irrigation. It is, by far, the most effective way to rid our dentitions of the biofilm that causes dental caries and periodontal disease. Medical research has also shown a definite link between dental disease and blockage of the blood vessels that supply the heart. This is a very easy way to help both your dental and physical health.
If you have noticed white spots or enamel pitting on your teeth, something in your diet may be the cause. If accompanied by other general symptoms, these dental problems may stem from a possible intolerance to gluten.
Gluten is a protein found in grains like wheat, barley or oats. Some people (an estimated one in 130 Americans) have a condition called Celiac Disease (CD) in which their immune system mistakenly treats gluten as a threat and initiates an attack of antibodies (individual proteins made by the immune system to target and kill specific foreign substances) against it. Tiny hair-like structures in the small intestine called cilia that aid in nutrient absorption may be destroyed in the process. As a result, the body can't properly absorb nutrients.
CD can be difficult to diagnose because its symptoms resemble other conditions like Irritable Bowel Syndrome. Typically, though, CD causes digestive issues like diarrhea, bloating and stomach aches, as well as fatigue, growth abnormalities and vitamin deficiencies. In the mouth, the most common symptoms are enamel defects like spotting and pitting. Patients may also lose a portion of their enamel in the grooves of the central incisors where the enamel may appear chalky or opaque rather than shiny, evidence of a condition called decalcification. CD may also cause canker sores.
Determining if you have CD is a two-step process. You must first undergo a blood test to see if antibodies are present for gluten. If the test returns positive confirming you have CD, the next step is a biopsy in which a small amount of intestinal tissue is removed and analyzed. This measures the degree of damage to the stomach lining, which will indicate whether or not you should remove foods containing gluten from your diet.
While research is ongoing to develop counteracting medications, removing gluten from your diet remains the most effective treatment for CD. Enamel defects caused by CD can also be treated with fluoride toothpastes and other aids to foster re-mineralization (restoring calcium and other mineral content to the enamel), and with cosmetic techniques to reduce any discoloration effect. CD patients should continue with normal oral hygiene efforts, with one exception: hygiene products (including polishing pastes and fluoride gels used in professional cleanings) should be gluten-free.
If you would like more information on how gluten may affect your oral 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 “Gluten & Dental Problems.”