If you’ve had a total joint replacement or similar procedure, you will want your surgeon to decide if you need to take an antibiotic before you undergo dental work. This is a precaution to prevent a serious infection known as bacteremia.
Bacteremia occurs when bacteria become too prevalent in the bloodstream and cause infection in other parts of the body, especially in joints and bone with prosthetic (replacement) substances. It’s believed that during invasive dental procedures bacteria in the mouth can enter the bloodstream through incisions and other soft tissue disruptions.
Joint infections are a serious matter and can require extensive therapy to bring it under control. Out of this concern, the use of antibiotics as a prophylactic (preventive measure) against bacteremia once included a wide range of patients for a variety of conditions and procedures. But after an in-depth study in 2007, the American Dental Association concluded that the risks for many of these patient groups for infection triggered by a dental procedure was extremely low and didn’t warrant the use of antibiotic premedication therapy.
As a result, recommendations for antibiotic therapy changed in 2009, eliminating many groups previously recommended for premedication. But because of the seriousness of joint infection, The American Academy of Orthopedic Surgeons still recommends the therapy for joint replacement patients about to undergo any invasive procedure, including dental work. It’s especially needed for patients who also have some form of inflammatory arthritis, a weakened immune system, insulin-dependent diabetes, hemophilia, malnourishment or a previous infection in an artificial joint.
The guidelines for antibiotic premedication can be complex. It’s best, then, to speak with both your orthopedic surgeon and us about whether you should undergo antibiotic therapy before you undergo a dental procedure. The ultimate goal is to reduce the risks of any disease and to keep both your mouth and your body safe from infection.
If you would like more information on the use of antibiotics in dental care, 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 “Premedication for Dental Treatment.”
When you look at the top row of a normal smile, you'll see symmetrical pairs: the central incisors in the middle, flanked by the lateral incisors and the canine (or eye) teeth on the outside of them.
Sometimes, though, teeth may not form as they should: in fact, it's one of the more common congenital defects with one in five people having missing or deformed teeth, often the upper lateral incisors. In the latter case, it's not uncommon for the eye teeth to drift into the missing lateral incisors' spaces next to the central incisors. This creates a smile even a layperson can tell is off.
There is a way to treat this with orthodontics and cosmetic dentistry that will transform that person's smile while restoring better mouth function too. It's often a long process, however, that's best begun early and must be precisely timed with dental development.
Using braces, we move the drifted teeth back to their proper positions, which will make room for a future dental restoration. It's usually best to begin this treatment during late childhood or early adolescence. The next step is to fill the newly-created space with prosthetic (false) teeth.
Dental implants are an ideal choice since they're durable and life-like, and won't require permanent alteration of adjacent teeth. They do, however, require a certain amount of bone volume at the site to support them; if the volume is insufficient we may have to place a bone graft to stimulate new growth.
It's also best not to install implants until the jaw has finished development, usually in the late teens or early adulthood. In the interim between tooth repositioning and implants we can customize a retainer or other removable appliance with a false tooth to occupy the space. This not only enhances the smile, it also prevents the repositioned teeth from drifting back.
These steps toward achieving a new smile take time and sometimes a team of specialists. But all the effort will be rewarded, as a person born without teeth can have a new smile and improved oral health.
If you would like more information on treating dental development deficiencies, 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 “When Permanent Teeth Don't Grow.”
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
One of the most popular subjects in books, magazines and social media is food — the things we should or should not eat (or at least not too much). While losing weight is a popular focus, it's only one part of the whole — a balanced diet that supplies the nutrients we need to be healthy.
What you eat can also make a difference in your oral health. Here are 4 changes you should make to your dietary habits to cut down on the risk of dental disease.
Adopt a nutritionally sound diet plan. When we say diet, we're not talking about the latest weight-loss sensation — we mean a planned way of eating for life. For most people, that's a balanced diet of fresh fruits and vegetables, protein and dairy. Your teeth and gums have the best chance of remaining strong and healthy with a nutrient-rich diet.
Manage your sugar intake. Sugar and similar carbohydrates are a rich food source for bacteria that cause dental disease. It's important then that you keep your sugar consumption within limits: don't eat more than six teaspoons of processed sugar a day (or three for a child); avoid sugary snacks between meals; and try to satisfy your sweet tooth with the natural sugars found in fresh fruits and vegetables.
Cut back on acidic beverages. Sodas, juices, sports and energy drinks are all the rage. They're also high in acid, which at chronic levels can soften and erode tooth enamel. So, try to drink them only at meal times and avoid sipping on them over long periods. And, if you're hydrating yourself after moderate work or exercise, try nature's perfect hydrator — water.
Avoid eating before bedtime. A good portion of the acid in our mouths after we eat can be neutralized by saliva. As we sleep, though, our saliva flow slows down and doesn't have the same buffering power as it does during the day. So, try not to eat as least an hour before you turn in for the night, especially foods with added sugar.
If you would like more information on nutrition and 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 “Nutrition & Oral Health.”
Your diet can play as important a role in your dental health as brushing and flossing. What you eat (particularly sugar) could increase your risk of tooth decay despite your hygiene habits. And vice-versa: a nutritious diet may help boost your preventive efforts even more.
Let’s look at two very different approaches to diet and see how your dental health is likely to fare under each.
A High Sugar/Low Fiber Diet. Modern western diets heavy with processed foods are inundated with two particular types of refined sugars. The first is sucrose, which comes mainly from either beets or sugar cane. Foods (and beverages) may also contain a refined sugar from corn known as high fructose corn syrup. Refined sugars are added for taste to thousands of products like cake, candy, soft drinks or even condiments like catsup. These “free” sugars are easily processed by bacteria into acid. Combine that with fewer fibrous vegetables in the diet and you have a recipe not only for obesity and other health issues, but tooth decay as well.
A High Fiber/Low Sugar Diet. Fruits and vegetables make up a large part of this kind of diet, while added free sugars much less so. That doesn’t make this diet sugar-free: all plant products contain simple sugars produced by photosynthesis. The difference, though, is that these sugars — glucose, fructose and sucrose (natural, not the refined versions) — are more slowly absorbed into the bloodstream during digestion because of the fiber content of fruits and vegetables. You’ll also receive other nutrients like vitamins and minerals necessary for good health. Eating this kind of diet will help decrease the risk of tooth decay.
So there you have it: eat more fresh fruits and vegetables and restrict your intake of processed foods and sweets. You may also want to fine-tune a few items to maximize decay prevention: for example, eat starches in their natural form (whole grains, beans or certain fruits) as much as possible rather than refined or in combination with added sugar (cakes, cookies, etc.). And while fresh fruits with their naturally occurring sugars aren’t a significant factor in tooth decay, dried fruits (especially with added sugar) might.
If you would like more information on proper diets for better 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 “Nutrition & Oral Health.”
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