Posts for tag: oral health
Say “bacteria,” especially in the same sentence with “disease” or “infection,” and you may trigger an immediate stampede for the hand sanitizer. The last thing most people want is to come in contact with these “menacing” microorganisms.
If that describes you, however, you’re too late. If you’re of adult age, there are already 100 trillion of these single-celled organisms in and on your body, outnumbering your own cells 10 to 1. But don’t panic: Of these 10,000-plus species only a handful can cause you harm—most are either harmless or beneficial, including in your mouth.
Thanks to recent research, we know quite a bit about the different kinds of bacteria in the mouth and what they’re doing. We’ve also learned that the mouth’s microbiome (the interactive environment of microscopic organisms in a particular location) develops over time, especially during our formative years. New mothers, for example, pass on hundreds of beneficial species of bacteria to their babies via their breast milk.
As our exposure to different bacteria grows, our immune system is also developing—not only fighting bacteria that pose a threat, but also learning to recognize benevolent species. All these factors over time result in a sophisticated, interrelated bacterial environment unique to every individual.
Of course, it isn’t all sweetness and light in this microscopic world. The few harmful oral bacteria, especially those that trigger tooth decay or periodontal (gum) disease, can cause enormous, irreparable damage to the teeth and gums. It’s our goal as dentists to treat these diseases and, when necessary, fight against harmful microorganisms with antibacterial agents and antibiotics.
But our growing knowledge of this “secret world” of bacteria is now influencing how we approach dental treatment. A generalized application of antibiotics, for example, could harm beneficial bacteria as well as harmful ones. In trying to do good we may run the risk of disrupting the mouth’s microbiome balance—with adverse results on a patient’s long-term oral health.
The treatment strategies of the future will take this into account. While stopping dental disease will remain the top priority, the treatments of the future will seek to do it without harming the delicate balance of the mouth’s microbiome.
If you would like more information on the role of bacteria in 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 “New Research Show Bacteria Essential to Health.”
In our constant battle against infectious disease, the “enemy” is often too close for comfort: hospitals and other medical facilities must be ever vigilant against opportunistic infections their patients may contract while in their care.
Dental offices are no exception. Because even the simplest procedure — a dental cleaning, for example — may result in exposure, providers and patients alike face a possible health risk. We must be especially concerned with blood-borne viral infections — spread by person to person contact through blood — the most serious being hepatitis B and C, and HIV/AIDS.
Hepatitis is a viral inflammatory disease that disrupts the critical functions of the liver, particularly as it cleanses and regulates the blood, and cause serious bodily impairment or death. The virus can be transmitted when the blood from an infected person makes its way into the bloodstream of another person, mainly through cuts or a needle injection. Human immunodeficiency virus (HIV) can lead to the chronic condition AIDS that destroys the body’s immune system; it spreads mainly through sexual contact, as well as through person to person blood contact.
The best defense against the spread of these diseases in dental offices or other healthcare settings is to eliminate as much as possible any opportunity for blood-to-blood contact. To accomplish this, all healthcare providers, including dentists, are mandated by federal, state and local authorities to incorporate and follow routine safety precautions. The U.S. Center for Disease Control and Prevention (CDC) issues regularly updated comprehensive guidelines for protocols and procedures to disinfect and sterilize equipment and facilities.
We dentists and our clinical staffs are also mandated by state licensing boards to refresh our knowledge of infection control procedures through continuing education. Such procedures cover every aspect of infection control, from barrier protection — by way of gloves, masks or gowns — to instrument disinfection.
Protecting patients as well as providers from the spread of infection is one of our profession’s highest standards. As a result, incidents of infection among the 170,000 practicing dentists in the United States are rare. You can be assured, then, that we’re taking every precaution to keep you and your family safe from disease when you visit our office.
If you would like more information on dental office procedures to prevent the spread of infection, 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.”
Enamel — that tough, outermost tooth layer — protects your teeth from all sorts of hazards, from bacterial attack to temperature extremes. But although the hardest substance in the human body, enamel has a mortal enemy — acid. High acid levels can cause the minerals in enamel to dissolve, a process called de-mineralization. And although saliva can neutralize these levels in approximately 45-60 minutes and restore some of the enamel’s lost minerals, a constant acidic environment can overwhelm this natural mechanism.
That’s why you should be careful with the amount and frequency of acidic foods and drinks like citrus fruits or coffee. You should be especially concerned about your intake of sodas, energy drinks or sports drinks. The latter in particular are designed to replace fluids and nutrients during intense exercise or sports events, but are often consumed as a regular beverage. And all these drinks mentioned are often sipped on throughout the day, resulting in a constant wash of acid in your mouth that can interrupt the protective response of saliva.
There’s one other source for high mouth acidity that comes not from outside the body but from within. GERD — Gastro Esophageal Reflux Disease — is a condition in which digestive acid refluxes (flows back) into the esophagus. While chronic acid reflux can damage the lining of the esophagus and lead to ulcers or even cancer, it may also pose a danger to teeth if the acid regularly rises into the mouth. Individuals encountering this will know it by the awful, acrid taste of vomit in their mouth.
To reduce the chances of high mouth acid due to food intake, limit the consumption of acidic foods and beverages to meal times and sports drink consumption to strenuous exercise or sporting events. Better yet, consider the greatest hydrator of all, water — with a neutral pH of 7.
If you’re experiencing chronic heartburn or other GERD symptoms, make an appointment to see your primary care doctor or a gastroenterologist as soon as possible. Many treatments are effective and will not only improve your general health but may also help preserve your tooth enamel.
If you would like more information on the effect of acid in the mouth and how to reduce it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Dentistry & Oral Health for Children” and “GERD — Gastro Esophageal Reflux Disease.”
Sometimes dental conditions point to health problems beyond the teeth and gums. An astute dentist may even be able to discern that a person’s oral problems actually arise from issues with their emotional well-being.Â In fact, a visit to the dentist could uncover the presence of two of the most prominent eating disorders, bulimia nervosa or anorexia nervosa.
Here are 3 signs dentists look for that may indicate an eating disorder.
Dental Erosion. Ninety percent of patients with bulimia and twenty percent with anorexia have some form of enamel erosion. This occurs because stomach acid — which can soften and erode enamel — enters the mouth during self-induced vomiting (purging), a prominent behavior with bulimics and somewhat with anorexics. This erosion looks different from other causes because the tongue rests against the back of the bottom teeth during vomiting, shielding them from much of the stomach acid. As a result, erosion is usually more severe on the upper front teeth, particularly on the tongue side and biting edges.
Enlarged Salivary Glands. A person induces vomiting during purging by using their fingers or other objects. This irritates soft tissues in the back of the throat like the salivary glands and causes them to swell. A dentist or hygienist may notice redness on the inside of the throat or puffiness on the outside of the face just below the ears.
Over-Aggressive Brushing. Bulimics are acutely aware of their appearance and often practice diligent hygiene habits. This includes brushing the teeth, especially after a purging episode. In doing so they may become too aggressive and, coupled with brushing right after purging when the minerals in enamel are softened, cause even greater erosion.
Uncovering a family member’s eating disorder can be stressful for all involved. In the long run, it’s best to seek out professional help and guidance — a good place to start is the National Eating Disorders Association (www.nationaleatingdisorders.org). While you’re seeking help, you can also minimize dental damage by encouraging the person to rinse with water (or a little baking soda) after purging to neutralize any acid in the mouth, as well as avoid brushing for an hour.
If you would like more information on the effect of eating disorders on 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 “Bulimia, Anorexia & Oral Health.”
Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.
First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.
At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:
- An artificial heart valve, or a heart valve repaired with artificial material
- A history of endocarditis
- A heart transplant with abnormal heart valve function
- Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
- A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
- Repaired congenital heart disease with residual defects, such as leakage or abnormal flow
In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.
The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.