Posts for category: Oral Health
Proponents of legalized marijuana have won phenomenal gains over the last decade. Despite the federal government's continuing criminalization of the drug, several states including California, Colorado and Massachusetts, have voted to legalize its recreational use.
Most people are aware of the social and political controversies the marijuana legalization movement stirs. But there's another side to this roiling issue: the health effects of marijuana, particularly for your teeth and gums. What may be lost beneath the more exciting headlines about ballot initiatives is the growing evidence that habitual marijuana use may increase the risk and severity of periodontal (gum) disease.
Gum disease is a bacterial infection caused by dental plaque, a thin film of bacteria and food particles that accumulates on teeth. The spreading infection triggers inflammation, a normal bodily response to disease that's ordinarily beneficial. But if the inflammation becomes chronic it weakens the gums' attachment to the teeth. This can create voids or periodontal pockets of infection around the teeth. The disease can eventually damage the underlying bone, which could accelerate tooth loss.
Poor oral hygiene is the biggest factor for an increased risk of gum disease; thinner gum tissue (an inherited condition or related to poor tooth position) is another factor, as well as lifestyle habits like tobacco use or excessive alcohol consumption. Add marijuana to the list: there's now some evidence that its use increases the risk for more severe periodontal pockets if the disease occurs.
In a recent study, researchers with the Columbia University College of Dental Medicine reviewed statistics on the care for nearly 2,000 adult patients; a quarter of those in the study were frequent marijuana users. The marijuana users proportionately had deeper periodontal pocket occurrences than the rest of the patients in the study that didn't use the drug.
The study doesn't say that marijuana causes periodontal (gum) disease. But it does suggest that marijuana use might increase its severity. As with other substances and practices in our society, marijuana use comes with a caveat: it may be legal where you live, but it may not necessarily be good for your health.
If you would like more information on the effects of marijuana use on 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 “As More States Legalize Marijuana, Link to Gum Disease is a Concern.”
Controlling discomfort during dental work is one of our top priorities. Advances in anesthesia over the last century have made that objective easier to attain, especially for routine procedures.
The term anesthesia means “without feeling or pain.” It refers to the use of substances to prevent a patient’s nervous system from sensing pain. There are two basic types: general, through intravenous injection (IV) or gas inhalation that places a patient in an unconscious state; and local, which only affects the part of the body involved in the procedure while the patient remains conscious.
The latter type has become very important in dentistry, especially for mild to moderate procedures. Because teeth and gum tissues are rich in nerves, patients can have a heightened level of sensitivity that can increase anxiety and discomfort during dental work. Local anesthesia reduces that discomfort and relaxes both patient and dental provider.
We typically administer local anesthesia in two ways: by applying the anesthetic to the outside tissue surface (with a cotton swab, patch or spray) or by injection. The first type, topical anesthesia, is most often used to eliminate the pricking discomfort of the needle used to inject the main anesthetic. Using both applications eliminates any painful sensation at all — the only thing you might feel is a slight pressure during the procedure.
As mentioned before, local anesthesia benefits us as well as you. Knowing you’re at ease and comfortable allows us to better focus on the procedure — we’re not rushed to finish to spare you further discomfort. A relaxed, unhurried atmosphere is essential to a successful outcome for any dental procedure.
We’ve also found solutions for another issue with local anesthesia that concerns patients: the length of time the numbing effect lingers after a procedure. In response, the dental profession has developed different types of anesthesia that reduce this after effect considerably. We’re also more selective about what procedures actually require anesthesia — some, like routine teeth cleaning or work on the outer enamel (which doesn’t contain nerves), can usually be performed without it.
All in all, local anesthesia reduces your level of discomfort and increases our ability to be thorough in performing your dental work. You’ll not only find the experience more pleasant, but it will also enhance the quality of your care.
If you would like more information on alleviating pain and discomfort during dental work, 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 “Local Anesthesia for Pain-Free Dentistry.”
In the battle against tooth decay, fluoride is an important weapon. Since the discovery of its dental health benefits a century ago, fluoride has been credited with saving countless teeth.
But over its history in dental care, this natural-occurring chemical has also had its share of controversy with concerns raised from time to time on potential health dangers. These run the gamut from “conspiracy theory” speculations to credible research like a 2006 National Research Council study that suggested a possible increased risk of bone fracture or cancer from over-consumption of fluoride.
Even so, there is actually little evidence or even record of incidence for such dire consequences. The only definitive health effect from fluoride found after decades of copious research is a condition called fluorosis, a permanent staining effect on the teeth. Fluorosis poses a cosmetic problem but does not harm the health of the teeth.
Moderation in fluoride use seems to be the key to gaining its health benefits while avoiding fluorosis. One influential fluoride researcher, Dr. Steven Levy, estimates 0.05-0.07 milligrams of fluoride per one kilogram of body weight (about a tenth the weight of a grain of salt for every two pounds) is sufficient to gain the optimum dental benefit from fluoride.
The real question then is whether your family’s current consumption of fluoride is within this range. That will depend on a number of factors, including whether your local water utility adds fluoride to your drinking water supply and how much. You may also be ingesting fluoride through processed foods, juices and even some bottled waters. And you can encounter fluoride in dental care including toothpastes and clinical treatments.
One way to moderate your family’s fluoride intake is to be sure all your family members are using the correct amount of fluoride toothpaste for their age while brushing. Infants need only a slight smear on the end of the brush, while older children can brush adequately with just a pea-sized amount. For other tips and advice, talk to your dentist about your family’s fluoride intake and how you might adjust it.
Even with the possibility of fluorosis, fluoride still provides an incredible benefit in preventing tooth decay. By understanding fluoride and keeping your intake within normal ranges you can maximize its benefit for healthier teeth and minimize the fluorosis risk.
If you would like more information on the role of fluoride in dental 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 “Fluoride & Fluoridation in Dentistry.”
Periodontal (gum) disease is a serious infection that can damage more than periodontal tissues — supporting bone structure is also at risk. Any bone loss could eventually lead to tooth loss.
To stop it from causing this kind of damage, we must match this disease's aggressiveness with equally aggressive treatment. The various treatment techniques all have the same goal: to remove bacterial plaque, the source of the infection, from all oral surfaces, including below the gum line. Buildup of plaque, a thin film of food particles, after only a few days without adequate brushing and flossing is enough time to trigger gum disease.
The basic removal technique is called scaling, using hand instruments called scalers to manually remove plaque and calculus (hardened plaque deposits) above or just below the gum line. If the disease or infection has advanced to the roots, we may use another technique called root planing in which we shave or “plane” plaque and tartar from the root surfaces.
Advancing gum disease also causes a number of complex problems like abscesses (localized infections in certain areas of gum tissue) or periodontal pockets. In the latter circumstance the slight normal gap between tooth and gums becomes deeper as the tissues weaken and pull away. This forms a void or pocket that fills with inflammation or infection that must be removed. Plaque buildup can also occur around furcations, the places where a tooth's roots divide off from one another.
It may be necessary in these more complex situations to perform a procedure known as flap surgery to gain access to these infected areas. As the name implies, we create an opening in the gums with a hinge, much like the flap of a paper envelope. Once the accessed area has been cleansed of plaque and infected tissues (and often treated with antibiotics to stop further infection), the flapped tissue is closed back in place and sutured.
To avoid these advanced stages it's important for you to see us at the first sign of problems: swollen, red or bleeding gums. Even more important is to reduce your risk for gum disease in the first place with dedicated daily brushing and flossing to remove plaque and regular dental visits for more thorough cleaning.
Gum disease can be devastating to your long-term dental health. But with diligent hygiene and early aggressive treatment you can stop this destructive disease in its tracks.
If you would like more information on treating gum disease, 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 Difficult Areas of Periodontal Disease.”
Like other healthcare providers, your dentist keeps records of your ongoing care. These include not only their written notes but also x-ray imaging, frequency of visits and cleanings, and any medical information that could affect your care. What’s more, they have a legal obligation to maintain these records.
Your dental records help guide decisions about your care. In that regard, you should consider something else—you may need to change providers: your dentist retires or you move; your dentist isn’t in your new insurance network; or, unfortunately, you have an “irreconcilable” difference with your provider.
If that happens, it’s very important your dental records find their way to your new provider. Here are 3 reasons why.
Your individual dental history. Each person’s dental situation and needs are unique. Your past records help clue in your new dentist about your past history and current needs, which will help guide how they treat you.
Time and money. Your dental records contain x-rays or other diagnostic information about your oral condition, including preparations for any upcoming dental work. If you change dentists before completing that treatment, your new dentist may have to start over with new diagnostic tests if they don’t have this previous data. It could cost you more money and make you wait longer for a needed procedure.
Coordinating dental care with your general health. Your mouth isn’t isolated from the rest of your body, and some dental treatment measures could affect other health conditions (and vice-versa). If your new dentist knows other health issues you may have from your previous records, it can help ensure you’re getting dental treatment appropriate to your overall health.
For the most streamlined transition between providers, it’s important your dental records follow you. You’re entitled to having those records transferred, and, if you’re uncomfortable asking yourself, your new provider can obtain them for you. Just be sure to ask.
If you would like more information on your rights regarding your dental care records, 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 “Why Your Dental Records Should Follow You.”