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Posts for: May, 2019

IfYouvehadJointReplacementyoumayNeedAntibioticsBeforeDentalWork

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.”


KeepingupGoodHygieneStillaNecessitywithDentalImplants

Dental implants are widely considered the most durable tooth replacement option, thanks in part to how they attach to the jaw. But durable doesn't mean indestructible — you must take care of them.

Implants have a unique relationship to the jawbone compared to other restorations. We imbed a slender titanium post into the bone as a substitute for a natural tooth root. Because bone has a special affinity with the metal, it grows to and adheres to the implant to create a secure anchor. This unique attachment gives implants quite an advantage over other restorations.

It isn't superior, however, to the natural attachment of real teeth, especially in one respect: it can't match a natural attachment's infection-fighting ability. A connective tissue attachment made up of collagen fibers are attached to the tooth root protecting the underlying bone. An elastic gum tissue called the periodontal ligament lies between the tooth root and the bone and attaches to both with tiny collagen fibers. These attachments create a network of blood vessels that supply nutrients and infection-fighting agents to the bone and surrounding gum tissue.

Implants don't have this connective tissue or ligament attachment or its benefits. Of course, the implants are made of inorganic material that can't be damaged by bacterial infection. However, the gums and bone that surround them are: and because these natural tissues don't have these same biologic barriers to infection and perhaps access to the same degree of antibodies as those around natural teeth, an infection known as peri-implantitis specific to implants can develop and progress.

It's therefore just as important for you to continue brushing and flossing to remove bacterial plaque that causes infection to protect the gums and bone around your implants. You should also keep up regular office cleanings and checkups. In fact, we take special care with implants when cleaning them by using instruments that won't scratch their highly polished surfaces. Such a scratch, even a microscopic one, could attract and harbor bacteria.

There's no doubt dental implants are an excellent long-term solution for restoring your smile and mouth function. You can help extend that longevity by caring for them just as if they're your natural teeth.

If you would like more information on caring for dental implants, 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 “Dental Implant Maintenance.”


DisclosingAgentsShowPlaqueYouveMissedWhenBrushingandFlossing

Removing plaque, a bacterial film that builds up on teeth, daily is crucial in preventing dental disease, but is your brushing and flossing making enough of a difference?

Plaque forms every day in our mouths as a result of eating. The bacteria in it produce acid, which can erode tooth enamel and cause tooth decay. Certain strains can also infect the gums and cause periodontal (gum) disease. Either of these primary diseases could lead to tooth loss.

Daily plaque removal with brushing and flossing keeps bacteria growth under control, so a quick swish of your toothbrush across your teeth won't be enough. Plaque's soft, sticky consistency enables it to hide in hard to reach places below the gum line, irregular biting surfaces, or in fillings or other dental work.

Because it's virtually invisible, it's hard to tell if you've successfully removed it. That's where disclosing agents can help. These are solutions, swabs or tablets with a dye that temporarily stains plaque while not staining tooth surfaces. Dental hygienists use them to show patients where they're missing plaque when brushing and flossing, but you can also use them at home to see how you're doing between dental visits.

After brushing and flossing, use the disclosure product according to the package directions. If you're using a solution, for example, swish it around in your mouth for about thirty seconds and then spit it out. The dye reacts with leftover plaque to stain it a bright color. Some products even offer a two-tone dye that displays older plaque in a different color from newer plaque.

After noticing the dyed plaque in a mirror, brush and floss until you don't see it anymore. You may have to change your approach, which will help you perform better in the future. Although safe in the mouth, you should still avoid swallowing the agent or getting it on your clothes. Any on your lips, gums or tongue will eventually wear off in a few hours.

A disclosing agent gives you a snapshot of where you need to improve your oral hygiene. Occasional “spot checks” will help keep your brushing and flossing well tuned.

If you would like more information on how to perform effective oral hygiene, please contact us or schedule an appointment for a consultation.