A couple of years ago the Associated Press published an article claiming the health benefits of flossing remained unproven. The article cited a number of studies that seemed to conclude the evidence for the effectiveness of flossing in helping to prevent dental disease as “weak.”
As you can imagine, dental providers were a bit chagrined while flossers everywhere threw away their dental floss and happily declared their independence from their least favorite hygiene task. It would have seemed the Age of Flossing had gone the way of the dinosaurs.
But, the demise of flossing may have been greatly exaggerated. A new study from the University of North Carolina seems to contradict the findings cited in the AP article. This more recent study looked at dental patients in two groups—those who flossed and those who didn’t—during two periods of five and ten years respectively. The new study found conclusively that the flosser group on average had a lower risk of tooth loss than the non-flossers.
While this is an important finding, it may not completely put the issue to rest. But assuming it does, let’s get to the real issue with flossing: a lot of people don’t like it, for various reasons. It can be time-consuming; it can be messy; and, depending on a person’s physical dexterity, difficult to perform.
On the latter, there are some things you can do to make it a less difficult task. You can use a floss threader, a device that makes it easier to thread the floss through the teeth. You can also switch to an oral irrigator or “water flosser,” a pump device that sprays a fine, pressurized stream of water to break up plaque between teeth and flush most of it away. We can also give you tips and training for flossing with just your fingers and thread.
But whatever you do, don’t give up the habit. It may not be your most favorite hygiene task but most dentists agree it can help keep your teeth healthy for the long-term.
With their durability, versatility and life-likeness, there’s no doubt dental implants have revolutionized teeth replacement. If you’re considering dental implants, however, there are some issues that could impact how and when you receive implants, or if you should consider another type of restoration.
Cost. Dental implants are initially more expensive than other tooth restorations, especially for multiple tooth replacement. However, be sure you consider the projected cost over the long-term, not just installation costs. Because of their durability, implants can last decades with little maintenance cost. In the long run, you may actually pay more for dental care with other types of restorations.
Bone health. Dental implants depend on a certain amount of bone to properly situate them for the best crown placement. If you’ve experienced extensive bone loss, however, there may not be enough to support the implant. This can often be overcome with grafting — immediately after extraction, at the time of implantation or a few months before implantation — to encourage bone growth. In some cases, though, bone loss may be so extensive you may need to consider an alternative restoration.
Gum Health. While implants themselves are impervious to infection, they’re supported by gum and bone tissues that can be affected. Infected tissues around an implant could eventually detach and lead to implant failure. If you have periodontal (gum) disease, we must first bring it under control and render your gums infection-free before installing implants. It’s also important to maintain effective oral hygiene and regular dental cleanings and checkups for optimum implant health.
Complications from osteoporosis. People with osteoporosis — in which the bones lose bone density and are more prone to fracture — are often treated with drugs known as bisphosphonates. In less than 1% of cases of long-term use, a patient may develop osteonecrosis in which the bone in the jaw may lose its vitality and die. As with bone loss, this condition could make implant placement difficult or impractical. Most dentists recommend stopping treatment of bisphosphonates for about three months before implant surgery.
If you have any of these issues or other complications with your oral health, be sure to discuss those with us before considering dental implants. With proper planning and care, most of these difficulties can be overcome for a successful outcome.
If you would like more information on pre-existing conditions that may affect 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 articles “Osteoporosis & Dental Implants” and “Infections around Implants.”
The next time you visit your dentist you might see an item quite different from the other dental instruments and equipment in the office: a blood pressure cuff. Checking blood pressure is becoming a more common occurrence in dental offices across the country.
Abnormal blood pressure and some of the medications used to treat it are often a factor in some dental procedures, particularly if anesthesia is involved. But your dentist may also check your blood pressure for another reason: dental visits represent another avenue to screen for this condition that increases the risk of serious health problems.
Undiagnosed high blood pressure is a prevalent but often “silent” problem because the early stages of the condition may not display any symptoms. Many people first become aware they have an issue only after a blood pressure check at their family doctor, pharmacy or a health fair, for example. Otherwise, they could go months, even years without this vital knowledge about their health.
But while people may only visit their doctor once a year (or less) many see their dentist much more often, even twice a year, for routine cleanings and checkups. Including blood pressure screenings as a routine part of dental treatment could alert patients to a potential issue much earlier than their next doctor’s visit.
In fact, one study published in the Journal of the American Dental Association looked at a group of dental patients with no reported heart disease risk and who had not seen a doctor in the twelve months before their dental visit. During their visit their blood pressure was checked. Of those then referred to a physician for an abnormal reading, 17% learned for the first time they had an increased risk of cardiovascular disease.
It’s estimated about 80 million Americans have some form of cardiovascular disease and many don’t even know it. Diagnosing and controlling high blood pressure is a key factor in treating these life-threatening conditions. And many dentists are joining the fight by making this simple screening method a part of their dental care services.
If you would like more information on blood pressure screening, 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 “Monitoring Blood Pressure: What you don't know can hurt you.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
Unlike other tooth replacement options, dental implants require a surgical procedure. But don't let your imagination run wild — the procedure is relatively minor and easy for most people to undergo.
Implants are unique among restorations because they replace a tooth's root. A metal titanium post, substituting for the root, must be surgically placed into the jawbone. While the procedure itself is simple and no more involved than a tooth extraction, it does require careful attention to detail before, during and afterward.
Our first step is to examine the target site with x-rays (often CT scanning) to pinpoint the best location for placement. This is critical because where we place the implant will have a huge bearing on how attractive and natural the implant finally appears. From this evaluation we frequently create a surgical guide.
Surgery begins with a local anesthesia to completely numb the site. You will feel no pain during the procedure and only minimal discomfort for a few days afterward. We then make small incisions in the gums to access the bone and create a small channel or hole.
Using the surgical guide, we then initiate a drilling sequence that gradually increases the size of the channel until it's the size and shape of the implant post. One thing we must do at this point is take our time: we use gentle pressure and water-cooling to avoid overheating and damaging the bone.
Once we're finished with drilling we remove the implant from its sterile packaging and imbed it directly into the prepared channel. It's then a matter of verifying the location with x-rays and then closing the gum tissue with self-absorbing sutures if necessary.
Most patients only need mild pain medication like aspirin or ibuprofen to manage discomfort afterwards. You won't even notice it in a week or less. After several weeks in which the bone grows and adheres to the implant (a process called osseointegration), you'll be ready for the final step, attaching the life-like porcelain crown to the implant.
Although the process can take several weeks to months, your discomfort should be minimal at any stage. In the end, your patience will be rewarded with a new, more attractive smile.
If you would like more information on the process of obtaining 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 Surgery.”
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