Tag Archives: Teeth Cleaning

Osteoporosis and Bisphosphonates – Bone Loss is Not Your Only Concern

Oral health is not commonly found in the forefront of everyone’s mind when we think of osteoporosis. For those at risk for osteoporosis, it should be something you not only discuss with your doctor but your dentist as well. Loss of bone in the mouth leads to loss of teeth, which makes it more difficult to properly nourish your body. There are many treatments used to address osteoporosis, but some such as Bisphosphonates severely impact you mouth. Bisphosphonates, such as Fosamax, Boniva, Actonel, and Reclast place a person at risk of developing osteonecrosis of the jaw which means a person’s gum tissue is not fully covering the bone leaving it exposed to the oral environment. This condition is difficult to treat, so if you need to be placed on Bisphosphonate treatment it would be best to see your dentist beforehand to make sure there are not any compromised teeth or teeth that need to be removed. The trauma associated with tooth extraction combined with use of bisphosphonates can lead you down the path of non-vital bone. While the exact cause is unknown, it is thought to be due to possible infection, the jaw’s limited ability to repair itself, or decreased vascularity of the jaw. Bisphosphonates reduce your bone’s ability to turn over so the constant production of bone reduces the blood supply due to the increased bone density. Recently it has been noted that use of bisphosphonates may increase a person’s risk of dental implant failure. A study conducted at the New York College of Dentistry found that women with dental implant failure were about 3 time more likely if they were taking oral bisphosphonates. Managing osteoporosis is a team effort and you should be seen by your dentist on a regular basis to preserve your oral health.

For More Information:

Implant failure may be related to bisphosphonate use

Osteonecrosis of the Jaw (ONJ)

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Weight Loss Could be Good for Your Oral Health

Those of you that have a resolution to lose weight, you will be benefiting your oral health as well. Check it out! http://goo.gl/MDnzt

Your Health is a Team Effort: Know When to Premed.

We no longer live in a time where your health can be effectively managed by a single physician, like in the days of house calls. You are the world’s leading expert on your health history and it needs to be shared equally amongst physicians and dentists.  Conditions affecting your entire health affect your oral health and vice versa.  It is imperative that you keep track of the information and advice your primary care physician, your dentist, and any specialists give you, so medical risks are not over looked. It has happened on countless occasions, a patient is seated in the operatory, the health history is updated as no changes, and in conversation it comes up that the patient has recently had a surgery or been in the hospital. In many cases you just need to wait a recommended period of time before you see your dentist or dental hygienist to avoid complications. When it comes to joint replacements and cardiac health an importance of premedication comes to light. The standard protocol for premedication for an appointment with your dentist or dental hygienist is two grams of amoxicillin one hour before your dental visit.  This may vary depending on your conditions.  If you are unaware of your need for premedication and show up to your teeth cleaning without premedicating you will need to be reappointed due to your risk of infection. We all have busy lives, if we can avoid these situations you won’t need to ask for more time off from work. We all would much rather spend time away from work with family or doing something fun instead of going to the dentist. Communication between your physician and dentist will help keep your free time free. The American Heart Association and the American Academy of Orthopedic Surgeons periodically reevaluate the risk if infection, the risk of antibiotic resistance, and the risks to patients while they strive for the safest recommendation. The recommendations are constantly changing and it is important to keep in touch with both your physician and dentist.

 American Academy of Orthopedic Surgeons Recommendation for Premedication

In 2009 the American Academy of Orthopedic Surgeons released a statement noting the risk of infection and the great expense for total joint replacement redo’s and that it is up to the clinical judgment of the physician for premedication. We went from a standard that recommended premedication for 2 years after a total joint replacement, to a recommendation of premedication for life before appointments with your dental hygienist or dentist. According to the American Dental Association website the AAOS is involving the ADA in evaluation of evidence based research before their next recommendation for premedication, which should be released in 2011.

 American Heart Association Recommendation for Premedication

In 2007 the American Heart Association changed their recommendations for premedication to:

  • Artificial heart valves
  • A history of infective endocarditis
  • A cardiac transplant that develops a heart valve problem
  • Congenital heart disease.
    • The congenital heart conditions consist of unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits, a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure, and any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device.

 If you have any questions consult your dentist or physician following your condition.

For more info also check out:

American Dental Association

So you think, “It’s Just a Teeth Cleaning”

Gum Disease only effects your mouth???
Research into the relationship between oral health and systemic disease is currently uncovering greater and more diverse connections between the afflictions of the human body and maladies of the mouth. Papers are constantly being published noting connection between oral health and systemic health including the oral precursors to variety of cancers ie, throat and pancreatic cancers. The presence of certain bacteria in saliva and dental plaque, has been linked to chronic pancreatitis the precurser to pancreatic cancer in otherwise normal patients. It has been noted that dental care received by women in the early menopause may be able to reduce their risk of heart disease and other disease symptoms such as burning mouth syndrome. Periodontal disease has been linked to an increased risk of upper respiratory infections and poor cardiovascular health. We are moving from a time where people thought that their mouth was separate from the rest of their body to a time where our dental health is a window into our overall health. The conclusion: the level of health of our bodies can be assessed by examining the health of our mouths. It is not just a teeth cleaning, it is the beginning therapy to a healthy vital body and mind.

Need for a Dental Hygienist
There are many nooks and crannies in our mouth that can be difficult to keep clean with regular brushing and flossing. As a result dental plaque builds up around teeth. Over time the calcium in our saliva will mix with the multiple layers of dental plaque and form dental calculus (tartar). As dental calculus builds up, it not only provides a surface to collect more bacteria that can weaken teeth and lead to decay, but it creates a constant irritation, both chemical and physical, to the gum tissue and leads to gum disease. When a person has a teeth cleaning any dental calculus that has built up is removed and the teeth are polished. Having smooth polished teeth will reduce your vulnerability to gum disease and benefit your overall health and quality of life. How frequently a person requires a thorough teeth cleaning relates to their severity of gum disease.

Progression of Gum Disease from Gingivitis to Periodontal Disease
Leaving dental plaque along the gum line causes the gums to become red and inflamed which is the first stage of gum disease (gingivitis). This inflammation is your body’s best effort to fight oral bacteria. When dental plaque is not effectively removed it becomes fixed to the teeth as dental calculus, it can only be completely removed by a professional such as a dental hygienist or a dentist. Swelling of your gums will get to the point that your tooth brush will not reach far enough below the gum line allowing the dental calculus continue down your root. Left untreated the gingivitis will progress to periodontal disease. Periodontal disease begins when inflammation catalyzes the break down of the bone and ligaments supporting the teeth. A routine teeth cleaning by your dental hygienist is not effective at this point, you require a deep cleaning (scaling and root planing) to return your mouth to health (severe disease may require more extensive treatment). A routine maintenance performed by your dental hygienist or dentist needs to be set up to avoid a progression in periodontal disease. A dentist or dental hygienist, when seen regularly, can spot the warning signs of medical issues to come. It is not just a teeth cleaning, it is the beginning therapy to a healthy vital body and mind.

More information can be found at:                                                           Medical News Today & Inside Dentistry