Posts for category: Oral Health
The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.
Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.
But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.
The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.
One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.
NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.
Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.
Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.
Here’s the bad news about periodontal (gum) disease: It’s a leading cause for tooth loss. Even worse: Half of adults over 30 will have some form of it during their lifetime.
But here’s the good news: If caught early, we can often treat and stop gum disease before it can do substantial harm to your mouth. And the best news of all—you may be able to avoid a gum infection altogether by adopting a few healthy habits.
Here are 4 habits you can practice to prevent a gum infection from happening.
Practice daily brushing and flossing. Gum disease is a bacterial infection most often arising from dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Removing plaque daily with brushing and flossing will reduce your chances of a gum infection. And be sure it’s daily—missing just a few days is enough for gum inflammation to get started.
Get regular dental cleanings and checkups. Even the most diligent personal hygiene can miss plaque, which may then harden into a calcified form impossible to remove with brushing and flossing called calculus (tartar). At least twice-a-year professional dental cleanings will clear away any remnant plaque and tartar, which can greatly reduce your risk for dental disease.
Make gum-friendly lifestyle changes. Smoking more than doubles your chances of gum disease. Likewise, a sugar-heavy diet, which feeds disease-causing bacteria, also makes you more susceptible to infection. Quitting smoking, cutting back on alcohol consumption and following a dental-friendly diet could boost your teeth and gum health and avoid infection.
Watch for signs of infection. Although you can greatly reduce your risk of gum disease, you can’t always bring that risk to zero. So, be aware of the signs of gum disease: sometimes painful, swollen, reddened or bleeding gums. If you notice any of these signs, make a dental appointment—the sooner you’re diagnosed and begin treatment, the less likely gum disease will ruin your dental health.
The U.S. Centers for Disease Control and Prevention calls it “one of the ten most important public health measures of the 20th Century.” A new vaccine? A cure for a major disease? No—the CDC is referring to the addition of fluoride to drinking water to prevent tooth decay.
Fluoride is a chemical compound found in foods, soil and water. Its presence in the latter, in fact, was key to the discovery of its dental benefits in the early 20th Century. A dentist in Colorado Springs, Colorado, whose natural water sources were abundant with fluoride, noticed his patients' teeth had unusual staining but no tooth decay. Curious, he did some detective work and found fluoride in drinking water to be the common denominator.
By mid-century, fluoride was generally recognized as a cavity fighter. But it also had its critics (still lively today) that believed it might also cause serious health problems. Ongoing studies, however, found that fluoride in tiny amounts—as small as a grain of sand in a gallon of water—had an immense effect strengthening enamel with scant risk to health.
The only condition found caused by excess fluoride is a form of tooth staining called fluorosis (like those in Colorado Springs). Fluorosis doesn't harm the teeth and is at worst a cosmetic problem. And it can be avoided by regulating the amount of ingested fluoride to just enough for effectively preventing tooth decay.
As researchers have continued to learn more about fluoride, we've fine-tuned what that amount should be. The U.S. Public Health Service (PHS), which sets standards for fluoride in drinking water, now recommends to utilities that fluoridate water to do so at a ratio of 0.7 mg of fluoride to 1 liter of water. This miniscule amount is even lower than previous recommendations.
The bottom line: Fluoride can have an immense impact on your family's dental health—and it doesn't take much. Excessive amounts, though, can lead to dental staining, so it's prudent to monitor your intake. That means speaking with your dentist about the prevalence of fluoride in your area (including your drinking water) and whether you need to take measures to reduce (or expand) your use of it.
If you would like more information on how best fluoride benefits your family's 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.”
Vitamins play a key role in your body’s health, including your teeth and gums. A vitamin-deficient diet is an invitation to all sorts of disease.
But what are vitamins? Although they differ individually in what effect they have on the body, they’re all organic compounds found in foods, especially fruits and vegetables. Each in a different way helps with bodily processes.
Vitamin C, for example, helps the body repair tissue. Without it, tissue breaks down easier, as British sailors discovered centuries ago on long sea voyages. Deprived of vitamin C in their diets they soon encountered health issues like bleeding gums. Eating limes — chock full of vitamin C—helped to clear up such problems (and also why they were called “limeys”).
Scientists have discovered thirteen vitamins, four of which—A, D, E and K—are soluble (dissolvable) in fat; the body stores these in the liver and fat tissue where they issue out into the body slowly. The rest—C and eight types of B vitamin—are soluble in water. Unlike the fat-soluble vitamins, these are used quickly and any remaining are excreted from the body.
When it comes to teeth, gums and the mouth, a rich assortment of vitamins helps maintain good oral health. For the teeth especially, vitamin D plays a critical role—it helps the body absorb the mineral calcium necessary for strong bones and teeth. You’ll find this vitamin plentiful in dairy products, but also fatty fish like salmon and tuna.
While vitamins occur naturally in foods, they can be manufactured in the form of dietary supplements. Unfortunately, the world of dietary supplements is a murky one, ungoverned by the restrictions and clinical trials that drugs undergo before they go to market. And, it’s big business: vitamin supplements are promoted as “insurance” for good health.
But while some people have conditions that may require a vitamin supplement, research has shown that most of us can effectively get our vitamins through a diet rich in fresh fruits and vegetables. So, do your teeth and gums (as well as the rest of your body) a favor—eat your fruits and veggies. Along with daily brushing and flossing, getting enough vitamins can go a long way toward keeping your mouth healthy and disease-free.
If you would like more information on nutrition and 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 “Vitamins & Dietary Supplements: What Every Consumer Should Know.”
It’s common for kids to be less than enthusiastic about visiting the dentist. For some, though, it’s even more of a challenge: A child with extreme anxiety and fear during dental visits could interfere with them receiving the dental care they need. The impact could even extend into adulthood.
Recognizing the need to reduce this high anxiety, dentistry has used a number of pharmacological tools for many years that relax a child during dental care. Sedatives have often been the only choice for reducing anxiety, especially during extensive procedures and treatments. But now there’s a promising new approach in dentistry that doesn’t depend on drugs.
Cognitive behavioral therapy (CBT), a psychotherapeutic method used for decades to treat depression, phobias and eating disorders, has been investigated recently as a possible approach for relieving children’s dental anxiety. During CBT, trained therapists use specific behavioral techniques to help patients develop mental and emotional strategies for dealing with stress.
During the usual course of CBT therapy, a therapist meets in counseling sessions with patients weekly over several months to help them change their routine thinking or behavior surrounding a stressful issue. Initially, the therapist guides the patient toward understanding the underlying causes for their negative reaction to the issue. They then work with the patient to devise an objective way to test whether those emotions and beliefs about the issue are true.
Using this effective method for changing behavioral and emotional responses for dental anxiety has had encouraging results from initial research. One study found CBT successfully reduced dental anxiety among a majority of a group of European children ages 9 through 16 who participated in the method.
CBT isn’t an overnight cure, often requires a number of months to achieve results. But for children who suffer from extreme fear of professional dental care, this drug-free method may provide long-term benefits that extend well past their childhood years.