Dr. Bob's Blog
By Dr. Malenius
December 17, 2020
Category: Dental Procedures
Tags: dental implant  
SmokingCouldIncreasetheRiskofanImplantFailure

Although they can be expensive upfront, dental implants often prove to be a wise investment in the long-term. With a success rate that outperforms other teeth replacement restorations, dental implants could be the answer to a more attractive smile that could last for decades.

But while their success rate is high (95% still functioning after ten years), they can and do occasionally fail. Of those that do, two-thirds happen in patients who smoke.

This unfortunate situation stems from smoking's overall effect on dental health. The nicotine in tobacco constricts oral blood vessels, inhibiting the flow of nutrients and antibodies to the teeth and gums. Inhaled smoke can scald the inside skin of the mouth, thickening its surface layers and damaging salivary glands leading to dry mouth.

These and other effects increase the risk for tooth decay or gum disease, which in turn makes it more likely that a smoker will lose teeth than a non-smoker and require a restoration like dental implants. And blood flow restriction caused by nicotine in turn can complicate the implant process.

Long-term implant durability depends on bone growth around the imbedded implant in the ensuing weeks after implant surgery. Because of their affinity with the titanium used in implants, bone cells readily grow and adhere to the implant. This integration process anchors the implant securely in place. But because of restricted blood flow, the healing process involved in bone integration can be impaired in smokers. Less integration may result in less stability for the implant and its long-term durability.

To increase your chances of a successful implant installation, you should consider quitting smoking and other tobacco products altogether before implant surgery. If that's too difficult, then cease from smoking for at least one week before surgery and two weeks after to better your odds of implant success. And be as meticulous as possible with daily brushing and flossing, as well as regular dental visits, to reduce your risk of disease.

There are many good reasons to quit smoking. If nothing else, do it to improve your dental health.

If you would like more information on tobacco use 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 “Dental Implants & Smoking.”

SupermodelAshleyGrahamsUnpleasantDentalEncounterWithaFrozenCookie

Ashley Graham has a beautiful and valuable smile—an important asset to her bustling career as a plus-size model and television host. But she recently revealed on Instagram a “confrontation” between one of her teeth and a frozen oatmeal cookie. The cookie won.

Holding her hand over her mouth during the video until the last moment, Graham explained how she sneaked a cookie from her mom's freezer and took a bite of the frozen treat. Taking her hand from her mouth, she revealed her broken tooth.

Okay, maybe it wasn't an actual tooth that was broken: the denticle in question appeared to have been previously altered to accommodate a porcelain veneer or crown. But whatever was once there wasn't there anymore.

Although her smile was restored without too much fuss, Graham's experience is still a cautionary tale for anyone with dental work (and kudos to her for being a good sport and sharing it). Although dental work in general is quite durable, it is not immune to damage. Biting down on something hard, even as delicious as one of mom's frozen oatmeal cookies, could run you the risk of popping off a veneer or loosening a crown.

To paraphrase an old saying: Take care of your dental work, and it will take care of you. Don't use your teeth in ways that put your dental work at risk, tempting as it may be given your mouth's mechanical capabilities.

¬†Even so, it's unwise—both for dental work and for natural teeth—to use your teeth and jaws for tasks like cracking nuts or prying open containers. You should also avoid biting into foods or substances with hard textures like ice or a rock-hard cookie from the freezer, especially if you have veneers or other cosmetic improvements.

It's equally important to clean your mouth daily, and undergo professional cleanings at least twice a year. That might not seem so important at first since disease-causing organisms won't infect your dental work's nonliving materials. But infection can wreak havoc on natural tissues like gums, remaining teeth or underlying bone that together often support dental enhancements. Losing that support could lead to losing your dental work.

And it's always a good idea to have dental work, particularly dentures, checked regularly. Conditions in the mouth can change, sometimes without you noticing them, so periodic examinations by a trained dental provider could prevent or treat a problem before it adversely affects your dental work.

We're glad Ashley Graham's trademark smile wasn't permanently harmed by that frozen cookie, and yours probably wouldn't be either in a similar situation. But don't take any chances, and follow these common sense tips for protecting your dental work.

If you would like more information on care and maintenance of cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty as Never Before” and “Dental Implant Maintenance.”

By Dr. Malenius
November 27, 2020
Category: Oral Health
Tags: dental injuries  
ProtectYourChildFromaDevastatingDentalInjury

Parents love watching their kids grow up, from those early wobbly steps to their first solo car drive. Of course, you can expect a few mishaps along the way, most of which won't leave them worse for wear. But some risks are just too hazardous to ignore—including the potential for dental injuries.

Each year, one in ten children suffers a traumatic dental injury, many of which require extensive treatment. That's why during National Child Safety and Prevention Month in November, we're highlighting areas of risk for pediatric dental injuries, and how you can prevent them.

That risk changes depending on a child's stage of development. Teething infants, for example, relieve gum pressure by gnawing on things. Make sure, then, that you have items for teething made of cloth or soft plastic, and keep harder items that could damage their gums and emerging teeth out of reach.

Toddlers learning to walk encounter numerous injury opportunities, like a fall that lands them face first on a hard surface. You can reduce this risk by moving tables and other hard furniture out of your child's travel paths, covering sharp edges with padding, or simply isolating your child from home areas with hard furniture.

Pay attention also during bath time. Wet porcelain is notoriously slippery even for adults, and possibly more so for a child. A sudden slip in the bathtub could cause a mouth injury, so encourage your child not to stand until it's time to get out.

School-aged children face another set of perils to their mouth from outside play. At this stage, your best preventive measure is teaching them to observe play safety: Make sure they know not to aim balls, frisbees or other play items at others' heads, and to be on the lookout for the same. You'll also want them to be safety-minded playing on swings, monkey bars or other playground equipment.

If your older kids take an interest in sports, particularly the contact variety, you'll want to protect them with an athletic mouthguard (and encourage them to wear it during both practice and regular games). You can purchase a mouthguard at any retail or sporting goods store, but the most protective and comfortable to wear are custom-made by a dentist. Although more expensive, they'll still cost less than treatment for a traumatic dental injury.

The wonderful adventure of childhood does have its risks, and some are more serious than others. By following these prevention tips, you can help your child avoid a dental injury that could rob them of a healthy mouth.

If you would like more information about childhood dental concerns, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dentistry and Oral Health for Children” and “An Introduction to Sports Injuries & Dentistry.”

PreventingGumDiseaseCouldHelpMoreThanYourTeethandGums

The top cause for adult tooth loss isn't decay or trauma—it's periodontal (gum) disease. The disease may begin with the gums, but it can ultimately damage underlying bone enough to weaken its support of teeth, causing them to loosen and fall out.

But that's not the end of the havoc gum disease can wreak. The consequences of an uncontrolled infection can ripple beyond the mouth and worsen other health problems like diabetes, heart disease or arthritis.

The common link between gum disease and these other conditions is the inflammatory response, a natural mechanism to fight infection caused by disease or trauma. This mechanism changes blood vessels to increase blood flow to hasten the travel of protective white blood cells to the injury or disease location.

But if this mechanism that supports healing becomes chronic, it can actually do harm. The chronic inflammation that occurs with gum disease can damage mouth structures, just as inflammation from diabetes or arthritis can damage other parts of the body. And any form of chronic inflammation, even that found in gum disease, can worsen other inflammatory diseases.

You can lessen this link between gum disease and other conditions—as well as improve your oral health—by preventing or seeking prompt treatment for any periodontal infection in the following ways:

  • Practice daily brushing and flossing to clear away bacterial dental plaque, the main cause of gum disease;
  • See your dentist regularly for more thorough dental cleanings and checkups;
  • See your dentist promptly if you notice red, swollen or bleeding gums, common signs of a gum infection;
  • Stop smoking to lower your risk for both gum disease and tooth decay;
  • Adopt a healthy diet, which can help you lose weight (a factor in diabetes and other inflammatory diseases) and strengthen your immune system;
  • Manage other inflammatory conditions to lessen their effect on your gum disease risk.

Taking these steps can help you avoid the inflammation caused by gum disease that might also affect the rest your body. Seeking prompt treatment at the first sign of an infection will also minimize the damage to your teeth and gums and the effect it could have on the rest of your health.

If you would like more information on prevention and treatment of 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 “Gum Disease & Systemic Health.”

4TipsToMakeDentalCareEasierforChildrenWithSpecialNeeds

Even the simplest, everyday things can be challenging for a child with special needs. Dental care is no exception.

If you have a child with a chronic condition that affects their physical, intellectual or behavioral abilities, you know how difficult keeping up with dental care practices can be. Here are 4 tips to help make dental care easier and ensure your child has healthy teeth and gums.

Take an active role in hygiene. Depending on their abilities, you may need to take a more active role in daily teeth cleaning. If you have to brush their teeth for them, it's usually easier to have them face you “knee-to-knee.” You can also use a second brush to keep their mouth propped open if they tend to bite or clench down while brushing.

Model behavior. If your child could eventually brush for themselves, it may still be a long training road. It can be an easier task if you make a habit of brushing your teeth together, or have them brush with a sibling. Not only does this allow you to monitor their progress, their learning process may be easier watching another person brush and then mimicking their actions.

Find the right dentist. Many children with special needs are subject to anxiety surrounding healthcare visits, including going to the dentist. Choosing the right dentist, skilled in the technical aspects of treatment for a special needs child and providing a “kid-friendly” environment, can make all the difference in the world. A pediatric dentist is often a good fit for children with chronic conditions.

Coordinate medical and dental care. A special needs child could have underlying health problems that complicate dental care, so keep your dentist well-informed about their overall health. Do likewise with their medical providers, particularly if their condition or treatments impact dental health, as in the case of medications they're taking that could inhibit saliva flow.

Ongoing dental care for a child with a chronic health condition can be difficult. But keeping their teeth and gums healthy is an important part of fostering greater overall health.

If you would like more information on dental care for special needs children, 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 “Managing Tooth Decay in Children With Chronic Diseases.”

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

ProtectYourselfFromGumDiseasefortheHealthofYourMouthANDYourBody

October is National Dental Hygiene Month, when we call attention to the importance of keeping those pearly whites clean. Brushing and flossing, along with regular dental cleanings, protect your teeth and gums from dental disease. It might also lessen the risk or severity of heart disease, arthritis—or even dementia or Alzheimer's disease.

Sound far-fetched? A number of years ago, researchers noticed that people with periodontal (gum) disease were also more prone to systemic conditions like chronic heart and lung diseases, diabetes or rheumatoid arthritis. The common thread: inflammation, the body's response to infection or trauma.

Inflammation in and of itself is a necessary part of the healing process. But if it becomes chronic, as it often does with a gum infection and these other systemic diseases, this defensive response meant to aid healing can instead damage tissues.

We've also learned that inflammation arising from gum disease may worsen inflammation associated with other systemic conditions. It can work the other way as well: If you have an inflammatory disease, your risk for gum disease goes up and any gum infection can be more acute.

What we've learned recently, though, might be even more concerning: Results from a recent study are showing some evidence of a link between gum disease and dementia and decline in cognitive ability. The study, published in the journal Neurology this past July, followed approximately 8,000 Americans for twenty years. Participants came from a variety of locations and demographic subsets, and were on average in their early sixties with no signs of dementia at the beginning of the study.

Of the participants who completed the study, about 19% had developed dementia. Of these participants, those with severe gum disease and tooth loss were slightly more likely to have dementia than subjects with healthy teeth and gums.

At the very least, these studies raise more questions about the connections between oral and general health, calling for further exploration. One thing's for sure, though—healthy teeth and gums play an important role in the overall quality of life and health. The time and effort required for the following are well worth it to maintain a healthy mouth.

  1. Brush and floss your teeth every day without fail;
  2. Visit your dentist at least twice a year for professional cleanings;
  3. Eat a “tooth-friendly” diet low in sugar and rich in vitamins and minerals (especially calcium);
  4. See your dentist as soon as possible if you notice swollen, reddened or bleeding gums.

We all want to stay fit and active throughout our senior years. Taking care of your teeth and gums—especially with daily oral hygiene—is a key part of the formula for a long and happy life.

If you would like more information about the importance of dental hygiene to overall health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “10 Tips for Daily Oral Care at Home.”

HowtoEnsureYourChildsTeethandGumsStayHealthyNowandLater

Being a parent can be a rewarding role. But it's also hard work, especially the effort required in keeping children healthy. In that respect, there's one area you don't want to overlook—their dental health.

Taking care of their teeth and gums has two aspects: their current state of dental health and their ongoing development that impacts future health. Fortunately, you can address both the present and the future by focusing on the following areas.

Prioritizing oral hygiene. From the moment your child is born, you'll want to practice daily oral hygiene to keep their teeth and gums clean of disease-causing bacterial plaque. This starts even before teeth erupt—simply wipe their gums with a clean wet cloth after feeding. As teeth emerge, begin brushing each one with a small amount of toothpaste. Around your child's second birthday, start training them to brush and floss on their own.

Limit their sugar intake. The biggest threat to your child's teeth is tooth decay, which is caused by bacteria. These bacteria multiply when they have plenty of sugar available in the mouth, one of their primary food sources. It's important then to reduce the sugar they eat and limit it to mealtimes if possible. Also avoid sending them to bed with a bottle filled with sweetened liquids, including juices and even formula.

Visit the dentist. You're not in this alone—your dentist is your partner for keeping your child's teeth healthy and developing properly. So, begin regular visits when your child's first teeth appear (no later than their first birthday). You should also consider having your child undergo an orthodontic evaluation around age 6 to make sure their bite is developing properly.

Practice oral safety. Over half the dental injuries in children under 7 occur in home settings around furniture. As your child is learning to walk, be aware of things in your home environment like tables and chairs, or hard objects they can place in their mouths. Take action then to move these items or restrict your child's access to them.

Good habits in each of these areas can make it easier to keep your child's teeth and gums healthy and on the right developmental track. That means good dental health today that could carry on into adulthood.

If you would like more information on children's 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 “Top 10 Oral Health Tips For Children.”





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