The Link to Heart Disease

The Link to Heart Disease

Poor dental hygiene (lack of brushing and flossing) can lead to other health problems not related to the mouth, including problems associated with the heart. Inflammation, which is the human body’s natural response to irritation, injury, or infection of tissue, has been shown to be a is a major risk factor for heart disease. While inflammation is meant to have a protective effect, untreated chronic inflammation can lead to more severe health complications. Both periodontal disease (severe, chronic gum disease) and cardiovascular disease are inflammatory diseases, and inflammation is the common factor that connects these two disease states.

Medical research is now showing that periodontal disease may increase the inflammation level throughout the body. Since several studies have shown that patients with periodontal disease have an increased risk for cardiovascular disease, the American Academy of Periodontology (AAP) and The American Journal of Cardiology ® have developed clinical recommendations for periodontists (dental specialist with training in diagnosing, preventing and treating gum disease), dentists, cardiologists, and internists.

This is why it is so important to practice good oral hygiene at home, including a twice daily routine of brushing and once daily regimen of flossing. By sustaining this habit of cleaning at home, you will keep the level of harmful bacteria low, thereby reducing the level of infection and resulting inflammation.

Antibiotic Prophylaxis

Prophylaxis is the prevention of an ‘occurrence’; For example, dental prophylaxis consists of removing plaque and cleaning the teeth to prevent cavities and gum disease.

Antibiotic prophylaxis is used in order to prevent the occurrence of bacterial infection from spreading from the mouth to the rest of the body, particularly during a dental cleaning or invasive procedure. It is possible for bacteria to move from the mouth via the very thin lining of the gum tissue that forms a collar all the way around a tooth (the sulcus; or base of the pocket around a tooth). Scanning electron microscope studies have found this lining to be only a single cell layer thick, therefore easily penetrated by bacteria.

The two general categories of patients requiring antibiotic prophylaxis are 1) those who must take the protective measure of an antibiotic in order to prevent bacteria from moving from the mouth to other vital organs. These are people that either have certain cardiovascular conditions (e.g. weakened heart valves) or who have a compromised immune system, and 2) those who receive it to prevent a severe local infection as a complication of a procedure, e.g. complicated wisdom tooth removal.

All of our patients with any heart condition or weakened immune system are strongly advised to inform us before undergoing any dental procedures in our office. We will assess your condition, and if necessary, confer with any attending physician(s) that you may have, in order to determine if you require antibiotics before any procedure.

Selecting a Toothbrush

Selecting a Toothbrush

There are so many different types of toothbrushes in the marketplace that it can be a difficult choice to know what is best. Our office considers any toothbrush that that provides you both a good tool for removal of plaque, plus is safe for the gums (soft bristles) as being best for your oral health.

When it comes to choosing between a manual or electric toothbrush, both can effectively and thoroughly clean your teeth, so it really becomes a matter of personal preference and manual dexterity.

Children may enjoy brushing with a powered toothbrush. Persons who have difficulty using a non-powered toothbrush due to issues of manual dexterity (eg. arthritis) may find a powered toothbrush more comfortable and easier to use.

Whether you decide on manual or powered, choose a toothbrush that you like and find easy to use, one which has soft bristles so as not to damage the gums, and make sure to brush twice a day to thoroughly clean all the surfaces of your teeth of the plaque.

Sensitive Teeth

Sensitive Teeth

If you wince with pain after sipping a hot cup of coffee or chewing a piece of ice, chances are that you suffer from “dentin hypersensitivity”, or more commonly, sensitive teeth.

Hot and cold temperature changes cause your teeth to expand and contract. Over time, your teeth can develop microscopic cracks that allow these sensations to seep through to the nerves. Exposed areas of the tooth can cause pain and even affect or change your eating, drinking and breathing habits.

At least 45 million adults in the United States suffer at some time from sensitive teeth.

Sensitive teeth result when the underlying layer of your teeth (the dentin) becomes exposed. This can happen on the chewing surface of the tooth as well as at the gum line. In some cases, sensitive teeth are the result of gum disease, years of unconsciously clenching or grinding your teeth, or improper or too vigorous brushing (if the bristles of your toothbrush are pointing in multiple directions, you’re brushing too hard).

Abrasive toothpastes are sometimes the culprit of sensitive teeth. Ingredients found in some whitening toothpastes that lighten and/or remove certain stains from enamel, and sodium pyrophosphate, the key ingredient in tartar-control toothpastes, may increase tooth sensitivity.

In some cases, desensitizing toothpaste, sealants, desensitizing ionization and filling materials including fluoride, and decreasing the intake of acid-containing foods can alleviate some of the pain associated with sensitive teeth.

Sometimes, a sensitive tooth may be confused by a patient for a cavity or abscess that is not yet visible.

In any case, contact our office if you notice any change in your teeth’s sensitivity to temperature.

Snoring/Sleep Apnea

Snoring/Sleep Apnea

IS SNORING KEEPING YOU AWAKE?

Did you Know?
24% of men and 18% of women suffer from snoring.
60% of men and 40% of women over the age of 60 snore (female snoring increases after menopause).

Loudness of snoring may reach as high as 90db (85db is considered hazardous noise by The Workers’ Compensation Board!)

Stanford University sleep researchers found that 75-80% of the patients they see are diagnosed with obstructive sleep apnea.

A CAA official stated that as much as 50,000 auto accidents happen in Canada as a result of sleepy drivers. Many of which suffer from obstructive sleep apnea.

What is obstructive sleep apnea?

With Obstructive Sleep Apnea, muscles of the soft palate at the base of the tongue and the uvula (the small conical, fleshy tissue hanging from the palate) relax and sag, obstructing the airway, making breathing laboured and noisy snorting). Collapse of the airway walls blocks breathing entirely. When breathing periodically stops, a listener hears the snoring broken by pauses. As pressure to breath builds muscles of the diaphragm work harder. Sleep is then temporarily interrupted, sometimes only for seconds. This, in turn, activates throat muscles and “uncorks” the airway.

The effort is akin to slurping a drink through a straw that is stuck in a lump of ice cream. A listener hears deep gasping as breathing starts. With each gasp, the sleeper awakens, but so briefly and incompletely that he or she does not remember doing so in the morning. Someone with obstructive sleep apnea may stop breathing for ten seconds or more…dozens, even hundreds of times each night, thus resulting in daytime sleepiness.

Symptoms Of OSA

There are many symptoms that could indicate obstructive sleep apnea. These symptoms listed here are only a partial representation and should not be the only criteria used to diagnose OSA:

Clouded intellect
Short term memory impairment
Morning headaches
Generalized muscle pain
Irritability Mood swings
Impaired judgment
Decreased sex drive
What can your dentist do to help?
The good news is that Oral Appliance Therapy has proven to be very successful in the management of snoring and mild to moderate obstructive sleep apnea. A dental appliance is a small plastic device, similar to an orthodontic retainer, or an athletic mouthguard. It is worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway. Dentists with training in dental appliance therapy can prescribe these special appliances to meet their patients individual situations and conditions.

Scaling and Root Planing

Scaling and Root Planing

Some cases of acute periodontal (gum) disease that do not respond to more conventional treatment and self-care such as flossing may require a special kind of cleaning called scaling and root planing.

The procedure begins with administration of a local anesthetic to reduce any discomfort. Then, a small instrument called a “scaler,” or an ultrasonic cleaner, is used to clean beneath your gum line to remove plaque and tartar.

The root surfaces on the tooth are then planed and smoothed. This lets the gum tissue heal and reattach itself to the tooth.

Sealants

Sealants

What are Sealants?
The premolar and molar teeth are the largest teeth in the mouth. They have a larger surface area and have several grooves and pits on the chewing surface. These grooves can be deep and are a prime place for plaque and acid to build up and cause cavities. It is for this reason that many dentists will suggest applying sealants, especially on young children. A sealant is a coating that is applied to the chewing surface of the teeth creating a smooth surface to act as a barricade protecting it from decay.

Applying a sealant is a quick and easy procedure. It does not involve any anesthetic. After the teeth are cleaned, a chemical liquid is applied to the tooth. This will etch the tooth surface making it feel a little rough. After a few seconds the etching solution is rinsed away. The etching allows the sealant to bond with the tooth. The sealant is then applied in a liquid form and a light is applied to the surface of the tooth to speed up the hardening process. Sealants can be reapplied every 5 to 10 years. Sealants are very effective in preventing decay and in some cases can prevent additional damage where decay has already begun.

Seniors and Oral Health

Seniors and Oral Health

More and more people are avoiding the need for dentures as they grow older, going against the notion that false teeth are a normal part of growing older.

In fact, there’s usually no reason for you NOT to keep your teeth your entire life, providing you maintain a healthy balanced diet and practice good oral hygiene.

Another desirable side effect of good oral hygiene: avoiding more serious problems such as hypertension, cardiovascular disease, diabetes, and even stroke. Indeed, medical research is beginning to show that a healthy mouth equates to a healthy body and a longer life.

Dexterity and Arthritis

People who suffer from arthritis or other problems of dexterity may find it difficult and painful to practice good oral hygiene.

Thankfully, industry has responded with ergonomically designed devices such as toothbrushes and floss holders that make it easier to grasp and control.

You can also use items around the house to help you. Inserting the handle of your toothbrush into a small rubber ball, or extending the handle by attaching a small piece of plastic or Popsicle stick may also do the trick.

Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers.

Repair of Fractured Teeth

Repair of Fractured Teeth

What is a crown?

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.

Crowns are typically used to restore a tooth’s function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.
Procedures
A tooth must usually be reduced in size to accommodate a crown. A cast is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.

Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
Caring For Your Crowns
With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.

Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

Plaque

Plaque

Plaque is a film of bacteria that forms on your teeth and gums after eating foods that produce acids. These foods may include carbohydrates (starches and sugars), such as candy and cookies, and starchy foods such as bread, crackers, and cereal.

Tooth decay leads to cavities and occurs when plaque remains on your teeth for an extended period of time, allowing the bacteria to ‘eat away’ at the surfaces of your teeth and gums. Ironically, the areas surrounding restored portions of teeth (where fillings, or amalgams have been placed) are particularly vulnerable to decay and are a breeding ground for bacteria.

Plaque can lead to gum irritation, soreness, and redness. Sometimes, your gums may begin to bleed as a result of plaque. This gradual degeneration can often cause gums to pull away from teeth. This condition is called receding gums.

Long-term plaque can lead to serious problems. Sometimes, the bacteria can form pockets of disease around tooth structures, eventually destroying the bone beneath the tooth.

Prevention Tips for Children

Prevention Tips for Children

Infants
The first dental appointment for children should be after the child turns 6 months of age and before their first birthday. The reason for such an early appointment is because the primary (first) teeth should have started to erupt and this is the time to detect anything of concern. Some of the issues that could cause problems are thumb sucking and baby bottle tooth decay.

Thumb-Sucking

Children find comfort from sucking a thumb, finger or a pacifier. This is normal. However, if the infant or child is doing this often, it can cause malformed teeth and an irregular bite pattern.

Thumb sucking engages powerful muscles that can alter the shape of the palate. This, in turn, can effect the position of the teeth and lips. If the child continues to suck their thumb or fingers after the four anterior teeth have erupted, conditions can worsen and it may require surgery to be corrected.

It is recommended that if by 4 years of age a child is still sucking their thumb or fingers you should seek the advise of your dental professional.

Baby bottle tooth decay
Baby bottle decay is caused by sugars found in breast milk, formula and in juices. Natural sugars found in milk and 100% fruit juice will have the same effect as refined sugar on the teeth. When an infant drinks from their bottle, the bacteria in their mouth will mix with the sugars from the drink. This mixture creates a mild acid that will attack the enamel of their teeth and form cavities. We can control this damage by managing how much sugar is given to the infant and controlling how long it stays there. Children that go to bed with a bottle of milk or juice are at an increased risk of decay. The sugars will pool in their saliva and have all night to work on destroying the outer layer (enamel) of the teeth. It is also risky to give a child juice between meals as this is just a continuos coating of sugar on the teeth throughout the day. In order to avoid baby bottle tooth decay, do not allow a baby to nurse on a bottle of milk or juice before going to sleep. Water is also the best choice to give between meals. Do not dip pacifiers into sweet substances and, as early as possible, teach your child to drink from a cup. Baby bottle tooth decay can interfere with the proper formation of the permanent teeth if it is left untreated.

Teething
Babies can begin teething as early as three to four months of age. This is a period where the teeth begin to sequentially erupt. The pain that children feel varies. Some babies can become irritable while others donʼt seem to be bothered at all. Symptoms of teething are swollen gums, drooling, crankiness, difficulty sleeping, and loss of appetite. You can help to alleviate some of the symptoms of teething by gently massaging your childʼs gums with a clean finger, a small cool spoon or a wet gauze pad. A teething ring may also help. The ADA (American Dental Association) and CDA (Canadian Dental Association) also report that if your child shows rashes, diarrhea and/or fever call your physician. These are NOT normal symptoms of teething.

Primary and Permanent Teeth
Most children at three years of age have 20 ʻprimaryʼ teeth. These teeth eventually get replaced by permanent teeth by the time the child turns 12 years of age. Somewhere between the age of 17-31, the 4 permanent molars, also known as wisdom teeth, may emerge.

It is very important that a childʼs primary teeth are kept healthy because they will determine the placement for the permanent teeth. If the primary teeth become diseased or do not properly erupt it can alter the growth pattern for the permanent teeth, leading to over crowding.

Brushing

Cleaning your baby’s mouth before teeth erupt
It is important to start cleaning a childʼs mouth before they even have any teeth. This is essential for two reasons. It develops a habit of keeping the mouth clean. Provides a clean and healthy environment for the primary teeth to erupt. The idea is to wipe all the gums. Firstly, with the baby in a comfortable lying position, make sure you can see clearly into the babies mouth. With a clean damp washcloth over your finger, wipe the babies gums. You can also buy special infant toothbrushes that fit right over your finger. Do not use toothpaste as the baby may swallow it. Once the teeth have grown through the gums you can clean the teeth with a child size, soft bristled toothbrush and a pea size amount of toothpaste. It is important to teach the child to spit out the paste when finished. It is recommended to avoid toothpastes containing fluoride on children under the age of two.

Proper technique for brushing your childʼs primary teeth
Use a soft bristled toothbrush with rounded edges. Make sure the toothbrush allows you to reach all the way to the back of the mouth. Hold your toothbrush at a 45 degree angle to your teeth. The bristles of the brush should be directed towards the gum line. Brush all three surfaces of the teeth, the chewing surface, the cheek side, and the tongue side. Brushing your teeth should take a minimum of 2 minutes to complete. Most people will miss the same spots repeatedly. To avoid this, change up your usual brushing pattern. The Canadian Dental Association and the American Dental Association recommend that you replace your toothbrush every three months.

Toothaches

Toothaches can be common in young children. Sometimes, toothaches are caused by erupting teeth, but they also could indicate a serious problem.

You can safely relieve a small child’s toothache without the aid of medication by rinsing the mouth with a solution of warm water and table salt. If the pain doesn’t subside, acetaminophen may be used. If such medications don’t help, contact your dentist immediately.

Fluoride
Fluoride is a mineral found in food and most drinking water systems. Fluoride is important to our oral health because it makes our teeth more resistant to decay. If your drinking water does not have acceptable levels of fluoride there are supplements that your dentist could recommend. A fluoride toothpaste sometimes is not enough. Too much fluoride can also pose a problem. Dental fluorosis, a condition that can affect the look of the tooth is the result when too high an amount of fluoride is ingested in early childhood.

Toothaches
Young children often experience a toothache. This could be a result of erupting teeth. You can help to relieve a childʼs toothache by rinsing the mouth with a solution of warm water and table salt. If there is no relief using this solution you can also give acetaminophen.

If the Acetaminophen does not alleviate the pain, there could be a more serious condition and you should contact the dentist immediately.

Injuries
Most children who have a trauma to their mouth, jaws and teeth are due to accidental play, whether it is playing or sport or by putting foreign objects in their mouth. In order to prevent injury to the jaw, teeth, lips and gums it is strongly recommended that during playtime children are adequately supervised and that children wear mouth guards while participating in sports. Mouth Guards are small and fit securely around the childʼs teeth and prevent injury to the whole mouth. Childrenʼs mouth guards are small and when first inserted into the mouth they mold to the childʼs teeth. In the case of a tooth that is avulsed (knocked out), hold the tooth by the crown and try to re-implant it into the mouth. Never touch the tooth by the root. Then bite on a clean cloth or gauze to hold the tooth in place and go directly to your dental office. If the tooth cannot be put back into the socket, submerge the tooth in saline, cold milk or the victims own saliva and go to the dental office. This is an emergency visit and you should not have to wait long to be seen. The longer you wait, the less likely it is that the tooth can be re-implanted into the socket. When there is an injury in your mouth make sure you rinse your mouth to remove any blood or particles. In order to control the swelling, place a cold cloth or cold compress on the cheek near the injury site. If the tooth is fractured, do a warm water rinse and apply a cold pack or compress. The cold pack along with Ibuprofen will help to control the swelling.

To repair a fractured tooth the dentist will first determine if the fracture is minor or severe and if the nerve is exposed or damaged. In less severe cases, it could be as simple as just adding some filling material to restore the look of the tooth and smooth out any sharp edges. In a severe case the dentist will have to decide if the tooth can be saved. If a child has a primary (baby) tooth that is loose it is often just a case of the roots dissolving as the permanent teeth come in. These teeth usually come out on their own or when a child bites into something hard, such as an apple. If the tooth is very loose you can encourage the child to wiggle it until is falls out. Never yank the tooth as it may break and become infected. If the primary tooth is loose due to injury, apply a cold compress to the mouth and gums to lessen the pain and swelling. Contact your dentist immediately. The dentist will have to take an x-ray to determine the extent of the damage. Braces and retainers can sometimes cause irritation. Placing a small piece of orthodontic wax, gauze or cotton over the wire tip can provide relief. If a piece of the retainer or braces is stuck into the soft tissue, do not detach it yourself. Contact the dental office immediately.

Sealants
The premolar and molar teeth are the largest teeth in the mouth. They have a larger surface area and have several grooves and pits on the chewing surface. These grooves can be deep and are a prime place for plaque and acid to build up and cause cavities. It is for this reason that many dentists will suggest applying sealants, especially on young children. A sealant is a coating that is applied to the chewing surface of the teeth creating a smooth surface to act as a barricade protecting it from decay.