Posts for: January, 2019
Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.
Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.
To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.
This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.
To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.
You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.
You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.
Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.
If you would like more information on implant-supported bridges, 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 “Oral Hygiene for Fixed Bridgework.”
Learning you’re pregnant can be a joyous moment. But it also means life is about to change as you focus on protecting you and your child from anything that endangers your health.
Because of these new concerns you might even hesitate about receiving dental care, especially involving anesthesia. But several medical organizations representing doctors, OB-GYN physicians and dentists wholeheartedly recommend continuing regular dental visits during pregnancy.
In fact, you should continue them because you’re pregnant: physical and hormonal changes during pregnancy could increase your risk of dental disease.
For, example, your consumption of carbohydrates (like sugar) could increase, which in turn increases your risk of tooth decay. You’ll also need to be more concerned about dental plaque, a thin bacterial film on your teeth that can cause disease. Hormonal changes during pregnancy may make you more sensitive to plaque, and thus more susceptible to disease — especially periodontal (gum) disease.
In fact, a specific form of gum disease called pregnancy gingivitis affects around 40% of expectant women at some point in their pregnancy. And if you already have gum disease, pregnancy could worsen it. Left untreated the disease could develop into more severe periodontitis, which may significantly damage your teeth’s support structures far below the gum line, leading to bone loss, which could result in the eventual loss of your teeth. Daily brushing and flossing, regular cleanings and checkups and, if your dentist prescribes it, antibacterial mouth rinses can help you stay ahead of it.
But what about other procedures while you’re pregnant? It may be best to wait on elective treatments for cosmetic purposes until after the baby is born. But some situations like deep tooth decay that could require a root canal treatment may become too serious to postpone.
Fortunately, several studies have shown it’s safe for pregnant women to undergo many dental procedures including tooth fillings or extractions. And receiving local anesthesia doesn’t appear to pose a danger either.
The important thing is to remain diligent with your own personal hygiene — brushing and flossing — and making other healthy choices like eating a nutritious diet. And be sure to let your dentist know about your pregnancy to help guide your dental treatment over the next few months.
Office cleanings and other minor procedures are a routine part of regular dental care. For some people, though, a routine visit could put them at slight risk for a serious illness.
The reason for this concern is a condition known as bacteremia. This occurs when bacteria, in this case from the mouth and conceivably during an office cleaning or other routine dental procedure, enters the bloodstream. Although for most people this isn’t a great issue, there’s been concern that bacteremia could further compromise the health of patients with or susceptible to other conditions like endocarditis (heart inflammation), prosthetic joints or compromised immune systems.
This concern grew out of a number of studies in the early 20th Century that seemed to show a link between dental bacteremia and infective endocarditis. At about mid-century it became a common practice to administer antibiotics before dental work (usually 2 grams of amoxicillin or an equivalent about an hour before) to high risk patients as a way of protecting them against infection. The practice later expanded to other health issues, including many heart conditions.
Beginning in 2007, however, guidelines developed jointly by the American Heart Association and the American Dental Association reduced the number of conditions recommended for antibiotic therapy. Based on these guidelines, we now recommend pre-procedure antibiotics if you have a history of infective endocarditis, artificial heart valves, certain repaired congenital heart defects, or heart transplant that develops a subsequent heart valve problem. Patients with prosthetic joints or immune system problems are no longer under the guidelines, but may still undergo antibiotic therapy if believed necessary by their individual physician.
If you have a condition that could qualify for antibiotic therapy, please be sure to discuss it with both your dentist and physician. We’ll work together to ensure any dental work you undergo won’t have an adverse effect on the rest of your health.
If you would like more information on antibiotic therapy and 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 “Antibiotics for Dental Visits.”