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Posts for: November, 2014

CertainTreatmentsforOsteoporosisCouldComplicateOralSurgery

Although periodontal (gum) disease is the most common cause of bone loss in the mouth, women at or past menopause face another condition that could cause complications with their oral bone health — osteoporosis.

While normal bone goes through a balanced cycle of resorption (the dissolving of bone tissue) and re-growth, osteoporosis, a hormone-induced disease, tips the scale toward resorption. This reduces bone density, which weakens the bone and makes them more susceptible to fracture.

Some studies have shown a link between osteoporosis and existing gum disease; however, the greater concern at present from an oral health standpoint regards the side effects of a certain class of drugs called bisphosphonates used in the treatment of osteoporosis. Bisphosphonates slow excessive bone resorption, which helps restore normal balance to the bone growth cycle.

Some long-term users of bisphosphonates, however, may develop a complication in their jaw bone known as osteonecrosis in which isolated areas of the bone lose vitality and die. This can complicate certain types of oral surgery, particularly to install dental implants (which rely on stable bone for a successful outcome). While research is still ongoing, it does appear individuals at the highest risk of osteonecrosis are those with underlying cancers who receive high-dose intravenous bisphosphonate treatment every month for an extended period of time.

It’s important then that you let us know before any dental procedure if you’ve been diagnosed with osteoporosis and what treatment you’re receiving for it. If you’ve been taking a bisphosphonate for an extended period of time, we may recommend that you stop that treatment for three months (if possible) before undergoing oral surgery. While your risk of complications from osteonecrosis is relatively small, adding this extra precaution will further reduce that risk and help ensure a successful outcome for your scheduled dental procedure.

If you would like more information on osteoporosis and oral 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 articles “Osteoporosis & Dental Implants” and “Good Oral Health Leads to Better Health Overall.”


By Pari J. Moazed, DDS
November 10, 2014
Category: Oral Health
HowDesignerNateBerkusGotaHeadStartonaGreatSmile

When it comes to dental health, you might say celebrity interior designer and television host Nate Berkus is lucky: Unlike many TV personalities, he didn't need cosmetic dental work to achieve — or maintain — his superstar smile. How did he manage that? Nate credits the preventive dental treatments he received as a youngster.

“I'm grateful for having been given fluoride treatments and sealants as a child. Healthy habits should start at a young age,” he told an interviewer from Dear Doctor magazine. We couldn't have said it better — but let's take a moment and examine exactly what these treatments do.

Fluoride treatment — that is, the topical (surface) application of a concentrated fluoride gel to a child's teeth — is a procedure that's often recommended by pediatric dentists. Although tooth enamel is among the hardest substances in nature, fluoride has been shown to make it more resistant to tooth decay. And that means fewer cavities! Studies show that even if you brush regularly and live in an area with fluoridated water, your child could still benefit from the powerful protection of fluoride treatments given at the dental office.

Another potent defense against cavities is dental sealants. Despite your child's best efforts with the toothbrush, it's still possible for decay bacteria to remain in the “pits and fissures” of the teeth — those areas of the molars, for example, which have tiny serrated ridges and valleys where it's easy for bacteria to grow. Dental sealants fill in and protect vulnerable areas from bacterial attack, greatly decreasing the risk that future dental treatment will be required.

Why not take a tip from our favorite celebrity interior designer, and ask about cavity-preventing treatments for your children's teeth? If you would like more information about fluoride treatments or dental sealants, please contact us for a consultation. You can learn more in the Dear Doctor magazine articles “Topical Fluoride” and “Sealants for Children.”


NewGuidelinesIssuedforAdministeringAntibioticsBeforeaDentalProcedure

One of the possible side effects of dental work is the introduction of oral bacteria into the bloodstream, a condition known as bacteremia. Although not unusual — it can also occur when you eat or brush your teeth — bacteremia could trigger a dangerous infection for some patients.

For many years, we in the dental profession have taken extra precautions with two such categories of patients: those with congenital (“at birth”) heart conditions who are more susceptible to infective endocarditis, a life-threatening infection of the heart lining or heart valves; and patients who’ve undergone joint replacements and are at a higher risk of developing blood-borne infections at the replacement site. It’s been a standard practice for many years to administer antibiotics to patients in these two categories sometime before they undergo a dental procedure as a way of curtailing the effects of any resulting bacteremia.

Recently, however, the guidelines for antibiotic pretreatment for dental work have changed as two major medical associations have revised their recommendations on the procedure. The American Heart Association (AHA) now recommends dentists administer antibiotic pretreatment only to heart patients with a history of endocarditis, artificial valves or repairs with artificial material, heart transplants with abnormal heart valve function and other similar conditions.

Likewise after a series of joint studies with the American Dental Association on infections in dental patients with orthopedic implants, the American Academy of Orthopedic Surgeons no longer recommends pretreatment for artificial joint patients. It’s now left to the dentist and patient to determine whether antibiotics before a procedure is appropriate based on the patient’s medical history. For example, premedication may still be prudent for joint replacement patients with compromised immune systems caused by systemic illnesses like cancer or diabetes.

Although the guidelines have narrowed, it’s still important for you tell us about any heart condition you may have, or if you’ve undergone any type of joint replacement therapy. It’s also advisable for you to discuss with your primary doctor how your condition might be impacted by any proposed or scheduled dental procedure. Our aim is to always minimize any risk to your overall health as we treat your dental needs.

If you would like more information on antibiotic treatment before dental procedures, please contact us or schedule an appointment for a consultation.