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Posts for: March, 2015

By Central Florida Cosmetic & Family Dentistry
March 26, 2015
Category: Oral Health
Tags: tooth decay  
AssessingandTreatingyourRiskforToothDecaycanPreventFutureOccurrences

For years the main approach to treating tooth decay (or caries) could best be described as “drill and fill” — remove the decayed tooth material and fill the resulting cavity. But a new approach has come to prominence that addresses not only the results of decay, but seeks to identify and treat the underlying conditions that caused the decay in the first place, and may continue to infect other teeth.

This approach is known as Caries Management By Risk Assessment or CAMBRA. Rather than a “One Size Fits All” approach, CAMBRA individualizes treatment and prevention options by first assessing your own individual risk for tooth decay.

We base this assessment on what might be called the Caries Balance. On one side are factors that increase your risk of tooth decay, easily remembered by the acronym BAD: Bad bacteria that produces acid; Absence of healthy, functional saliva that neutralizes the effects of acid; and Dietary habits that are heavy with sugars, acids and between meal snacking. On the other side are protective factors that reduce your risk, known as SAFESaliva and sealants that protect the surfaces of teeth; Antimicrobials that help rid the mouth of bad bacteria; Fluoride, which strengthens teeth against de-mineralization caused by acid; and an Effective diet.

The assessment first involves a survey of questions about your hygiene habits, dental history and lifestyle: Do you brush twice and floss once daily? Do you live in a fluoridated area or use fluoride mouth rinse? Do you smoke? Have you had frequent cavities in the past? These and other questions, along with a complete dental exam and acid level testing, can give us a more accurate understanding of your risk and how best to incorporate treatment that reduces it even further.

Using CAMBRA, you and our dental team develop a true partnership that actually transforms your dental health from simply treating existing caries, to preventing future occurrences.

If you would like more information on the CAMBRA approach to caries prevention, 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 “Tooth Decay: How to assess your risk.”


By Central Florida Cosmetic & Family Dentistry
March 18, 2015
Category: Dental Procedures
UnderstandingTheFactorsThatCanInfluenceDentalImplantSuccess

Dental implants traditionally have a high success rate with numerous studies showing long-term success rates of over 95%. This is just one of the reasons they have been widely accepted as the best method for permanently replacing missing teeth. In fact, over-dentures, which are full dentures supported and stabilized by at least two dental implants, are now considered the standard of care by the American Dental Association (ADA) for people who have lost all of their teeth in one or both jaws. And while they have a high success rate, there are some factors that can compromise the success rates of implants.

These factors are generally divided into three categories: general health concerns, local factors, and maintenance issues.

  • General health concerns: Your general health, lifestyle, and habits can play a major role in the success of dental implants. For example, smoking, diabetes, osteoporosis (porous bone) or a compromised immune (resistance) system can all negatively impact implant healing and success. And if you have a history of radiation treatment to your jawbones, you are at a higher risk for complications.
  • Local factors: Some examples of local factors that can affect implant success include bone quality and quantity — having sufficient bone in the right place to accurately secure and locate the implants.
  • Maintenance issues: While implants are excellent high tech replacements for missing permanent teeth, they do require routine maintenance. This includes daily cleaning and continued professional care. Otherwise, implants are just like any other technically sophisticated devices — they may be susceptible to breakdown.

To learn more about dental implants, read “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.


By Central Florida Cosmetic & Family Dentistry
March 10, 2015
Category: Uncategorized
Tags: dental exam  
CouldADentalCheckupSaveYourLife

Most everyone knows that going to see your dentist for regular checkups and cleanings can help save your smile — but did you ever stop to think that it just might save your life?

That's what recently happened to 11-year-old Journee Woodard of Edmond, Oklahoma. The young girl was having a routine teeth cleaning when hygienist Rachel Stroble noticed something unusual: The whites of her eyes (her sclera) had a distinctly yellow tint. Dr. Michael Chandler, Journee’s dentist, confirmed the hygienist’s suspicions, and advised her mom to take her for further testing. The tests revealed that Journee had a tumor covering parts of her pancreas, gallbladder and liver; it could have ruptured at any moment, with devastating consequences.

The tumor was removed three days later in a 9-hour operation, and Journee is now recovering. As for her dentist, Dr. Chandler told reporters that he and his staff were just doing their jobs thoroughly. “It's hard to feel like I’m a hero,” he said (though others might disagree).

Is this a one-in-a-million case? Maybe — yet for many people, a family dentist may be the health care professional who is seen more often than any other. That can put dentists in the unique position of being able to closely monitor not only a person’s oral health, but also their overall health.

There are several reasons why that’s so. One is that most systemic diseases (such as diabetes, leukemia, and heart disease, for example) can have oral manifestations — that is, symptoms that show up in the mouth. If your dentist notices something unusual, further testing may be recommended. Dentists also regularly screen for diseases specific to the mouth — such as oral cancer, which has a much better chance of being cured when it is caught at an early stage.

But beyond checking for particular diseases, dentists often notice other things that may indicate a health issue. For example, if you complain of dry mouth or snoring, and appear fatigued in the dental chair, your dentist may suspect undiagnosed sleep apnea: a potentially serious condition. Many other signs — such as yellowed eyes, a pounding heart rate, or shortness of breath — can indicate potential problems.

Of course, we’re not even mentioning the main reason for regular dental checkups — keeping your smile healthy and bright; for many people that’s reason enough. How does Journee’s mom feel about keeping dental appointments? “I will never miss another dentist appointment,” she told reporters. “I will never reschedule.”

If you would like more information about routine dental checkups, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine articles “The Dental Hygiene Visit” and “Good Oral Health Leads to Better Health Overall.”


By Central Florida Cosmetic & Family Dentistry
March 02, 2015
Category: Oral Health
EatingDisordersMayContributetoDamagedTeethandGums

While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.

Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.

It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.

Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.

Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.

The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.

If you would like more information on the effect of eating disorders on 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 article “Bulimia, Anorexia & Oral Health.”