Posts for: August, 2014
When you’re trying to maintain a good oral hygiene routine, your toothbrush is bound to see a lot of action. Day in and day out, it gets used about twice a day, every day — morning and night, whether you’re feeling great or under the weather, in a hurry or not. And it's stored in the bathroom: a moist environment with the potential for exposure to plenty of bacteria (and not just the ones that live in your mouth). So after all of that service, does your toothbrush itself need any particular care or cleaning — and do you need to worry about getting sick from brushing?
Let’s answer the last question first. It’s very unlikely that you can re-infect yourself with an illness (a cold, for example) from using your own toothbrush. That’s because once you’ve been infected, the antibodies that are built up in response to the invading germs will generally prevent you from getting the same disease for some time afterward. Using someone else’s toothbrush, however, is a never a good idea — especially if they are sick (whether they show any symptoms or not), and doubly so if the bristles are still wet. It’s very possible to transfer all kinds of bacteria — even the bacteria that cause tooth decay — from person to person this way.
Can bacteria really survive for any length of time on your toothbrush? The short answer is yes, as they can (and do) live almost everywhere. But for people in a normal state of health, there’s no real reason to worry: Through long exposure, your body is generally quite capable of defending itself from these microorganisms. The American Dental Association states, “[T]here is insufficient clinical evidence to support that bacterial growth on toothbrushes will lead to specific adverse oral or systemic health effects.”
However, if you or a family member have a compromised immune system (due to radiation treatment, chemotherapy or disease, for example), it might make sense to take some precautions. Using an antibacterial mouthrinse before you brush can reduce the amount of bacteria in your mouth — and on your toothbrush. Washing the brush afterward with an antimicrobial cleaner or sanitizer can also decrease the level of bacteria that remains on the toothbrush.
For everyone else, it’s best to follow a few common-sense steps for toothbrush care: Rinse your brush with tap water after you use it, to remove any remaining toothpaste and debris; store it upright, where it can air-dry before it’s used again (not in a closed container, where bacteria can thrive); and get a new brush every three months. Your toothbrush is a major weapon in the fight against tooth decay — keeping it in good shape will help you maintain a healthy mouth and a healthy body.
If you have questions about toothbrushing or oral hygiene care, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine article “Oral Hygiene Behavior.”
Tooth preservation is the ultimate aim of a root canal treatment. But how long should you expect a treated tooth to last? The answer will depend on a few different variables.
A root canal treatment is necessary when a tooth’s pulp — the inner tissue made of nerves, blood vessels and connective tissues — becomes infected with disease. As the pulp dies, the infection spreads into the adjacent bone; this can eventually lead to loss of the tooth.
To stop this process, we enter the tooth and remove all of the pulp, disinfect the pulp chamber and the root canals, and then fill the chamber and canals. Depending on the type of tooth and level of decay, we seal the tooth with a filling or install a crown to prevent re-infection. it’s then quite possible for a treated tooth to survive for years, decades, or even a lifetime.
There are a number of factors, though, that may affect its actual longevity. A primary one depends on how early in the disease you receive the root canal treatment. Tooth survival rates are much better if the infection hasn’t spread into the bone. The earlier you’re treated, the better the possible outcome.
Tooth survival also depends on how well and thorough the root canal is performed. It’s imperative to remove diseased tissue and disinfect the interior spaces, followed by filling and sealing. In a related matter, not all teeth are equal in form or function. Front teeth, used primarily for cutting and incurring less chewing force, typically have a single root and are much easier to treat than back teeth. Back teeth, by contrast, have multiple roots and so more root canals to access and treat. A front tooth may not require a crown, but a back tooth invariably will.
These factors, as well as aging (older teeth tend to be more brittle and more susceptible to fracture), all play a role in determining the treated tooth’s survival. But in spite of any negative factors, a root canal treatment is usually the best option for a diseased or damaged tooth. Although there are a number of good options for replacing a lost tooth, you're usually better in the long run if we can preserve your natural tooth for as long as possible.
If you would like more information on root canal treatments, 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 “Root Canal Treatment: How Long Will it Last?”
The next time you’re visiting Boston, why not make time for a stroll in the city’s renowned public garden? It’s got a little something for everyone: acres of greenhouses and formal plantings, a picturesque pond where you can go for a paddle in swan-shaped boats, and the first (and perhaps the only) statue dedicated to an anesthetic gas.
Yes, the Ether Monument (also called “The Good Samaritan”) is a vaguely Moorish-looking sculpture that commemorates the first use of anesthetic in a medical procedure. This ground-breaking event took place at nearby Massachusetts General Hospital in 1846. But if it seems that perhaps the park designers were feeling a bit light-headed when they commissioned this statue* then just think of what it would have been like to have a tooth drilled without it!
Today, of course, ether is no longer used for anesthesia; that’s because medical science has developed far better ways to make sure you don’t feel pain when you’re having a procedure. However, we do still use a gas for people who need a little more help relaxing during dental treatment. It’s called nitrous oxide, but sometimes goes by the nickname “laughing gas.”
This sweet-smelling gas, mixed with oxygen, is often administered in a process called inhalation conscious sedation. It doesn’t put you to sleep — you can still follow directions and respond to verbal cues — but it makes you very comfortable, and may even induce a slightly euphoric feeling, which wears off quickly when the gas is stopped. That’s what makes it ideal for some dental procedures: It’s quite effective for people who might otherwise have a great deal of dental anxiety, yet it’s quick, easy and safe to administer — and you can usually drive yourself home afterward.
Sometimes, however, you may need even more relaxation — for example, if you’re having multiple wisdom teeth extracted. In this case, it may be best to use intravenous (IV) conscious sedation. Here, the precise amount of medication you need is delivered directly into your bloodstream via a tiny needle. As with nitrous oxide, you’ll remain conscious the whole time, but you won’t feel any pain — and afterward, you probably won’t remember a thing.
Sedation dentistry has come a long way since the days of ether… but making sure you don’t feel pain or anxiety remains a critical part of what we do. Before a procedure, we’ll talk to you about what type of anesthesia is best — and if you have any questions or concerns, we’ll work with you to make sure you have the best experience possible. If you would like more information about sedation dentistry or relieving dental anxiety, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Sedation Dentistry” and “Sedation Dentistry For Kids.”
If you’re experiencing chronic halitosis (bad breath), it could be a sign of oral disease (as well as a systemic condition or treatment). In fact, it’s quite possible to visit our office about bad breath and find the cause is actually tooth decay, gum disease or some other oral condition.
In those cases treating the more serious condition might also result in a reduction in bad breath. Here are a few scenarios where such treatment could result in both better health and fresher breath.
Repairing decayed teeth. Repairing teeth damaged by decay — removing diseased tissue, filling cavities or repairing defective fillings — will also reduce the level of decay-causing bacteria. Such bacteria are often responsible for bad breath since they also release volatile sulphur compounds (VSCs), characterized by a foul “rotten eggs” odor. After treatment, these odors can diminish significantly.
Treating gum disease. Periodontal gum disease is a progressive infection caused by bacterial plaque. The basic treatment is to remove as much offending plaque and tartar (hard deposits) as possible. This may require extensive cleaning techniques (like root planing) to remove plaque from tooth root surfaces beneath the gum line, as well as antibiotic therapy. Periodontal therapy not only restores health to gum tissues, it may also alleviate bad breath caused by bacteria.
Extracting third molars (wisdom teeth). The opercula (flaps of gum tissue) around wisdom teeth have a tendency to trap food debris, which fosters bacterial growth. If this leads to chronic infection we may recommend removing the wisdom teeth. This not only reduces the chances of infection but may also alleviate bad breath caused by the bacterial growth.
Treating candidiasis. This is a yeast infection arising as a result of antibiotic use that suppresses normal oral flora. It’s also a source of bad breath. Treating the infection and restoring normal balance in the mouth may help alleviate bad breath as well as prevent disease.
You may see a pattern here: many of these conditions that simultaneously contribute to bad breath stem from high levels of bacteria, which flourish in plaque built up on tooth surfaces due to inadequate oral hygiene. Effective daily brushing and flossing (along with semi-annual office cleanings) removes much of the offending bacterial plaque. As a result you’ll experience better oral health — and maybe fresher breath too.
If you would like more information on controlling chronic bad breath, 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 “Bad Breath.”
Dental implantation is the premier option for tooth replacement available today. While acquiring dental implants does involve a surgical procedure, don’t let that deter you — with proper preparation the procedure is relatively minor and routine.
Implants are root replacements inserted directly into the jawbone to which a life-like, artificial crown is secured (strategically placed implants can also support fixed bridges or removable dentures). They’re typically made of titanium, which is osseophilic or “bone-loving”: bone will grow and adhere to the implant over a few weeks time.
Pre-planning can help minimize discomfort during and after the implantation procedure. We first conduct a radiographic examination of the site with x-rays or CT imaging; this enables us to assess the site’s bone quality and quantity. We can also create a surgical guide from the imaging to pinpoint the precise location for an implant to ensure a successful outcome.
Before beginning the procedure, we numb the area with a local anesthesia (we can also administer a sedative or other relaxation medication if you’re experiencing mild apprehension). The procedure often begins by creating a flap opening in the gum tissue with a few small incisions to access the bone. Using the surgical guide, we then begin a drilling sequence into the bone that progressively increases the size of the hole until it precisely matches the size and shape of the implant.
When the site preparation is complete, we remove the implant from its sterile packaging (which minimizes the chance of infection) and immediately insert it into the prepared site. We verify proper positioning with more x-rays and then suture the flap opening of the gum tissue back into place.
Thanks to both the pre-planning and care taken during surgery, you should only experience minimal discomfort. While narcotic pain relievers like codeine or hydrocodone may be prescribed, most often non-steroidal anti-inflammatory drugs like aspirin or ibuprofen are all that’s needed. We may also prescribe an anti-bacterial mouthrinse (with chlorhexidine) to assist healing.
In just a few weeks your custom-made restorations will be attached to the implants. It’s the completion of a long but not difficult journey; the resulting smile transformation, though, can last for many years to come.
If you would like more information on dental implants, 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 Implant Surgery.”