If you’ve had a total joint replacement or similar procedure, you will want your surgeon to decide if you need to take an antibiotic before you undergo dental work. This is a precaution to prevent a serious infection known as bacteremia.
Bacteremia occurs when bacteria become too prevalent in the bloodstream and cause infection in other parts of the body, especially in joints and bone with prosthetic (replacement) substances. It’s believed that during invasive dental procedures bacteria in the mouth can enter the bloodstream through incisions and other soft tissue disruptions.
Joint infections are a serious matter and can require extensive therapy to bring it under control. Out of this concern, the use of antibiotics as a prophylactic (preventive measure) against bacteremia once included a wide range of patients for a variety of conditions and procedures. But after an in-depth study in 2007, the American Dental Association concluded that the risks for many of these patient groups for infection triggered by a dental procedure was extremely low and didn’t warrant the use of antibiotic premedication therapy.
As a result, recommendations for antibiotic therapy changed in 2009, eliminating many groups previously recommended for premedication. But because of the seriousness of joint infection, The American Academy of Orthopedic Surgeons still recommends the therapy for joint replacement patients about to undergo any invasive procedure, including dental work. It’s especially needed for patients who also have some form of inflammatory arthritis, a weakened immune system, insulin-dependent diabetes, hemophilia, malnourishment or a previous infection in an artificial joint.
The guidelines for antibiotic premedication can be complex. It’s best, then, to speak with both your orthopedic surgeon and us about whether you should undergo antibiotic therapy before you undergo a dental procedure. The ultimate goal is to reduce the risks of any disease and to keep both your mouth and your body safe from infection.
If you would like more information on the use of antibiotics in 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 “Premedication for Dental Treatment.”
For some time now you've noticed a painful, burning sensation in your mouth for no apparent reason. It doesn't matter what you eat or drink — or whether you eat or drink — the dry, tingling sensation seems to stay with you.
You may have Burning Mouth Syndrome (BMS). You feel as if your mouth is scalded or burning generally or in a certain area like the lips, tongue or inside of the cheeks. Regardless, the discomfort (which seems to grow as the day wears on) can contribute to irritability, anxiety or depression.
It's not always easy to lock in on the specific cause. BMS has been linked, among other things, to diabetes, vitamin deficiencies, or cancer therapy. It's common among women around the age of menopause, so there's some speculation it could be affected by hormonal changes. It could also be connected with dry mouth (brought on by age or medications), an allergic reaction to toothpaste ingredients, acid reflux or autoimmune disorders.
While there's no single proven treatment for BMS, there are some things you can do to lessen its effects. First, stop habits that cause dry mouth like smoking, drinking alcohol or coffee and eating hot and spicy foods. Second, keep your mouth moist by frequently drinking water or using products that stimulate saliva flow.
You might also try toothpastes without sodium lauryl sulfate (a detergent that can cause skin peeling in some people), whiteners or strong flavorings like cinnamon. If you have chronic dry mouth, speak with your physician about any medications you're taking that might be causing it and seek alternatives. And because stress seems to magnify your symptoms, try to reduce it in your life through relaxation techniques, exercise or group support.
In some cases, BMS may resolve itself over time. In the mean time, making these lifestyle changes could help ease your discomfort.
If you would like more information on burning mouth syndrome, 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 “Burning Mouth Syndrome: A Painful Puzzle.”
March is national nutrition month—a good time to look at the connection between diet and oral health. You probably know that sugar is a major culprit in dental problems. This is because bacteria feed on sugars and create acid that can lead to tooth decay and gum disease. Avoiding sugary foods and drinks as much as possible is a good rule of thumb, but there are some food choices that actually benefit your oral health. Here are nutrition tips that will help keep your smile healthy for life:
Say cheese. Dairy products such as milk, cheese and yogurt contain calcium and phosphorus to build teeth and strengthen the supporting bone. And cheese neutralizes acid in the mouth to help fight cavities and gum disease.
Choose lean proteins. Lean meats, poultry, fish, milk and eggs help strengthen teeth. They are rich in protein and phosphorous, which is essential for building strong bones and teeth.
Eat a rainbow. Fruits and vegetables provide many key nutrients, including vitamins necessary for healing, bone strength, and healthy gums. Besides being nutritious, fruits and veggies scrub your teeth while you chew and stimulate the production of saliva, which is necessary for neutralizing acid and rebuilding enamel.
Nibble on nuts. Nuts contain protein, fiber and healthy fats. They also contain essential vitamins and minerals to keep teeth strong and gums healthy. Further, chewing nuts stimulates saliva production, lowering the risk of tooth decay.
Go for the grains. Studies have shown that eating too many refined carbohydrates such as white bread and sweet bakery items can lead to chronic inflammation, which is a factor in gum disease, heart disease, stroke and other conditions. In contrast, eating complex carbohydrates such as whole grains may reduce inflammation in the body.
What you put in your body can play a big role in preventing tooth decay and gum disease, so choose foods that provide the right building blocks for optimal dental and overall health.
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
“Cut down on sweets, especially between meals” is perhaps one of the least popular words of advice we dentists regularly give. We’re not trying to be killjoys, but the facts are undeniable: both the amount and frequency of sugar consumption contributes to tooth decay. Our concern isn’t the naturally occurring sugars in fruits, vegetables, grains or dairy products, but rather refined or “free” sugars added to foods to sweeten them.
The World Health Organization and the U.S. Food and Drug Administration both advise consuming no more than 50 grams (about ten teaspoons) of sugar a day. Unfortunately, our nation’s average per person is much higher: we annually consume around 140 pounds per capita of refined sugars like table sugar or high fructose corn syrup, more than three times the recommended amount. Soft drinks are the single largest source of these in our diets — Americans drink an average of 52 gallons every year.
The connection between sugar and tooth decay begins with bacteria that ferments sugar present in the mouth after eating. This creates high levels of acid, which causes the mineral content of tooth enamel to soften and erode (a process called demineralization) and makes the teeth more susceptible to decay. Saliva naturally neutralizes acid, but it takes about thirty minutes to bring the mouth’s pH to a normal level. Saliva can’t keep up if sugars are continually present from constant snacking or sipping on soft drinks for long periods.
You can reduce the sugar-decay connection with a few dietary changes: limit your intake of sugar-added foods and beverages to no more than recommended levels; consume sweets and soft drinks only at meal times; replace sugar-added foods with fresh fruits and vegetables and foods that inhibit the fermentation process (like cheese or black and green teas); and consider using mint or chewing gum products sweetened with xylitol, a natural alcohol-based sugar that inhibits bacterial growth.
Last but not least, practice good oral hygiene with daily brushing and flossing, along with regular office cleanings and checkups. These practices, along with limits on refined sugar in your diet, will go a long way toward keeping your teeth and mouth healthy and cavity-free.
If you would like more information on the relationship of sugar and dental disease, 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 “Nutrition & Oral Health.”
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