Red Oak Dentistry

Antibiotic Prophylaxis for Dental Appointments

Antibiotics and Dental Appointments

Prescribing antibiotics prior to dental procedures used to be commonplace for a multitude of health conditions.

However, this may not be necessary anymore.

Before taking a trip to the pharmacy, have a discussion with your Dentist or Primary Care Physician.

Everyone has beneficial and harmful bacteria in the mouth. Chewing, brushing, and flossing allow these bacteria to enter the bloodstream. For most of us, this is not a problem if you have a healthy immune system. There are still a select few individuals who still should pre-medicate with antibiotics prior to their dental appointment.

Let’s take a closer look at the conditions that may or may not affect you.

An increasing number of people have prosthetic or artificial joint implants. In the past, it was thought that the bacteria that entered the bloodstream from a routine dental appointment could possibly cause an infection within the artificial joint. This is not the case, and it is not necessary for these patients to pre-medicate prior to a dental appointment. The ADA has determined that dental procedures are not associated with prosthetic joint implant infections, and antibiotics given before dental procedures do not prevent such infections.

The subset of patients who actually do require premedication is rather small. These patients include patients with a prior history of bacterial endocarditis (heart infection), cardiac transplant patients, patients with artificial cardiac valves, patients that have had a cardiac valve repaired with artificial materials, patients with un-repaired congenital heart disease, and patients with repaired congenital heart defects. Patients with mitral valve prolapse or what is commonly known as a heart murmur generally don’t need premedication anymore.

Finally, there are other extenuating circumstances that need to be considered. If you are generally immunocompromised or undergoing treatments for cancer you should discuss the need for premedication with your doctor.

If you still feel the need to pre-medicate even though it is not necessary, there are several important factors to consider. At a minimum, antibiotics cause nausea and upset stomach. Antibiotics can also cause allergic reactions that may or may not be severe, leading to possible anaphylactic shock. Unfortunately, constant exposure to antibiotics puts you at risk for developing resistance to medication. This can be a problem if your body is trying to fight off a more serious infection like MRSA or pneumonia. Increased use of antibiotics can also lead to an infection called C. difficile that causes extreme diarrhea and other intestinal problems.

For more information regarding Antibiotic Prophylaxis prior to your Dental appointment, please visit https://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis.

Don’t hesitate to bring any questions or concerns to your next appointment.

Emily H., RDH

Red Oak Dentistry

The Connection Between Diet and Tooth Decay

The foods we eat can have an impact on our dental health.

Unfortunately, many foods and beverages that we consume every day can have negative effects on the enamel that protects our teeth.

This damage can eventually lead to tooth erosion and decay.

Even foods that seem harmless may contain sugars and acids that damage tooth enamel.

On the pH scale, 1.0 is very acidic (battery acid for example) and 7 is neutral (like water). Water or milk are considered neutral and non-erosive to teeth, while fruit juices, sodas, energy drinks are highly acidic and cause erosion of tooth enamel.

Not only can tooth erosion lead to decay, it can also cause sensitivity and change the appearance of your teeth. Brushing and flossing twice per day is the best way to prevent erosion and tooth decay. However, there are other steps that you can also take to minimize your overall risk. First, let’s discuss some aspects of your diet that may be exponentially increasing your risk for erosion and decay.

Food and drinks that are high in sugar content are harmful to the teeth. However, food and drinks that are more acidic, also damage the teeth. When you combine high sugar and acid content, you have a recipe for disaster. Citrus, citrus-flavored, carbonated, and sour foods and drinks are more acidic and should be avoided as much as possible. Other culprits include soda (even diet, due to the acid content), fruit juices, sports drinks, energy drinks, coffee, tea, and wine. All of these beverages are high in either sugar or acid content, or worse, both. Things that are sticky like dried fruit and candy should also be avoided as they adhere to the teeth and cause issues long after you stop eating them.

Obviously, most people don’t want to live off of raw vegetables and water for the sake of their teeth.

I’m not giving up my morning coffee and I certainly don’t expect any of my patients to do the same.

You may be wondering what you can do to combat the harmful effects of sugars and acids. First and foremost, limiting consumption is the best form of prevention. However, if you just can’t live without that glass of orange juice or can of soda, it’s best to just drink it and get it over with versus sipping on it over a long period of time. Using a straw can also be helpful. Many people may think that brushing immediately after consuming anything sugary or acidic is the best way to protect their teeth. This is not the case. You’re actually causing more harm by spreading the acid around the entire mouth while removing enamel at the same time. It’s a good idea to wait an hour before brushing, allowing saliva a chance to wash away acids and re-mineralize the teeth. You can also rinse your mouth with water, drink milk, or enjoy a snack of cheese. Water, as well as dairy and other calcium-rich foods can help neutralize acidity. Finally, studies have shown that chewing an ADA approved sugar-free gum for 20 minutes can help increase saliva flow while also helping to pull debris and food out of the deep grooves of the teeth.

It’s important to understand that other intrinsic and environmental factors may be involved in tooth erosion and decay aside from diet. People suffering from acid reflux or GERD, bulimia, chronic alcoholism are typically at a much higher risk for tooth decay. Pregnancy can also make people more susceptible to decay due to changing hormones and greater tendency to have GERD during pregnancy. If you think any of these factors might be playing a role in your oral health, I highly encourage you to bring it up at your next dental visit. Although it may seem like an overwhelming or embarrassing conversation to have, it can really make a difference in not only the health of your teeth, but also your overall health.

If you have any questions or concerns regarding your teeth and erosion, or if you would like additional information regarding the acidity levels of different foods and drinks, please let us know at your next dental appointment.

Emily H., RDH

Red Oak Dentistry

Electric Toothbrush vs. Manual

According to the American Dental Association, if used correctly, both electric and manual toothbrushes are effective at removing harmful plaque that may lead to tooth decay and gum disease.

However, many studies showed that electric toothbrushes decrease the amount of plaque buildup when compared to a manual toothbrush.

In fact, one study showed that plaque was reduced by 21 percent and gingivitis by 11 percent after only 3 months of use.

In my professional opinion, I have never seen a manual toothbrush that can compete with the results of an electric toothbrush. If you’re considering making the switch from a manual toothbrush, I can promise you that after a few days of using an electric toothbrush, you’ll never look back and both your gums and your Dental Hygienist will thank you!

Aside from being more effective, there are many reasons to consider making the switch to an electric toothbrush.

For starters, electric toothbrushes do all the work for you. This can make brushing much easier for people with limited mobility, such as individuals with carpal tunnel, arthritis, and developmental disabilities. Orthodontic appliances are very difficult to clean around. An electric toothbrush may help improve your oral health if you’re struggling to clean around those hard-to-reach brackets. In general, kids and teenagers don’t do a great job in the brushing department. If an electric toothbrush offers a more engaging brushing experience, you may see an overall improvement in your child’s oral health habits. Finally, using an electric toothbrush can cut down on waste, especially since you’re only replacing the brush heads every 3 months versus the entire toothbrush.

Now that you’re ready to make the change to an electric toothbrush, the difficult task may be finding the right one for you.

I will always support a product that has the ADA seal of acceptance. This means that the product has been proven safe and effective for use.

However, when it comes to electric toothbrushes, I do have some personal favorites.

In our practice, we are big supporters of the Phillip’s Sonicare and the Oral-B brands.

Both brands have been around for a long time and have a lot of research behind their products. The nice thing about both of these brands is that the newer models have two minute timers and a brake on the toothbrush if you’re applying too much pressure. This ensures that you’re brushing for the correct amount of time without applying too much pressure on the gums. If you’re wondering what model might be right for you, it really boils down to how much you want to pay and personal preference. A middle of the road model in terms of price may not have all the bells and whistles of a higher end model, but chances are, it will do just as good of a job brushing your teeth, if used correctly.

However, for patients with generalized gum recession, I tend to gravitate towards a Sonicare, as it can be a little gentler on the gums. If you are prone to plaque and calculus (tarter) buildup, using an Oral-B may be the better choice for you.

Although the electric toothbrush may seem a little pricey at first glance, think of the overall investment that you’re making with your purchase. After all, who doesn’t want healthier gums, less plaque and calculus buildup, and a whiter smile?

If you’re still on the fence about making the switch, bring your questions and concerns to your next dental appointment. We really can’t say enough good things about using an electric toothbrush and we’d be happy to give you any information that may ease your concerns.

Emily H., RDH

Red Oak Dentistry

Flossing

“My gums bleed when I floss, so it stops me from doing it.”

“I’m using an electric toothbrush that does a great job, so I don’t need to floss.”

“I don’t have time to floss.”

“Do I really need to clean in between my teeth?”

These are just a few of the many questions and statements that I receive from patients regarding flossing and cleaning in between their teeth. Most patients already do a great job incorporating brushing into their daily routines, but seem to struggle when it comes to flossing and cleaning in between the teeth. The answer is YES, you do need to floss! Let’s talk about the importance of flossing or using other interdental cleaners to maintain optimal oral health.

A few years ago, some news reports questioned the benefits of flossing your teeth. As your Dental Hygienist, I want to emphasize that cleaning in between your teeth is not only import to support your oral health, but also important in maintaining your overall health! The mouth is a very harsh environment that can contain over 500 species of bacteria (1). Some of the harmful types of bacteria can lead to gum disease as well as tooth decay. Unfortunately, brushing alone cannot effectively clean in between the teeth. This is where flossing and other interdental cleaners come into play!

In my opinion, the string dental floss or dental tape is the most effective tool that you can use to clean in between the teeth. There is no difference in the effectiveness of waxed or unwaxed floss. However, I have found that most patients have a much easier time using waxed floss. I also like the traditional string floss because you have the ability to contour the floss around the tooth and underneath the gumline. It’s best to use a piece of floss that’s between 12 and 18 inches long. You can hold your strand of floss in one hand and gently wrap the remaining floss around you’re your middle finger on your opposite hand. Allow yourself to work in one inch increments. Ideally, you’d like to hug each side of each tooth while gently moving the floss up and down. If you’re new to flossing, you may notice that your gums may feel a little sore and they may also bleed. Don’t let this alarm you. As your floss more, this should subside. If the bleeding and soreness does not subside, please let us know at your next dental check-up.

Although I personally feel that dental floss or tape is the best tool to use in between the teeth, it’s not the only tool that you can use. In fact, the best tool to use is the one that you will actually use on a daily basis. This may come in the form of a hand-held flosser, small brushes, special wooden or plastic picks, or a water flosser. When choosing the right interdental aide, it’s important to consider the ADA Seal of Acceptance. This means that there is scientific evidence that demonstrates the safety and efficacy of the product that you are using. For a list of ADA approved interdental cleaners and other products, please visit
www.ada.org/en/science-research/ada-seal-of-acceptance/ada-seal-products.

The most important thing to consider when cleaning in between the teeth is finding what works for you. The ADA recommends brushing your teeth twice a day for at least two minutes and cleaning in between your teeth once a day. As long as you’re doing an effective job, it doesn’t matter if you brush or clean in between the teeth first. As a rule of thumb, it’s always a good idea to clean in between your teeth before you go to bed at night to avoid leaving behind any food particles or bacteria while you sleep. Most interdental cleaners are disposable. Only use them one time to avoid using a product that may have lost effectiveness or re-introduce harmful bacteria back into the mouth. For more information regarding interdental cleaners as well as a video on flossing, please visit https://www.mouthhealthy.org/en/az-topics/f/flossing.

Emily H. , RDH
Red Oak Dentistry

Citation
1. American Dental Association. Federal Government, ADA Emphasize Importance of Flossing and Interdental Cleaners, 2016, www.ada.org/en/press-room/news-releases/2016-archive/august/statement-from-the-american-dental-association-about-interdental-cleaners.

The Ultimate Toothpaste Guide

What kind of toothpaste should I use?  It’s a common question I’m asked several times a day by many of my patients.  With a million different products out there, the dental aisle can be a very confusing and intimidating place.  New trends without any evidence-based research can also lead people to products that may not be beneficial in the long run.  Fear no more!  Let’s take a moment to break down what you’re really looking for in a toothpaste.

First and foremost, it’s very important that your box of toothpaste has the ADA seal of approval.  ADA stands for the American Dental Association.  When you see the ADA seal on any dental product, it means that the product has been approved as safe and effective for use.  Without this seal, there is no way to know if the product is safe to use, or actually doing what it’s claiming to do.  It’s very important to keep this in mind when considering a new product or trend that has absolutely no research behind it.

When it comes to your toothpaste, the brand doesn’t matter so much, but the ingredients do.  The most important active ingredient in your toothpaste should be Fluoride.  The Fluoride may be in Sodium Fluoride, Stannous Fluoride, or Sodium Monofluorophophate form.  The main purpose of the Fluoride is to help re-mineralize the teeth and prevent decay.  Fluoride is safe to use topically, but should be used sparingly with small children or other individuals who may ingest the toothpaste.  It’s best to start with a smear of toothpaste at the first sign of a tooth until the age of 3.  After age 3, it’s safe to use a pea sized amount.

There are several other details to consider when selecting the appropriate toothpaste for your needs.  One major complaint in the dental chair is generalized sensitivity due to gum recession or other issues. If this is the case for you, it’s a good idea to choose a toothpaste containing Potassium Nitrate.  This will help limit some of your sensitivity with continued, daily use.  Unfortunately, some active ingredients in whitening toothpastes can also cause or exacerbate sensitivity. Try to stay away from whitening, abrasive toothpastes if sensitivity is something you struggle with.

Overall, picking a specific brand of toothpaste is mainly based on personal preference.  Even though it can seem a little overwhelming considering all of the choices out there, it’s important to keep in mind what really matters.  Does this toothpaste have the ADA seal?  Does this toothpaste contain Fluoride?  Will this toothpaste hurt or help my sensitivity?  If what you’ve chosen checks off these boxes, you’ve found a winner!  For more information, please visit https://www.ada.org/en/member-center/oral-health-topics/fluoride-topical-and-systemic-supplements

Emily H. , RDH
Red Oak Dentistry

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