Your Mouth and Heart Disease

Today, we often hear in the news that oral health is connected to and an important component of our overall health. More than 80 percent of Americans are living with periodontal disease which is an inflammatory condition affecting the bone and gums around teeth. Periodontal disease often goes untreated in people who don’t regularly visit the dentist because they don’t experience any pain initially and therefore don’t follow up with a dentist.

The American Heart Association (AHA) and American Dental Association (ADA), among other associations, both cite plenty of evidence for the association between oral health and heart disease. While the association has not been shown to be causative, that is, it has not been proven that periodontal disease causes heart disease, patients with periodontal disease had a 20% higher risk for heart disease.

Why are these things related? While there is still more research being done on finding a direct causative link between periodontitis and heart disease, if there is one, there is certainly a more general connection between the 2 conditions. Chronic inflammation in the body in localized areas like the mouth, increases the overall tax on the body as your body tries to fight these areas of chronic inflammation. Lowering your body’s defenses drains defensive resources and can lead to other problems like heart disease.

Endocarditis:

According to the AHA and the American College of Cardiology (ACC) in 2017, it is recommended that patients who have had prosthetic heart valves, congenital heart disease, previous Infective Endocarditis and cardiac transplant with regurgitation engage in antibiotic prophylaxis prior to dental procedures to limit the risk or Infective Endocarditis. Your Cardiology and Dentist can tell you more specifics about these parameters.

Symptoms and Warning Signs

According to the American Association of Periodontology (AAP), you may have gum disease, even if it is in the early stages, if:

• Your gums are red, swollen and sore to the touch.
• Your gums bleed when you eat, brush or floss.
• You see pus or other signs of infection around the gums and teeth.
• Your gums look as if they are “pulling away” from the teeth.
• You frequently have bad breath or notice a bad taste in your mouth.
• Or some of your teeth are loose, or feel as if they are moving away from the other teeth.

Prevention Measures

Good oral hygiene and regular dental examinations are the best way to protect yourself against the development of gum disease. It is recommended that you brush your teeth twice a day with a soft bristle brush or an electric tooth brush such as Oral B Braun or Sonic Care brush. It is also important to floss once a day and use an ADA accepted toothpaste with fluoride. You should also visit your dentist for regular professional cleanings. We look forward to seeing you and helping you to maintain your optimal oral health!

Carolyn S. RDH

Red Oak Dentistry

Foods That Cause Tooth Decay

When it comes to tooth decay, it’s important to know the main culprit – acid. Acid is what eats away at our enamel and causes cavities.

Acid can enter our mouths in one of two ways: either directly through what we eat (citrus fruits, for example), or as a byproduct when oral bacteria consume the sugars that we eat.

Ultimately, a simple way to identify foods that cause tooth decay is to ask whether it’s acidic or sweet/starchy.

Acidic foods include things like energy drinks, soda, coffee, Gatorade, wine, citrus fruits, and sour candy.

Sweet foods include things like candy or sugar-sweetened beverages and fruit while starches include food like bread, chips, cereal, pasta and crackers.

The longer these things interact with your teeth, the greater the chance for tooth decay to occur. For example, sipping on soda throughout the day, or chewing a gooey caramel treat, increases the amount of sugar that coat your teeth. Bacteria love to feast on this sugar, creating an acidic environment and putting your teeth at risk for decay.

To help protect your teeth against tooth decay:

• Reduce your consumption of sweets and refined starches
• Enjoy acidic foods in moderation or as part of a meal
• Decrease or eliminate your consumption of soda or sugar-sweetened beverages
• Swish with water after meals and snacks
• Maintain good oral hygiene to brush away plaque buildup (floss at least once a day and brush twice a day)

And, as always, make sure to visit us regularly so we can remove tartar buildup and assess for early signs of decay.

If it has been more than 6 months since your last dental cleaning and exam don’t hesitate to call us today and book your next appointment. Raleigh Office Phone Number 919-781-8984

Carolyn S. RDH

Red Oak Dentistry

Dental X-Rays: Why They’re Important

Many patients feel that Dental X-rays or radiographs are not necessary if they are not having any pain or issues with their teeth. However, x-rays are used to detect damage and disease that may not be felt or visible to the eye. X-rays are also used to evaluate a patient’s periodontal status and used to check for any oral pathology like oral cancers, cysts, and tumors.

Typically, the type of x-rays taken during a routine dental visit are bitewings and/or a panoramic image. Bitewings are used to evaluate the mouth for decay and periodontal disease while the panoramic image is used to evaluate the entire jaw structure for any abnormalities or the presence of wisdom teeth. Although both types of images require very low levels of radiation, they are completely safe to take. Even so, every safety precaution such as a lead apron with a thyroid collar will be used to minimize radiation exposure. If necessary, x-rays are safe to take during pregnancy, breastfeeding, or if you are trying to become pregnant.

A common question most patients have regarding x-rays is “how often should I have them?” Frequency can depend on a number of factors, such as oral health status, risk for disease, health, age, and any signs and symptoms of disease. Children may need x-rays more often as the teeth and jaw structure are still developing, and the teeth are more likely to be affected by decay. Ultimately, bitewing radiographs are typically taken once a year while the panoramic radiograph is taken about every 3 to 5 years.

The bottom line is x-rays are extremely important and absolutely necessary to perform a thorough, comprehensive exam. Your dentist will review your history, examine, your mouth, and determine your specific needs for dental x-rays. As always, patient safety is of the upmost importance, so please don’t hesitate to share any concerns during your next appointment.

Emily H., RDH

Red Oak Denitstry

Now In-Network With Delta Dental Premiere

About a third of the American population has not seen a dentist in the last year. When asked why not, almost half responded that it was too expensive. Here’s the thing. Going to the dentist can be expensive, but NOT going can lead to extreme tooth decay and much more costly problems down the road. That’s why getting the right dental health coverage is crucial.

Why Delta Dental Premiere?

Imagine the luxury of freely visiting any dentist in the world, receiving the highest quality of dentistry, and enjoying cost protection from all unnecessary expenses. Network-based, Delta Dental Premier saves enrollees out-of-pocket fees because Delta Dental Premier dentists agree to accept fees that are typically lower than average submitted fees. In the end, this saves money for both employees and employers. Talk to your employer today about having unlimited access to any dentist and other advantages available through Delta Dental Premier.

For all things Delta Dental Premiere, click here.

Is dental health insurance out of the question for you?

We’ve got you covered. Our simple and affordable in-house dental plan may be just what you’re looking for because it requires:

• No yearly maximums
• No deductibles
• No claim forms
• No preauthorization requirements
• No waiting periods
• No pre-existing condition exclusions

For an annual cost of $299 per person, we will keep your oral health in tip-top shape with preventative care that includes two periodic exams, two cleanings, two X-rays and two oral cancer screenings each year. It even includes 10% off all other needed treatments.

Mouth Sores and Lesions

Mouth sores and oral lesions are a common issue for many patients. Unfortunately, they are often a painful problem to have. Luckily, most sores will generally heal on their own within two weeks. Mouth sores can be caused by bacterial, viral, or fungal infections, as well as trauma from a sharp edge on a tooth, a sharp chip, or an ill-fitting appliance. Occasionally, oral lesions can be caused by other disease or autoimmune processes. The most commonly experienced mouth sores are canker sores and fever blisters.

Canker sores are commonly referred to as ulcers. These non-contagious lesions can be small or large and typically have a white or gray appearance with a red border. Although canker sores generally go away on their own within two weeks, they can be extremely painful. Topical anesthetics, antimicrobial mouthwashes, and warm salt water rinses can help alleviate some of the pain. It is also a good idea to stay away from hot, spicy, or acidic foods that can cause more irritation to the ulcer.

Fever blisters on the other hand, are highly contagious lesions that are caused by the Herpes Simplex type 1 virus. Lesions present themselves as painful, fluid-filled blisters that erupt and scab over. Patients may notice a tingling sensation prior to the arrival of the fluid-filled blisters. The blisters may erupt in the oral cavity and around the nose, chin, and lips. Like the canker sore, fever blisters should heal on their own within two weeks. However, topical anesthetics and prescribed antiviral medications can be used lessen the symptoms and duration of the outbreak, especially is used before the outbreak. If you get the tingling feeling that accompanies fever blisters or have active vesicles, it is best to defer dental treatment so it doesn’t spread to other areas of your mouth and face or to other people. Once infected with the virus, it is possible to have multiple outbreaks throughout a lifetime.

When it comes to any type of mouth sore or oral lesion, it is always a good idea to err on the side of caution. On rare occasion, oral lesions can be caused by diseases and autoimmune processes, or cancer. As a rule of thumb, if a lesion does not go away within three weeks, come in for an evaluation or possible biopsy.

Emily H., RDH

Red Oak Dentistry

Dry Mouth

Dry mouth, also known as xerostomia, can be a common problem for many patients. Unfortunately, dry mouth can result as a side effect of certain medications such as antihistamines, decongestants, pain killers, diuretics and many others. It is always a good idea to discuss any possible side effects such as dry mouth with your doctor or pharmacist. Another cause of dry mouth is Sjogren’s syndrome. Sjogren’s Syndrome is an autoimmune disorder that attacks the glands and organs that are responsible for secreting tears and producing saliva.

Experiencing a dry mouth can be a major annoyance. However, a dry mouth can also lead to extensive tooth decay. This occurs because saliva acts as the body’s defense mechanism to wash away food debris, neutralize harmful acids, and provide disease fighting substances for the mouth. Common symptoms and problems associated with dry mouth may include:

• A constant sore throat
• A burning sensation
• Trouble speaking
• Difficulty swallowing
• Hoarseness
• Dry nasal passages

Luckily, there are some things that you can do to lessen the harmful and annoying effects of a dry mouth. Using a spray bottle filled with water can be a very helpful method to restore moisture to the mouth (without making you have to go to the bathroom every 15 minutes!) Chewing sugar-free gum or using sugar-free candy can also help to stimulate salivary flow. Finally, there are a plethora of products designed specifically for dry mouth. As always, it is important that any product used contains the ADA seal of acceptance.

Emily H., RDH

Red Oak Dentistry

Bruxism

Feeling stressed?

You’re not alone.

Due to the stress, you could be clenching or grinding your teeth.

This process called bruxism, which usually occurs as you sleep. Clenching and grinding can also be a result of sleep disorders, an abnormal bite, or teeth that are misaligned. Bruxism is also twice as likely to occur in individuals who smoke and drink alcohol. Although teeth grinding can also be common in children, treatment is usually not necessary. Children usually outgrow this damaging habit by adolescence.

You may be wondering what symptoms could possibly arise from clenching and grinding your teeth.

Fractured or loose, painful teeth are the very serious, obvious signs of clenching and grinding. However, jaw soreness and dull headaches are other tell-tale, less obvious signs. If you experience any of these symptoms, it’s a good idea to discuss the option of a custom fit night guard that is worn during sleep to protect the teeth. Many individuals also find themselves clenching or grinding during the day. If you feel like you may fall into this category, try to be aware of the conditions that may cause you to clench or grind. Try to make a conscious effort to have your lips and jaw relaxed with your teeth apart.

Stress can also be a huge influencing factor for clenching and grinding.

Although relaxing can be difficult, it’s important to try for the sake of your teeth and overall well-being. Medication, counseling, and exercising are all excellent options to help alleviate stress. In extreme cases, a muscle relaxant before bedtime may be recommended.

Finally, a sleep study is recommended for any individuals grinding as a result of a sleep disorder. Sleep apnea is a serious condition that can lead to many other health issues. If you think you may be clenching and grinding, please bring any questions or concerns to your next dental visit.

Emily H., RDH

Red Oak Dentistry

Antibiotic Prophylaxis for 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

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