Salem, Oregon Center of Cosmetic Dentistry
2510 12th Street SE
Salem, OR 97302
503-378-1212

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By Dr. Karst
August 29, 2014
Category: Oral Health
Tags: oral health   dental care  
UseaRiskManagementApproachforDentalCareSuccess

As our profession advances, we dental professionals continue to find the biggest factor for successful outcomes is an informed patient. The more you know about your own teeth and gums, the greater your chance for a healthy outcome.

Regular dental care is fundamental to becoming informed. Your regular office visits and cleanings are an opportunity for us to “get real” — for you to learn the unvarnished truth about your dental issues and the reasons why you need to consider some options regarding your oral health. We also need to be just as realistic about what can or can’t be done to improve your situation and the cost involved.

The best way to approach this is to develop a plan based on managing risk. Risk is essentially weighing anything we may potentially lose against the solutions for not losing it. In dentistry, we look at risk in four basic areas: periodontal, the threats to structures like gums, ligaments and bone that support the teeth; biomechanical, the threats to the structural integrity of teeth such as decay, enamel erosion or fracture; functional, problems that can arise with how the teeth, muscles and jaw joints work together; and aesthetic, the impact of all these threats to the outward appearance of your smile.

Once we know the risks you’re facing, we then determine the best treatment approach for managing the risk based on costs and potential outcomes. For example, if you’re diagnosed with gum disease, you’re at risk for losing supporting bone and, ultimately, the affected teeth. Our primary goal is to prevent that loss from occurring through plaque and calculus removal that slow or stop the disease and allow affected tissues to heal. But if the disease has advanced and you’ve already experienced bone or even tooth loss, we may then need to modify our treatment goal by including gum surgery or tooth replacement options like dental implants.

Using a risk management approach helps us identify what needs to be treated and the most reasonable and achievable options for treating it. The foundation for this approach is prevention — stopping problems before they start or progress. Developing and maintaining this kind of action plan will help reduce your ultimate costs — emotional, social and financial.

If you would like more information on dental treatment planning, 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 “Successful Dental Treatment.”

BadBreathMightbeaSignofaMoreSeriousOralCondition

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.”

IntroducingtheRoyalBabyandHisNewTeeth

Not long ago, a certain Royal Baby made his first major public appearance. At a “crawl-about” in New Zealand, young Prince George (the 8-month-old son of Prince William and Kate Middleton) was formally introduced to the world, along with a group of adorable tots and their proud parents. The press was quick to note not only the future King of England’s cute expressions and his determined crawling — but also the appearance of his first two tiny bottom teeth.

Congratulations, William and Kate — and now, it’s time to think about the taking care of those royal baby teeth. In fact, before you know it, it will be time for the age one dental visit. Why is this so important? Essentially, because proper dental care in the early years helps to establish routines that will lead to a lifetime of good oral health.

It’s a misconception to think that baby teeth aren’t important because they will be shed after a few years. In fact, not only do they have a vital function in a child’s ability to eat and speak properly — they also serve as guides for the proper development of the permanent teeth that will follow. So caring for a tot’s primary teeth is just as important as it is for grown-up teeth.

What’s the best way to do that? To prevent tooth decay, clean an infant’s gums after each feeding with a soft cloth moistened with water — and don’t let your baby go to sleep with a bottle in his or her mouth! When teeth appear, gently brush them with a soft-bristled toothbrush and a tiny dab of toothpaste. At around age two, your child can begin to learn how to brush — with your careful supervision and follow-up, of course.

Avoiding sugary and acidic drinks (including some fruit juices) is another excellent way to keep those tiny teeth healthy! If you do allow any sugar, limit it to mealtimes; this gives the saliva plenty of time to do its work of neutralizing the sugar and acid that can cause tooth decay.

And don’t forget the first visit to the dentist, which should take place by age one! Even at that early age, we’ll make sure your child (and you) feel comfortable in the dental office, and help you get started with the best oral hygiene practices. We will also check for signs of cavities, watch for developmental milestones, and screen for potential future problems.

If you have questions about caring for your young child’s teeth, please contact us or schedule an appointment. For more information, see the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “Age One Dental Visit.”

SmokingmayIncreasetheRiskofEarlyImplantFailure

In a recent study, 92% of dental implants were found to have survived the twenty-year mark — an impressive track record for any dental restoration.

Still, implants do fail, although rarely. Of those failures, tobacco smokers experience them twice as often as non-smokers. The incidence of early failure (within the first few months after implantation) is even higher for smokers.

Early implant failure typically happens because the titanium implant and the surrounding bone fail to integrate properly. Titanium has a natural affinity with bone — the surrounding bone will attach and grow to the titanium in the weeks after surgery, forming a strong bond. An infection around the implant site, however, can inhibit this integration and result in a weaker attachment between bone and implant. This weakness increases the chance the implant will be lost once it encounters the normal biting forces in the mouth.

Smokers have a higher risk of this kind of infection because of the way tobacco smoke alters the environment of the mouth. Inhaled smoke burns the mouth’s top skin layers and creates a thick layer of skin called keratosis in its place. Smoke also damages salivary glands so that they don’t produce enough saliva to neutralize the acid from food that’s left in the mouth after eating. This creates an environment conducive to the growth of infection-causing bacteria. At the same time, the nicotine in tobacco can constrict the mouth’s blood vessels inhibiting blood flow. The body’s abilities to heal and fight infection are adversely affected by this reduced blood flow.

The best way for a smoker to reduce this early failure risk is to quit smoking altogether a few weeks before you undergo implant surgery. If you’re unable to quit, then you should stop smoking a week before your implant surgery and continue to abstain from smoking for two weeks after. It’s also important for you to maintain good brushing and flossing habits, and semi-annual dental cleanings and checkups.

Although smoking only slightly raises the chances of implant failure, the habit should be factored into your decision to undergo implant surgery. Quitting smoking, on the other hand, can improve your chances of a successful outcome with your implants — and benefit your life and health as well.

If you would like more information on the effects of smoking on dental health, please contact us or schedule an appointment for a consultation.

WorkWithYourChildsSchooltoEncourageHealthySnackFoods

There’s a new focus on children’s nutrition by both parents and schools; in fact, many school districts have instituted policies that encourage children to eat more nutritional foods and snacks. Regarding snacks in particular, the United States Department of Agriculture (USDA) recently released new regulations for the Smart Snacks in Schools Initiative that call for more whole grains, fruits and vegetables and less fat, sugar and salt in snack foods.

These regulations will help fight obesity and related medical problems like diabetes, but many dentists don’t believe they go far enough in one particular area — the consumption of sugar, a major cause of tooth decay. Dentists also feel the guidelines are too generous in the amount allowed for highly acidic beverages like sodas, ice tea, sports drinks and energy drinks that increase the risk of enamel erosion and tooth decay.

You may also be concerned about how much sugar your child is eating, and for the most part you’re able to manage their intake when they’re at home. But what can you do to influence their snack choices and habits when they’re at school?

For one thing, get involved with your child’s school and with other parents. Let school officials know your concerns about the sugar, fat and salt content of the snacks offered in the school’s vending machines and food service, and work to implement policies that discourage less nutritional snack foods. You should also set limits for your children about what snacks they can buy at school — along with explaining why they should avoid certain kinds of snack foods in favor of others. And, be sure to send healthy snacks along with them when they go to school that are bite-sized and fun.

It’s also important to help your children limit how often they snack and avoid “grazing” — nibbling on snack food for hours on end. Grazing can cause the mouth to be continuously acidic and never allow saliva an opportunity to neutralize the acid. You can also suggest similar policies to school officials, such as shutting down vending machines at certain times of the day.

Nutrition is essential to good health, in the mouth as well as the rest of the body. As a parent, it’s your job to see that your children eat nutritiously — enlisting their schoolâ??s help will make that job a little easier.

If you would like more information on dental-friendly snacking, 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 “Snacking at School.”





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