Why do you need to Premed?

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antibioticsHave you ever had a joint replaced or heart surgery? There is a possibility you were recommended by your physician, surgeon, or dentist to take an antibiotic prior to future dental treatment.

Antibiotics are used to treat bacterial infections. During some dental procedures, bacteria from the mouth can be introduced into the bloodstream. The bacteria can then travel elsewhere in the body and cause an infection. In these circumstances, an infection is uncommon but can become serious and life threatening. Those who are at higher risk are suggested to take an antibiotic premedication to help prevent the chance of an infection.

However, antibiotics are not for everyone. Bacteria can still enter into the bloodstream by normal oral activities such as brushing, flossing, and eating. We all have bacteria in our mouth and a healthy immune system will prevent any harm. This is why there is always concern and caution taken into consideration when recommending a premedication and further more preventing antibiotic resistance. The benefit of taking them should outweigh the risk of an infection. Guidelines have been created to help with how to determine who may benefit the most.

Before 2012, taking a premedication prior to dental treatment was common for those with joint replacements, heart surgeries and many other conditions. The American Dental Association and American Association of Orthopedic Surgeons published updated guidelines in 2012 and 2015. These guidelines, updated every several years, are based on new scientific research. In 2017 the American Heart Association and American College of Cardiology released further updated guidelines in addition to those in 2012, which the American Dental Association reaffirmed.

Those whom are at higher risk for infection after dental treatment are suggested to take an antibiotic based on these updated guidelines. These considerations are listed as followed, but are not limited to:

  • Prosthetic cardiac valves, heart transplant, certain congenital heart diseases and previous infective endocarditis
  • Prior joint replacement infection
  • Currently taking immunosuppressive medications, acquired or congenital immunodeficiency, and systemic immunocompromising disorders(e.g. rheumatoid arthritis, lupus erythematosus)
  • Extensive and invasive procedures are planned in the near future or are susceptible to a systemic infection

If you are unsure or know you are at risk for an infection following dental treatment please consult with your physician or surgeon to decide whether an antibiotic premedication is needed.

 

REFERENCES:
http://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis

 

https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/aae_antibiotic-prophylaxis-2017update.pdf

So, you don’t like to floss?

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Flossing is recommended daily to clean plaque bacteria from in between the teeth that brushing alone doesn’t remove. Anytime we leave plaque between our teeth we put ourselves at risk for bleeding, inflamed gums, infection, gum disease and decay. Although flossing is the best way to clean between the teeth, there are other options that can work well and may be easier to use. Here are just a few options that we like to recommend in our office.

  • flossers and floss threadersFlossing Helpers: Flossers make it easier to floss because there is a handle attached to the floss. Floss threaders can help you get your floss between tight areas or where an orthodontic retention wire is present.

 

  • plastic picksPlastic toothpicks: These are very thin, flexible plastic picks that are easy to use and work well at getting in between the tight spaces of the teeth.

 

interdental brushes

  • Interdental brushes: These are small nylon brushes, attached to a handle, and come in different brush sizes to adapt to both tight and larger areas between the teeth.

 

  • Soft Picks: These are small, spongy picks that fit well between most spaces of the teeth. They are also very compact and easy to carry with you on the go.

 

  • Rubber Tip Stimulator: These not only work great to stimulate and clean areas along the gum line, but they can also be used to gently massage areas between the teeth.

 

  • Water Irrigation (Water Pik): These devices use water pressure to blast plaque and bacteria from between the teeth. There is a bit of a learning curve to using this device, but once it’s mastered it is an excellent way to remove plaque from the entire mouth.

Water Pik

The best way to keep our teeth and gums healthy and bacteria free is daily brushing along with daily cleaning between the teeth. If flossing doesn’t seem to be your thing, ask your dental health care provider about these other options and for tips on how to properly use them.

What could be causing your tooth pain?

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We’ve all been there, waking up in the middle of the night, not being able to fall asleep, and enduring a long, painful day, all because of a toothache. We’ve asked out doctors to help us in identifying the most common reasons for dental pain, listed below.

Some of the more common ways dental pain is experienced are:

  • Sensitivity to temperature
  • Pain when biting or chewing
  • Dull or throbbing aches
  • Constant Pain

The most common issues associated with these types of pain include:

  • Infection: If you have swollen gums, a small bump on your gums, or fluid or pus present, this could indicate an infection. The infection could be limited to your gums or could indicate a more serious issue, such as an abscess tooth.
  • Clenching and Grinding: If you wake up with your jaw or all of your teeth aching, often accompanied by headaches, this may be due to clenching and grinding your teeth while you sleep. A common solution to this pain is a night guard. A night guard will limit the wear on your teeth and is usually an effective solution to this type of pain.
  • Cavities: Sensitivity to temperature and pain when biting and chewing are often associated with a cavity. It could be a new area of decay or a loose or missing filling.

These are just a few of the reasons for dental pain. It is always best to consult with your dentist if you are experiencing any type of dental discomfort.

Wisdom about Wisdom Teeth!

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Third molars (also known as wisdom teeth) are the four teeth located furthest back in the mouth, and are the last to develop, usually beginning around age 16. Keep in mind the age for wisdom teeth development can vary greatly; some people don’t develop wisdom teeth at all, and some develop more than four!

Whether your teeth are currently causing an issue or not, your dentist may recommend you get them extracted. Wisdom teeth can be monitored by your dentist using a panorex x-ray. This x-ray identifies presence, alignment and orientation of the wisdom teeth.

There are several reasons a dentist may recommend that these teeth be extracted:

  • The teeth may be developing at an angle.
  • The teeth may be pushing up against another tooth, causing damage to the other tooth.
  • Your mouth may not have enough room to accommodate them. As a result, this may push the other teeth out of alignment or cause pain in the future.
  • The erupting teeth are causing an infection on the gum on top of the teeth.

Issues with wisdom teeth can be indicated by swelling of the gums, difficulty or pain when opening your mouth, and pain when chewing with or putting pressure on the teeth near the back of the mouth.

Wisdom teeth are most easily extracted at a younger age. Delaying removal can increase the pain and healing times associated with their removal. If you suspect that your wisdom teeth are causing your dental pain, you should see your dentist for further evaluation. A referral to an oral surgeon may be necessary to extract your wisdom teeth.

Helpful Tips for your Child’s First Dental Visit!

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photo of a child's first visitWe understand that coming to the dentist causes a certain amount of anxiety for many of our patients, young and old alike. It may be the fear of the unknown, a difficult personal experience, or stories of a ‘bad experience’ from a friend or family member. It is our goal at Family Dentist Tree to ensure all of our patient’s feel comfortable during their appointments.

We would like to offer some tips that may be helpful in preparing your child for a positive first visit to the dentist.

Our dentists recommend your child’s first check-up and cleaning around age three, unless there is a problem or concern before then. Prior to their first appointment, you can bring them with you to your cleaning appointment if you’d like! This will help familiarize your child with our office and lets them see how their first appointment will go, and how well you do at yours!.Helpful tips:

When telling them about their first appointment, keep it simple:

“The hygienist will clean your teeth and make them shiny!”

“The dentist will count your teeth.”

“You will get to sit in the big chair!”

In addition, if you are preparing for your child’s first appointment to do a filling, remove a tooth or address a potential tooth ache, these tips may be helpful as well:

Most of the time, the less explaining, the better! Please be careful to avoid using words and phrases such as: shot, needle, “it might hurt,” or “there is nothing to be scared of.”

We have lots of creative ways to explain what we will be doing before treatment begins, for example, instead of using the word drill for our hand piece, we might say to your child, “This is Mr. Whistler, he will help us chase the sugar bugs away!” Another phrase we may use is “we will use sleepy water to put your tooth to sleep.”

We offer Nitrous Oxide (laughing gas) at your discretion and have TV’s on the ceiling with headphones that can help them feel relaxed and comfortable.

Although we do allow parents in the treatment rooms at any time during their visit, it has been our experience to have your child come to the treatment room alone, while reassuring them that mom or dad will be right here waiting when we are finished! This is only a recommendation and of course we respect the parent’s wishes if they would like to accompany their child during their visit.

If you have any questions or concerns regarding your child’s visit, please do not hesitate to contact us at any time! You can find out more information about first visits here!

We look forward to seeing your child soon!

 

Tooth Brushing Resistance – How to Teach Your Child That Brushing Can Be Fun!

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Photo of a teething child

Teaching your child to take care of their teeth is just one way you can show them how to take responsibility for their body.  This can be a challenge because toddlers are motivated mainly by fun and pleasure, not by health and necessity.  If you want to end your child’s resistance to brushing, your best bet is to make this chore a fun ritual for them.  They will eventually catch on that brushing their teeth is a regular and necessary part of taking care of their whole body—and they’ll enjoy doing it.  Here are some tricks you can use to make it fun!

Make the toothbrush a toy.  Let them play with it (not by running around with it in their mouth).  Most kids will “play” with a toothbrush by biting or sucking on it, but doing so will help them get used to having a toothbrush in their mouth.  There are some electric toothbrushes that play songs.   There are cool smart phone apps (Disney, Brusheez, Chomper Chums, etc.).  Create the impression that tooth brushing is fun.

Play show and tell.  While you are showing your child how to “play” with the toothbrush, talk about the “sticky stuff” that collects on all of our teeth.  Tell them about the “sugar bugs” that will cause holes in their teeth and make them so they are not strong and white.  If you have a cavity that is filled or crowned, show it to your child to reinforce this point.  Show them how to brush their teddy bear’s “teeth,” or even let them brush yours!

Play copycat.  Capitalize on a toddler’s natural desire to mimic fun activities they see.  Bring them into the bathroom with you to watch you brush your teeth.  Be sure to lay out their toothbrush where they can reach it.  While you are brushing, exaggerate a show of excitement.  They’ll likely be encouraged to copy what you’re doing.

Open a toddler-friendly “book”.  Your local library (or Amazon.com) has many children’s books with “dental hygiene” storylines (Berenstain Bears, Dr. Seuss, etc.).  If your child learns better by visualizing, there are many excellent tooth brushing videos available on YouTube.  Sharing this information with them will make dental hygiene fun, familiar and non-threatening.

When nothing else will work.  Take advantage of your child’s normal environmental “restraints” such as a high-chair, a bathtub ring or another parent’s lap to gain access to his mouth.  Even if they cry a bit, you will gain better visualization of his mouth.   Your goals would be to quickly inspect, brush and reinforce the importance of this routine.  Toothpaste does not necessarily need to be used at this young age.  Flossing can be introduced later as they become accustomed to the tooth brushing ritual.

An ounce of prevention.  As a parent, you have control of your child’s diet.  Minimizing sugary drink consumption and ensuring that they never go to bed with any drink other than water will help prevent cavities before they start.

Worst Behaviors for Your Teeth

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There are a number of common habits that can cause harm to your teeth that you may not know about. For example, drinking certain beverages, chewing on things like ice or popcorn kernels, smoking, and lip or tongue piercings.

Casual everyday things, such as, not wearing a mouth guard, hard bristled brushes and using your teeth to open things can damage your teeth in many ways.

picture of custom night guard

Ask about a custom mouth guard at your next visit!

  • Mouth guards are recommended for anyone participating in contact sports. They protect your teeth from cracks and fractures.
  • Tongue or lip piercings can chip and crack your teeth. They can also contribute to gum recession, this is when gum tissue pulls away from the teeth, potentially leaving root surface of the tooth exposed.
  • Smoking and chewing tobacco can cause and worsen periodontal disease (gum disease), which can lead to tooth loss.
  • Hard bristled brushes and brushing too hard can cause gum recession too, revealing a softer layer of your teeth that erodes easier than enamel. Soft or extra soft toothbrushes are a better option.
  • Using your teeth as tools to tear open things like bags or bottles can fracture or crack your teeth.
  • Grinding your teeth can cause wear, fractures, and jaw pain. A night guard can help with nighttime grinding.
  • Lemons are acidic, and if you make it a habit to suck on them often they can erode the enamel on your teeth, causing cavities.
  • Cough drops can be as harmful to your teeth as hard candy. Many cough drop brands have high levels of sugar. When that sugar breaks down it results in acid that can eat away at your teeth.
  • Chewing on non-food items like pens or pencils, biting your nails and chewing ice can all lead to fractures or cracks. Chewing sugarless gum is a better option if you need to chew on something.
  • photo of sugary and acidic foods and beveragesSugary beverages like soda, sports drinks, and fruit juices promote the growth of bacteria that leads to sensitivity and decay. Diet soda may seem like the healthier option, as it is lower in sugar, but it is also acidic and can cause cavities.

Delicious Healthy Summer Recipes

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One of our hygienists wanted to share a couple of her favorite summer recipes!

Lemon Roasted Asparagus with Parmesan

Makes: 6 Servings

Prep Time: 5 Minutes

Cook Time: 25 Minutes

Ingredients:

2 bunches of Asparagus, ends snapped off

1 1/2 tablespoons olive oil

4 cloves garlic, lightly crushed and peeled

Zest (in long strips) and juice of 1 lemon

3/4 teaspoon salt

Freshly ground black pepper, to taste

Pinch of red pepper flakes

1/4 oz. shaved Parmesan

Directions:

Preheat the oven to 425 degrees. In a roast pan, toss the asparagus with the oil, garlic, lemon zest, salt, black pepper and red pepper flakes. Roast 20 to 25 minutes, tossing occasionally, until browned. Drizzle lemon juice to taste over asparagus, then transfer to a serving dish, discarding lemon zest and garlic. Sprinkle with Parmesan. Serve.

 

 

Spicy Hoisin-Glazed Turkey Meatballs

Makes: 6 Servings

Prep Time: 15 Minutes

Cook Time: 10 Minutes

Ingredients:

Nonstick cooking spray

1/4 cup diced red onion

1/2 pound ground turkey

1 egg white, lightly beaten

3 tablespoons plain, dried bread crumbs

3/4 teaspoon sesame oil

1/2 teaspoon garlic powder

Black pepper, to taste

1/4 cup Hoisin sauce

1/4 teaspoon sriracha hot sauce, or to taste

Juice from 1/2 an orange

Fresh cilantro sprigs (optional)

Directions:

Preheat oven to 425 degrees. Line two rimmed baking sheets with foil and mist with cooking sprays. Bring a small pot of water to a boil. Add the onion and boil 1 minute. Drain in a sieve and let cool.

In a bowl, combine onion with the turkey, egg white, bread crumbs, sesame oil, and garlic powder. Season with black pepper and stir until combined.

Scoop out slightly rounded teaspoons of the turkey mixture, roll into 3/4-inch meatballs and place on prepared backing sheets. (Dampen hands before handling meatballs, as mixture will be sticky)

Whisk together the Hoisin and sriracha in a small bowl. Spoon about 1/4 teaspoon of the glaze over each meatball. Placing baking sheets in the oven, and bake until meatballs are cooked through, about 6 to 7 minutes.

Remove from oven. Preheat broiler: broil meatballs, watching carefully, until glaze is sizzling, 1 to 2 minutes. Drizzle orange juice over meatballs and transfer to platter. Garnish with cilantro if desired, skewer with toothpicks and serve.

 

Why are you pulling on my tongue and what are you looking for?!

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Cancer – the uncontrolled growth of cells that invade and cause damage to surrounding tissue. Unfortunately, the frequency of oral cancer is on the rise – 100 new cases per day in the United States are being reported – one person every hour of every day will die from it. Risk factors include use of tobacco and alcohol and most recently determined, some strains of HPV (human papilloma virus), but within the last 5 years cases are increasing in males and females under age 50 with no risk factors. The fatality rate for oral cancer is one of the highest due to lack of detection before it spreads to other parts of the body.

The best tool we have to fight these results is early detection. To provide the highest standard of care for our patients, we perform an oral cancer screening at the time of our exams. Mostly this is a visual examination of the tongue, lips, and soft and hard tissues. The panoramic x-ray also gives us an overall picture of abnormalities of the hard tissues.

cancer screening process

Photo obtained from http://www.beverlyheightsdental.com/oral-cancer-screening.

What are we looking for? Any changes in appearance of tissue in the oral cavity including patches of red, white or ulcerations. Also any swelling or lumps, rough patches or a white film that can’t be wiped off. Many benign lesions look the same as cancer in the beginning stages, so at what point should you be concerned? The rule of thumb is most non-cancerous conditions will heal within 14 days. We may ask you to monitor any area we show you or have you return to see us in 2 weeks to re-evaluate. At this point if the condition continues, a biopsy may be recommended.

Many patients visit their dentist more regularly than their physician, so receiving this cancer screening is a vital part of keeping us healthy.