By Martin, Kissell & Pushee, PC
December 27, 2020
Category: Dental Procedures
Tags: dental implant  
SmokingCouldIncreasetheRiskofanImplantFailure

Although they can be expensive upfront, dental implants often prove to be a wise investment in the long-term. With a success rate that outperforms other teeth replacement restorations, dental implants could be the answer to a more attractive smile that could last for decades.

But while their success rate is high (95% still functioning after ten years), they can and do occasionally fail. Of those that do, two-thirds happen in patients who smoke.

This unfortunate situation stems from smoking's overall effect on dental health. The nicotine in tobacco constricts oral blood vessels, inhibiting the flow of nutrients and antibodies to the teeth and gums. Inhaled smoke can scald the inside skin of the mouth, thickening its surface layers and damaging salivary glands leading to dry mouth.

These and other effects increase the risk for tooth decay or gum disease, which in turn makes it more likely that a smoker will lose teeth than a non-smoker and require a restoration like dental implants. And blood flow restriction caused by nicotine in turn can complicate the implant process.

Long-term implant durability depends on bone growth around the imbedded implant in the ensuing weeks after implant surgery. Because of their affinity with the titanium used in implants, bone cells readily grow and adhere to the implant. This integration process anchors the implant securely in place. But because of restricted blood flow, the healing process involved in bone integration can be impaired in smokers. Less integration may result in less stability for the implant and its long-term durability.

To increase your chances of a successful implant installation, you should consider quitting smoking and other tobacco products altogether before implant surgery. If that's too difficult, then cease from smoking for at least one week before surgery and two weeks after to better your odds of implant success. And be as meticulous as possible with daily brushing and flossing, as well as regular dental visits, to reduce your risk of disease.

There are many good reasons to quit smoking. If nothing else, do it to improve your dental health.

If you would like more information on tobacco use and dental health, 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 “Dental Implants & Smoking.”

By Martin, Kissell & Pushee, PC
December 17, 2020
Category: Oral Health
Tags: oral health  
InfectionControlattheDentalOfficeIsntSomethingNew

In the midst of the current global pandemic, we're all focused on staying healthy and avoiding infection. For many, their first thought before resuming any regular activity is, “Will I or my family be safe?”

If you've asked that about visiting the dentist, rest assured, it is. In fact, dentists have been at the forefront in protecting patients from viral and bacterial infections for decades. Here's why you're in safe hands at the dentist's office.

Barrier control. Although we're focused at the moment on Covid-19, there are other pathogens (microorganism that cause disease) for which there has been an ongoing concern among healthcare providers. Many of these like the viruses that cause hepatitis or HIV/AIDS spread through blood-to-blood contact. That's why we routinely use gloves, face shields and other barrier devices, even during routine visits, to prevent bloodborne transmission between patients and staff, or other patients.

Disinfection. Viruses and other pathogens may continue to live on surfaces in treatment areas for various durations. To prevent their transmission to humans, we follow strict procedures for disinfecting all treatment-related surfaces after each patient visit. One-use treatment items are disposed separately from regular waste. Permanent instruments and equipment are cleaned and thoroughly sanitized to the highest standard.

Protocols. There are approximately 170,000 dentists across the U.S., yet each generally follows the same high standards for infection control. Regulating bodies at state levels have made infection control a crucial part of licensing requirements and continuing education, and every dental practice must have an infection control plan they meticulously follow. Because of these strict standards, an infection occurring in a dental office setting is extremely rare.

In addition to these regular procedures, dentists have also added extra safety measures to better address the current crisis, and will continue these until the crisis has abated. Staying knowledgeable and flexible to new challenges is also a feature of dental providers' infection control mission.

If you do have concerns, please feel free to contact us to learn more about the specific measures we have in place to keep patients safe. Protecting you and your family during dental care will always be our top priority.

If you would like more information on patient safety at the dentist's office, 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 “Infection Control in the Dental Office.”

FindOutHowTheseFamousCelebritiesProtectTheirSmilesFromTeethGrinding

The fast-paced world of sports and entertainment isn’t all glitz and glamour. These high-profile industries create a unique kind of emotional and mental stress on celebrities. For many of them, a way to “let off steam” is an oral habit known as teeth grinding.

Teeth grinding is an involuntary habit in which a person bites and grinds their teeth outside of normal activities like eating or speaking. It’s common among young children, who usually grow out of it, but it can also affect adults, especially those who deal with chronic stress. If not addressed, teeth grinding can eventually wear down teeth, damage gum attachments or fracture weaker teeth. It can even contribute to tooth loss.

A number of well-known personalities in the spotlight struggle with teeth grinding, including actress Vivica Fox, model and TV host Chrissy Teigen, and star athletes Tara Lipinski and Milos Raonic of ice skating and tennis fame, respectively. The habit represents not only a threat to their dental health, but also to one of their most important career assets: an attractive and inviting smile. Fortunately, though, they each use a similar device to manage their teeth grinding.

Besides seeking ways to better manage life stress, individuals with a teeth-grinding habit can protect their teeth with a custom mouthguard from their dentist. Made of slick plastic, this device is worn over the teeth, usually while sleeping, to minimize dental damage. During a grinding episode, the teeth can’t make contact with each other due to the guard’s glossy surface—they simply slide away from each other. This reduces the biting forces and eliminates the potential for wear, the main sources of dental damage.

Chrissy Teigen, co-host with LL Cool J on the game show Lip Sync Battle, wears her custom-made guard regularly at night. She even showed off her guard to her fans once during a selfie-video posted on Snapchat and Twitter. Vivica Fox, best known for her role in Independence Day, also wears her guard at night, and for an additional reason: The guard helps protect her porcelain veneers, which could be damaged if they encounter too much biting force.

Mouthguards are a prominent part of sports, usually to protect the teeth and gums from injury. Some athletes, though, wear them because of their teeth grinding habit. Tara Lipinski, world renowned figure skater and media personality, keeps hers on hand to wear at night even when she travels. And Milos Raonic, one of the world’s top professional tennis players, wears his during matches—the heat of competition tends to trigger his own teeth-grinding habit.

These kinds of mouthguards aren’t exclusive to celebrities. If you or a family member contends with this bothersome habit, we may be able to create a custom mouthguard for you. It won’t stop teeth grinding, but it could help protect your teeth—and your smile.

If you would like more information about protecting your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”

By Martin, Kissell & Pushee, PC
November 27, 2020
Category: Dental Procedures
Tags: dental implant  
TalkWithYourDentistAboutAntibioticTherapyBeforeImplantSurgery

Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.

To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.

One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.

In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.

These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.

As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.

If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.

If you would like more information on getting dental implants, 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 “Implants & Antibiotics.”

By Martin, Kissell & Pushee, PC
November 17, 2020
Category: Oral Health
Tags: dental care  
AMildNSAIDMayBeAllYouNeedToManageDiscomfortAfterDentalWork

Undergoing dental work is for the most part a pain-free affair. But once you're home and the anesthetic begins to wear off, you may have some discomfort.

Fortunately, most post-procedure pain can be managed with non-steroidal anti-inflammatory drugs or NSAIDs. And while stronger versions of these pain relievers can be prescribed, you may only need one sold over-the-counter.

NSAIDs like ibuprofen or acetaminophen work by inhibiting the release of prostaglandins, substances that stimulate inflammation in traumatized or injured tissues. It differs in this way from the two other primary pain medications: Steroids act like natural hormones that alleviate physical stress in the tissues; and narcotics like morphine or codeine suppress the brain's reaction to nerve firings.

While these stronger types are effective for stopping pain, they can have several serious side effects. Narcotics in particular can be addictive. Although they may be necessary in serious cases of acute pain, most dentists turn to non-addictive NSAIDs first, which are usually effective with the kind of discomfort associated with dental work and with fewer side effects.

That's not to say, however, that NSAIDs are risk-free—they must be taken properly or you could suffer serious health consequences. For one, NSAIDs have a blood-thinning effect that's even more pronounced when taken consistently over a period of weeks. This can lead to bleeding that is difficult to stop and erosion of the stomach lining leading to ulcers. Prolonged use can also damage the kidneys.

As a rule of thumb, adults shouldn't take more than 2400 milligrams of ibuprofen or other NSAIDs in a day, unless otherwise directed by their doctor. For most, a 400-milligram oral dose taken with food (to minimize stomach upset) is usually sufficient to relieve pain for around five hours.

You'll usually avoid unwanted health effects by keeping within your dentist's recommended doses and taking an NSAID for only a few days. Taking an NSAID properly can help keep your discomfort to a minimum after dental work without the need for stronger drugs.

If you would like more information on managing dental pain, 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 “Treating Pain With Ibuprofen.”





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