Facts About Dental Myths

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COMMON DENTAL MYTHS DEBUNKED

With the magnitude of information available to us these days, it’s harder than ever to separate facts from myths; especially when it comes to your health. There are a million dental related myths that might steer you in the wrong direction when it comes to a healthy smile. It’s important to be informed and know the facts. Here are a few common dental myths, followed by the facts.

Oral Hygiene Only Affects Your Teeth

Many people hear the phrase “oral hygiene” and they think of the simple act of brushing or flossing. While oral hygiene is important for keeping your teeth healthy, poor oral hygiene can be linked to several other health problems- including heart disease. Taking care of your mouth actually means taking care of a lot of things within your body. Untreated periodontal disease contributes to more low birth weight babies than both drinking and smoking combined.  Having poor oral hygiene can cause a multitude of problems- not all of them related to your teeth.

You Shouldn’t Get Your Wisdom Teeth Out Until They Start to Hurt

Typically, it’s always better to be safe than sorry, and your dentist will generally advise you of the same. If you wait for your wisdom teeth to become painful, they might have already done other damage to your gums or teeth. Many people believe that as long as they have no pain, there’s no reason to have an unnecessary surgery. In rare cases, wisdom teeth can stay intact as long as they are not interfering or causing damage. One of the most common reasons to remove wisdom teeth is because they are so difficult to keep clean and rather than incurring costly repairs to those teeth many dentists will suggest having them removed.  Frequent exams are necessary in this case to monitor and maintain your health. It’s generally better to have your wisdom teeth removed before any pain, rather than take the gamble.

White Teeth Are Healthier Teeth

Teeth are actually not meant to be pure white. Tooth color can vary widely, for example, depending on your race, pigmentation varies greatly.  Also, as you get older, your teeth will naturally take on a more faded color as things do with time, however they can still be perfectly healthy. A color beyond a light yellow could be cause for concern, but generally the pinkness of your gums is a better indication of oral health as opposed to how white your teeth are.

If Teeth Look Healthy, and Are Not Hurting, There is No Reason to Visit a Dentist

The most common mistake people make regarding their dental health is skipping regular preventive visits because they do not see or feel any problems. Even in the absence of a visible problem or discomfort, regular visits for x-ray exams, cleaning and necessary restorative care are necessary to maintain your teeth and gums for life. Discovering diseases in the mouth earlier rather than later will typically reduce cost, recovery time and severity of dental treatment that may need to be performed.

It’s important to educate yourself on the facts surrounding whole body health and well-being. Muddled information and common misperceptions can leave people confused. The best way to combat myths and augment dental health is to see and speak with your dentist regularly. Have open dialogue and productive conversations about what is and is not true. Being informed, savvy and educated will keep you and your dentist smiling. 

George A. Malkemus, DDS

Dentist in Rohnert Park
2 Padre Parkway Suite #200
Rohnert Park, CA 94928
 Phone: (707) 585-8595

5 Candy Alternatives That Will Keep Trick-or-Treaters Smiling

Treat Trick-or-Treaters to a Healthy Treat This Season

The fall season brings an amazing amount of fun activities for you and your family. From the excitement of Halloween, to school fall festivals, kids and parents alike look forward to the cool weather and family memories. Unfortunately, Halloween and fall festivals can also do a number on your child’s teeth. Hard candies, sweet treats and sugary snacks can be cavities waiting to happen. Handing out Halloween candy doesn’t mean you have to hand out oral health disasters. There are a number of healthy alternatives to the candy bars and licorice- some that trick-or-treaters might even enjoy more than the sugar rush. The days of handing out apple slices and pennies to avoid contributing to tooth destruction are gone! Take a look at some of these creative trick-or-treat alternatives that will leave all the little ghosts and ghouls smiling throughout the year.

Applesauce Pouches                                                                                     

Applesauce is still a sweet treat, and not nearly as hard on the teeth. Not only that, they’re portable, affordable and a great way to avoid the mess of some other treats. You can get a pack of 48 pouches for about 35 dollars on Amazon, which is enough to give all the trick-or-treaters something healthy to smile about.

Mini LaraBars

Larabars are gluten free, vegan, kosher and only have about 8-11 grams of sugar per bar. They also come in mini form, making them perfect to hand out on Halloween. The great thing about these treats is that the kids won’t even know they’re healthy! LaraBars have flavors such as cherry pie, apple pie and cashew cookie and are just as delicious as the other mini candy bars that will be weighing down their bag. If you can’t find LaraBars, or they’re a little too pricey for you, granola bars of any kind will be a better choice than chocolate.

Vegan Rice Crispy Treats

Rice crispy treats are a delicious sweet treat for trick-or-treaters, but you don’t have to use all the sugary marshmallow to make them amazing. There are a number of recipes you can follow which swap out a few classic ingredients for something a little healthier in order to create the perfect Halloween snack. By using brown rice syrup instead of marshmallow, brown rice crisps instead of white rice and coconut oil instead of butter- you can make delicious, healthy treats that many claim are better than the original. Check out one the recipes here. 

Sugar Free Gum

While sugar free gum may not be the most exciting item in your child’s bag, it’s still a quality alternative to all the junk they’ll be getting. You can get tasty sugar free gum such as Dubble Bubble and throw a few pieces in along with other healthy treats. Parents will appreciate the lack of sugar, and the kids (especially those kids who love their chewing gum) will be happy with a full bag of “candy.”

Toys

If you want to skip the food items altogether, many parents have opted to hand out toys instead. There are a number of items you can get in bulk for cheap such as pencils, erasers, stickers, mini water guns, temporary tattoos, mini play dough, sidewalk chalk, bouncing balls, bubbles and more. The possibilities are endless and none of these things will land your child in the dentist’s chair. If you’re thinking of skipping the candy and handing out toys, head to your local dollar store to find amazing deals on bulk items.

There’s also the option of handing out pre-made veggie and fruit snacks, however this may only be a good idea if you’re close with the surrounding neighbors. Parents are often a little leery of pre-prepared snacks and the time and money you spent might simply end up in the trash. These days there really are dozens of candy alternatives that don’t skimp on the flavor. Do your own research to find what works best for you and your family, have fun with it, and get everyone involved. Keep in mind that most trick-or-treaters will be over-flowing with the sugary stuff- so its good practice as a parent and oral health advocate to provide something that will keep their smiles healthy throughout the year.

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George A. Malkemus, DDS

Dentist in Rohnert Park
2 Padre Parkway Suite #200
Rohnert Park, CA 94928

MalkemusDDS.com Phone: (707) 585-8595

Dental Treatment for Patients on Blood Thinner

Blood thinners do not affect most dental procedures.  However, blood thinners can have an effect on blood clotting during dental surgery.  Depending on the medication, the dosage and the extent of dental surgery, bleeding can be a concern.  The low level of aspirin use for blood thinning is rarely a concern.  However, stopping aspirin use the day before dental surgery is usually recommended. 

Warfarin use presents the most common potential bleeding problems that dentists encounter.  Stopping coumarin medication prior to dental treatment is controversial.  Since it takes 48 to 72 hours for warfarin to be effective, it must be stopped 2-3 days before treatment, which puts the patient at risk for serious blood clotting complications.   So the risk-benefit has to be determined, that is, uncontrolled bleeding verses blood clot formation in the vessels.

Warfarin should not be stopped for most dental procedures including most extractions and implant placements.  But with any dental surgery, a consultation with the patient’s physician and a recent INR blood test should be reviewed.  Usually an INR up to 2.5 is acceptable and safe for dental surgery, thus coumarin does not need to be stopped or lowered.  With a common sense approach, I ask my patients if they clot, that is, the bleeding stops, in a reasonable amount of time with direct pressure on a skin cut.  During dental surgery, treatment can be done to enhance clotting, such as, the use of clotting agents, stitches, bone grafts and membranes.  Bone grafts and membranes preserve bone in an extraction site as well as reduce bleeding.

Last year I saw a dental phobic 57-year–old patient Todd, who was taking warfarin for deep venous thrombosis from poor circulation in his lower legs and thighs.  He was in severe pain from a split lower left molar and needed an extraction.  After consulting with his physician and determining his INR was 2.2, Todd continued his normal warfarin regime.  With conscious sedation, his tooth was removed and a bone graft and membrane were placed with no bleeding complications.  He was comfortable throughout the procedure with no memory of the event.  Eight weeks later, a root replacement titanium implant was placed under conscious sedation with him continuing his warfarin use.  Just as during his first treatment, Todd had no bleeding problems and happily had no memory of the implant procedure.   4 months later, an implant crown was fabricated and placed with the same great results.

While a risk-benefit assessment, bleeding verses clotting, must be made for each patient, dentist can perform most dental treatments safely for patients taking warfarin without the need for stopping warfarin therapy.     

Enjoy Life and Keep Smiling!

George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 27 years at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com.  Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com

Antibiotics and Your Heart

If you have had to take antibiotics prior to dental treatment because of your heart condition, you may not need to any more.  The recent guidelines from the American Heart Association recommend not taking antibiotics prior to dental treatment in most heart condition cases.  You should contact your cardiologist, physician, and dentist to see if you should stop or continue.

For decades, the American Heart Association [AHA] recommended that patients with certain heart conditions take antibiotics shortly before dental treatment.   This was done with the belief that antibiotics would prevent infective endocarditis [IE], an infection of the heart’s inner linings or valves.  The idea was bacteria in the mouth could enter the blood stream during dental treatment and travel to the heart.  It was thought that with a heart murmur, turbulence in the blood flow caused by the heart valve would allow the bacteria to eddy out and start a growth on the valve – not a good thing.  However, a growing body of scientific evidence has shown this is not the case.

The scientific evidence shows that the risks of taking preventive antibiotics out weigh the benefits for most patients.  The risks include adverse reactions to antibiotics and development of drug-resistant bacteria.  Adverse reactions range from upset stomach, nausea and diarrhea to allergic reactions such as hives or life threatening anaphylactic shock.  Allergic reactions to medications, as well as, foods, environmental substances including insect bites and stings can occur after years of never being allergic.  If you have redness, swelling or itchiness after taking medication, stop future pills and call your doctor.  If you have accelerating symptoms especially difficulty breathing, seek immediate emergency help, i.e., call 911.  Use an epi-pen if available, which is found in some emergency kits or carried by people who are allergic to bee stings.

The over use of antibiotics causing the development of drug-resistant bacteria is another reason the AHA guidelines have changed.   Drug-resistant bacteria are formed from antibiotic use.  The inappropriate use of antibiotics increases the risk of drug-resistant forms and prevents their effectiveness when antibiotics are really needed.

Scientists also found no compelling evidence that taking antibiotics before a dental procedure prevents IE in patients who are at risk of developing a heart infection.  There is actually more exposure to bacteria from their mouths during basic daily activities such as eating, drinking, brushing or flossing.  People with gum disease are at a much higher risk of having bacteria enter their bloodstream and causing infective endocarditis and heart disease. So a person’s best defense against IE is preventing gum disease through good oral hygiene, brushing and flossing, healthy diet, and regular professional cleanings with a registered dental hygienist.

A bacterial infection of the gums, called periodontal disease, can affect the entire body.  Gum disease is correlated with heart disease, diabetes, strokes, ulcers and pre-term births.  Bacteria that build up between the tooth and gum can enter into the bloodstream when gums bleed. These bacteria can travel throughout the body and cause serious health problems. Periodontal disease can be prevented with good oral health habits; such as, brushing and flossing, and regular professional cleanings.                                                     

                                                                                                                            AHA Guidelines: Who Should Take Prophylactic Antibiotics Before Dental Treatment

The AHA guidelines state that patients who have taken prophylactic antibiotics routinely in the past, but no longer need them include people with mitral valve prolapse, rheumatic heart disease, calcified aortic stenosis, or most congenital [present from birth] heart conditions.

Certain heart conditions still require pre-medication with antibiotics in patients who would have the greatest danger of a bad outcome if they developed a heart infection.  Preventive antibiotics before a dental procedure are advised for the following patients:

-Artificial heart valves

-A history of infective endocarditis

-Certain specific, serious congenital heart conditions

-A cardiac transplantation that develops a problem in a heart valve

If you have any of these heart conditions, you should consult your cardiologist for the use of antibiotics prior to dental procedures.

The new recommendations apply to any dental procedures that could involve possible bleeding in the gums or oral tissues.  Antibiotic use prior to dental treatment is not necessary for an examination or x-rays, but is mandatory for teeth cleanings and oral surgery treatment like extractions.

The AHA guidelines emphasize that maintaining optimal oral health and practicing oral hygiene are more important in reducing the risk of infective endocarditis than is the taking antibiotics before a dental visit.   So keep brushing and flossing and have regular dental cleanings.

ENJOY LIFE AND KEEP SMILING!

George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com.  Visit Dr. Malkemus’ Web site at malkemusdds.com

George A. Malkemus, DDS

Dentist in Rohnert Park
2 Padre Parkway Suite #200
Rohnert Park, CA 94928

MalkemusDDS.com Phone: (707) 585-8595