Keep Calm and Floss On

On August 2nd, this New York Times article was published and caused quite a bit of controversy in both the dental community and with the general public. While it is not conclusive in its findings, the overarching claim is that flossing may not be as beneficial as once thought. As dental professionals, we take very seriously the responsibility we have ensuring our patients receive the best possible education and care regarding the health of their smiles. For this reason, we feel compelled to express our disagreement with the suggestion that flossing may be overrated, and why that’s a harmful position to propagate.
Let’s first look at the article, which uses a lot of language such as:
• “…flossing may be overrated.”
• “…most of the current evidence fell short…”
• “That flossing has the same benefit is a hunch that has never been proved.”
• “…there is some mediocre evidence that flossing does reduce bloody gums and inflammation known as gingivitis.”
There is a stark difference between something ‘not having been proved’ and something being ‘disproved’. Please know that there is no evidence remotely close to suggesting the latter. In fact whether the evidence is “mediocre” or not, the only evidence the article does mention (quoted above) is in favor of flossing. A lack of ability to prove something is not cause to discourage an entire population from participating in a highly beneficial component of their health care. This is particularly true because evidence is acquired by conducting large-scale studies, which are extremely costly. It would hardly be economical to spend the research funding to prove something we already have no doubt offers a variety of benefit for your oral and overall health.
We do not agree with the article’s brash call to action, or more accurately, call to inaction, and we fear how this may increase the number of people inflicted with preventable damage to their smile. Looking again at the line “…there is some mediocre evidence that flossing does reduce bloody gums and inflammation known as gingivitis.” Gingivitis is the first stage in periodontal disease – the very condition flossing aims to combat. To reduce gingivitis is to reduce your chances of progressing into advanced gum disease, a condition more than half of Americans already suffer from (CDC).
It is unfortunate the scale of damage this article has the potential to incite; too many readers will take this “lack of evidence” as being evidence to the contrary, and feel it gives them permission to neglect a very essential part of their oral health care.
We can only do our best to keep our patients like you educated and on the path to a lifelong happy and healthy smile – a path that certainly includes consistent flossing.
CDC: “Periodontal Disease.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 10 Mar. 2015. Web

Dr.Malkemus

2 Padre Pkwy #200, Rohnert Park, CA 94928

Phone | (707) 585-8595

http://www.malkemusdds.com

Dental Deep Cleaning for Healthy Gums

What is scaling and root planing? When is it recommended?

As with many aspects of general dentistry, scaling and root planing is a treatment related to keeping your mouth free of gum disease. Your routine appointments and your home care are preventative measures to maintain your oral health; but as nice as it would be to keep your oral health in perfect condition all the time, sometimes that just doesn’t happen. When we identify the onset of gum disease, we work quickly to reverse the condition and get you back on a healthy track. This is where scaling and root planing treatments play a critical role.

Often referred to as periodontal cleaning or deep cleaning, they are all the same form of treatment. The procedure removes dental plaque and tartar, specifically below the visible gum line. The spaces between your gums and teeth are prime breeding ground for bacteria and infection, so without treatment they can deepen and compromise your oral health. There are a variety of tools and methods available for periodontal cleaning, and each is designed to finely clean the dental pockets the gum disease is attacking and deepening. Successfully completed, the build-up collected around the teeth and gums will be removed, and the gums will heal tightly around the teeth for a secure and healthy fit.

Post-Treatment Follow-Up

Scaling and root planing are advantageous procedures if gum disease is present, but what about the importance of following up after you’ve been treated? Despite the fact healing and improvements will be seen immediately following treatment, the actual procedure is only the first step in arresting the periodontal disease. The true efficacy of scaling and root planing is contingent upon a number of variables, including patient compliance.

It is imperative the patient and our office collaborate to prevent the infection from recurring. Infection is often the result of negligent oral care, which will need to be excellent and diligently preformed following treatment. As it takes a significant period of time for the infection and bacteria to build-up, the remedial steps taken after scaling and root planing will not be an overnight solution – time and consistency will be necessary for a full recovery.

Subsequent appointments are often necessary in order to monitor and track the healing progress, and we will discuss the frequency and importance of these with you to ensure your understanding and comfort. Our office will be there to help through each and every step of this process with respect to your unique needs, as well as offer any resources or information necessary to restore your smile to a happy and healthy state.

 

Dr.Malkemus

2 Padre Pkwy #200, Rohnert Park, CA 94928

Phone | (707) 585-8595

http://www.malkemusdds.com

Amalgam Fillings: Should They Be Replaced?

What is a filling?
Receiving a dental filling is a common procedure that many people have personally experienced. As a bit of a background, a filling becomes necessary when a tooth is damaged by decay and needs to be restored and protected. The function of a filling is to both seal off any spaces where bacteria could enter, and to reshape the tooth to its original form and function. Fillings are an invaluable part of dental work because they offer both a solution for present damage, and act as preventative guards against potential future damage.
A variety of materials are used to create fillings: gold, porcelain, a composite resin, or an amalgam (commonly referred to as silver fillings) are all common choices. There is no ‘best’ type of filling, and the right option for you is truly dependent on your individual case and personal preference.
Why remove a filling?
There are a few different reasons one may want to replace a filling, including a more natural look. Porcelain and composite resins look the most natural and are placed to match your tooth color, and it is not uncommon for those with gold and silver fillings to request these more subtle options. Each type of filling has its own lifespan, which can range from just a few years to several decades, so sometimes a routine replacement may also be in order.
However, in addition to appearance and time, there is also a debate surrounding the use of amalgam fillings.
What is the amalgam filling debate?
By definition, the word ‘amalgam’ is synonymous with the words ‘mixture’ or ‘blend’. As an example, a smoothie would be considered an amalgam of fruits!
In the dental world, ‘amalgam’ as it is used to describe a filling indicates it is a mixture of materials – this means that silver fillings are not pure silver, they have other similar materials in them as well. The proposed problem with these fillings is that the material could contain toxic or harmful matter that could negatively affect your health.
Unfortunately, it isn’t so simple. The biggest concern expressed by those opposed to amalgam fillings is the potential exposure to mercury, and patients potentially being poisoned as a result. That does sound awful, until you consider that we are all exposed to some level of mercury. Mercury is present in fish! A person would have to eat a lot of fish before there was any risk of poisoning, and the same could be said about a small tooth filling that is mostly made of silver. On the other hand, we understand if you have concerns about the material used in your filling.
If you already have an amalgam filling, it’s important to note that removing a filling when not completely necessary is an extra procedure, and with any medical procedure there are always risks involved. If you are getting a new filling and are uncomfortable with the idea of amalgam, just let us know and we can find an option that is right for you. There are many choices when it comes to your filling material, and we want you to walk out of our office feeling confident with your smile and your health.

Dr.Malkemus

2 Padre Pkwy #200, Rohnert Park, CA 94928

Phone | (707) 585-8595

http://www.malkemusdds.com

Pre-Medication for Dental Work After Joint Replacement

What is pre-medicating? What do artificial joints have to do with dental treatment? Why is this related to my oral health and not just overall health?
Good questions! Although artificial joints can seem like a far cry from concerns with your dental health, the two are more related than one may think. When it comes to artificial joints, there is an increased risk of infection due to the inorganic material in the body that should be taken into consideration. This is true from the time of placement, but it may also play a role with future medical treatments. It has long been suggested that pre-medicating should be a standard prerequisite to dental and other procedures, but what is pre-medicating and why would it help?

Pre-Medication Before Dental Procedures

Pre-medicating is the act of giving medication prior to a medical or dental procedure, which is done with the intention of staying ahead of potential infection problems. The theory is that bacteria from the mouth can enter the blood stream, and those with artificial joints are already more susceptible to infection. Pre-medication is meant to help mitigate this risk prior to the procedure to keep your overall health in check from start to finish.

Sounds simple – what’s the dilemma?

Your replacement joints may not affect treatments at all! Many question pre-medication as it does not appear to be necessary. In fact, the ADA directly states “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.” There is evidence that dental procedures are not associated with prosthetic joint implant infections, along with the fact that there is evidence to suggest that there are potential harms in taking medication when not completely necessary. As such, the risks do not outweigh the benefits of pre-medication. In individual cases, there may be exceptions; however, as a rule pre-medication is not a necessary prerequisite for effective dental treatments.
Please be sure to let us know if you have artificial joints, or any out of the ordinary medical circumstances. We will be sure to take them into consideration when it comes to developing your treatment plan. For the most part, your artificial joints will not require special treatment on your end – we can treat you as we would any other patient to keep your smile looking sharp!

Dr.Malkemus

2 Padre Pkwy #200, Rohnert Park, CA 94928

Phone | (707) 585-8595

http://www.malkemusdds.com

Easter Hard Candy

Easter means many things to different families everywhere, but one thing that remains consistent is the appearance of candy! Whether it’s hidden in eggs or just passed around, it comes at a nice nearly halfway mark in the year from Halloween. Sweets make for some excellent treats, and there is no reason not to indulge (in moderation of course)! However, all candies are not created equal, and it may be worth knowing which ones you can have relatively guilt free, and which could spell trouble for your wonderful smile.

When it comes to Easter indulgences, chocolate may make it onto the nice list – we know, this is great news to many of you. The less forgiving candies are the ones that make that all-too-familiar CRUNCH! Hard candies, like lollipops or jolly ranchers, can be an awfully tempting treat to bite. But best case scenario is they can pack hard-to-reach pieces of sugar into your gums that end up sitting there, as saliva can have a difficult time breaking them down. Worst case scenario, that crunch sound may be coming from a broken tooth, and sending you straight from your Sunday activities into our office. We do love seeing our patients, but not at the expense of their healthy smile! It happens more often than you think, and it’s not just because of the sugar – even some who are prone to absentmindedly crunching on ice have discovered the dangers of biting down on crunchy munchies when they find a piece of their tooth broken off. Your teeth are durable for normal eating and chewing, but anything that causes too much stress can run the risk of chipping or breaking one of your pearly whites. Before you try to impress your friends with breaking that jaw breaker in half, remember that it’s earned that name for a pretty good reason.

Even if you resist that satisfying crunch, there are still a few other points of concern for hard candies that you don’t run into with other options (like chocolate!). Hard candies that you suck on tend to spend a concentrated period of time in a single location, which over-exposes particular areas of your mouth to sugar and lead to a very concentrated build-up of acid, which can be a quick way to damage the enamel. Consider this next time you find yourself unwrapping that tootsie pop or after-meal mint, and perhaps enjoy a stick of gum instead. It’s not often that the solution for a sweet treat is yet another sweet treat, but you’re in luck because this time it is! After enjoying your holiday treats, consider enjoying a piece of sugar-free gum – the increased saliva productions while chewing can actually help dislodge and break down the remaining sugar in your mouth.

Overall, we don’t want to take the enjoyment out of candy-filled holidays – enjoy your time with your friends and family, and definitely don’t be afraid to pop open that plastic egg and see what treats hide inside. If you do find yourself going crazy for the crunchy candies, we hope you chew safely…and if things go wrong, you always have your friends at our office to set things straight (:

Dental Health and Pregnancy

Pregnancy changes a lot about the female body, which is no surprise considering all the physical and hormonal effects that take place over the course of those 9 months. All that considered, the profound connection between pregnancy and dental health can still be a shock to many.

As an example, the rapid surge in hormones, such as estrogen and progesterone, can alter the manner in which gum tissue reacts to plaque. Plaque buildup affects everybody, so it’s always important to make sure your teeth are being cleaned thoroughly. However, ‘pregnancy gingivitis’ is a condition that affects the vast majority of mothers-to-be and should be carefully monitored. Prevention is always more useful than treatment, and for that reason we encourage a diet high in Vitamin C and B12 – don’t forget, baby’s teeth are developing too so it’s important to have a diet that’s nutritious for your teeth and theirs! Be sure to brush twice daily with a fluoridated toothpaste and floss each evening as well.

In addition to ‘pregnancy gingivitis’, pregnant women are also at risk for ‘pregnancy tumors’. These tumors are inflamed, but non-cancerous, growths that may develop when the gums become swollen and irritated. Usually the tumors will resolve themselves post-birth, but if you find one and it’s uncomfortable or painful, don’t hesitate to call our office so we can help you proceed with the right treatment for you.

In general, if you are either currently pregnant or planning to become pregnant, you should always let your dentist know immediately in order to best proceed to minimize the risk of pregnancy-related complications. If needed, most procedures can be performed during pregnancy, particularly if you are in pain or have any concerns. However, we do not recommend any elective procedures until after the baby’s birth in order to minimize health risks to you or the child. Pregnancy does come with health concerns to be monitored, but as was the case before you received the news about your bundle of joy, consistent and thorough cleaning is always your best bet. Above all else, relax and enjoy this special time!

Dr.Malkemus

2 Padre Pkwy #200, Rohnert Park, CA 94928

Phone | (707) 585-8595

http://www.malkemusdds.com

 

Effects of Osteoporosis on your Oral Health

Effects of Osteoporosis on your Oral Health

Osteoporosis isn’t a new discovery, or a disease unheard of by many. That being said, many people don’t realize how closely tied to your oral health it can actually be.

In short, osteoporosis is caused by an insufficient consumption of calcium and vitamin D. It affects the bones, making them less dense and thus more likely to break. Osteoporosis is directly tied to your long-term dental health as this weakening of the bones may heavily compromise the jaw bone.  A weakened jawbone can have a host of detrimental consequences for your teeth, including increased tooth mobility, or complete tooth loss.

The best cure for the degradation of the jawbone is avoiding it all together with a balanced diet high in vitamin D and calcium, and getting a sufficient amount of exercise. Barring that, be sure to attend your dental appointments regularly so that way the structure and health of your mouth can be monitored, and any problems that may develop are addressed immediately and not permitted to deteriorate.

As it is, due to hormone imbalances and changes over life, women are most at risk to developing osteoporosis, but it can absolutely develop in either gender depending on a host of lifestyle variables, not limited to diet and exercise.

Symptoms to pay attention to that may be indicative of osteoporosis affecting the jaw include: pain and/or swelling in the gums or jaw, as well as infection; injured gums not healing in a timely fashion; teeth that become loose for no reason or after only minor strain; numbness or discomfort in the jaw; or at worst, exposed bone. If you experience any of these symptoms, don’t hesitate contacting your dentist to prevent exacerbating the issue.

Dr.Malkemus

2 Padre Pkwy #200, Rohnert Park, CA 94928

Phone | (707) 585-8595

http://www.malkemusdds.com