Gum Disease/Periodontal Disease

Some form of gum and bone disease is present in most adult mouths.

Periodontal disease is unrecognized because the condition is generally painless and slow in progression. Symptoms include red, inflamed gums, which bleed easily with brushing and flossing, bad breath and teeth becoming loose as condition worsens.

The supporting structures of the teeth including the gums and bone are termed Periodontium.

Gum and bone breakdown begins at the gum line with gingivitis and progresses to the more severe periodontitis. When oral hygiene is neglected and poor over all health is encountered, gum disease begins.

Gingivitis is a mild inflammation of the gum tissue when food deposits, dental plaque or the more calcified calculus are allowed to remain on the teeth.

Periodontitis is when food deposits, plaque and calculus continue to remain on the teeth, over time the bone begins to degenerate. This condition is termed Periodontitis.

As bone surrounding the root degenerates, teeth loosen, drift, migrate eventually leading to the loss of tooth. Proper treatment can still save most teeth.

Gum Disease Treatment Alternatives:

The success of conservative gum disease treatments rests on significant coordination and cooperation between the patient and the dental professional. Periodontal health can be stabilized with conservative treatment alone but in some cases the more invasive conventional therapy is required.

Conventional Periodontal Therapy is usually surgical. It involves gently lifting away the gum tissue from the affected teeth, removing and root planing the calcified calculus, re contouring the irregularities on the root and bone surfaces and carefully placing back and securing the reflected tissue. After a healing period and maintenance of good oral hygiene, the periodontal condition can be improved or stabilized.

Prevention of gingival and periodontal disease only requires optimal oral hygiene practices, healthy diet and a restriction on tobacco and alcohol use.

Maintenance of periodontal health may require more frequent dental hygiene visits and adherence to individual hygiene recommendations made to you by the dental professional.

Oral Health is Important to Overall Health Maintenance. Let Smile Artistry, a trusted dentist in Chino, help you achieve your best smile yet!

Visit wwwsmileartistrychino.com for additional information

Snoring and Sleep Apnea

It is estimated that 30-50% of patients snore while sleeping- the incidence of snoring increases with age and men snore more frequently than women. Most people are unaware that there is professional help available for snoring.

A related condition, sleep apnea or obstructive sleep apnea (OSA) is a condition where the breathing space in the back of the mouth is closed off. OSA causes significant pauses in breathing and can be life threatening.

Dentists are associated with the treatment of both snoring and OSA. However, a team approach is a safe and effective means to treat these conditions. Dentists work with dental laboratories; sleep technicians and board certified sleep physicians as a team to curb snoring and sleep apnea.

Causes of snoring are partial or complete closure of airway is the cause of snoring as seen in:

Obstruction of nasal airway

Weak throat muscles

Lower jaw being too far back closing off throat

Sleeping posture- sleeping on back causes closure of breathing space

Fat accumulation in and around throat

Loss of muscle tone related to aging

Use of muscle relaxants including alcohol and sedative hypnotics

Snoring Effects:

Sleep deprivation

Social and marital challenges

Increased potential for heart attack and stroke

Snoring can be reduced or eliminated with relative ease but the associated condition of OSA needs more consideration. The pauses in breathing in children and adults happen between 5- 30 times an hour and causes daytime fatigue, slow reaction time and vision problems. About 15% of the American population suffers from sleep apnea. It is a serious condition that can be life threatening. Since OSA is associated with snoring, it must be addressed as part of the treatment for snoring.

Types of Sleep Apnea:

Obstructive sleep Apnea- occurs when soft tissue in the back of throat relaxes during sleep and blocks airway and causes loud snoring

Central Sleep apnea- much less common condition and occurs when the nervous system fails to signal the muscles that control breathing

Complex Sleep apnea- a combination of OSA and central sleep apneas and is associated with significant medical problems

All forms of sleep apnea often go unnoticed and can become serious when left untreated over time.

Snoring and Sleep Apnea Treatments:

Continuous Positive Airway Pressure (CPAP)

Anti snoring oral appliances / mouthpiece for snoring

Surgery

Medications

Losing Weight

Stopping Smoking

Sleeping on Side

Over the Counter Nasal Sprays

Nasal Strips or Clips

Anti Snoring Pillows

CPAPs and anti snoring devices are the most used and most successful treating options. Severity of snoring and OSA condition is measured by a sleep monitoring device to select appropriate treatment. Assuming that the OSA is not severe, sleep apnea dental appliances can easily control snoring and OSA.



Potential Side Effects of Oral Appliances:

Jaw/facial pain

Bite Changes

Tooth Pain

Jaw Joint Pain

Drooling

Dry Mouth

Sound, restful and peaceful sleep is possible. Cost of our sleep apnea dental appliances, or our mouthpiece for snoring are very minimal considering the huge benefits of sound sleep and increased productivity. 

Visit www.smileartistrychino.com for more information on our services.

Antibiotics and Dental Procedures

The mouth is packed with various strains of bacteria, which in a healthy individual maintain optimal oral health. During daily routines like chewing, brushing or flossing, the bacteria can enter the blood stream but don’t present a problem for most of us  when the immune system is healthy. In compromised health, bacteremia (bacteria entering blood stream) can cause infections elsewhere in the body.

Specific heart conditions and orthopedic implants such as artificial joints have known to be the more vulnerable sites for potential infections. 

Antibiotic prophylaxis, or preventative use of antibiotics prior to a dental visit is recommended in conditions like-

-Artificial heart valves

-History of infection of the lining of the heart or heart valves known as Infective Endocarditis

-A heart transplant

-Congenital heart conditions like Cyanotic congenital heart disease

-Defects repaired with a prosthetic device

The criteria for antibiotic prophylaxis is periodically updated by the American Heart Association and the American Dental Association depending on current research and development. Currently, the AHA recommends prophylactic antibiotics only on patients with a history of endocardial bacterial endocarditis.

American Associations of Orthopedic Surgeons in their revised guidelines no longer recommend antibiotics for patients with artificial joints.

In an abundance of caution, our office coordinates with the patient’s physician to determine the appropriate antibiotic protocol. 

Visit www.smileartistrychino.com to E mail us at lovemydentist@gmail.com

Palliative Treatment for Frail and Older Adults (Article 4 of 4)

The goal of palliative treatment is to enhance the quality of life during a painful episode  or for someone with a terminal illness A dentist's role could greatly enhance patient comfort and quality of life as the mouth is often the first site on pain.

  The first step in  palliative oral care is establishing good communication with the patient. With a good understanding of the patient's health circumstance, conducting a thorough oral exam  and asking for symptoms, severity and frequency is very important to determine the most bothersome issue and dealing with it promptly.

The most common oral complaint is dry mouth  If possible increase water consumption or use ice chips if choking is not a concern.. Foam swabs are helpful with providing moisture although not effective for plaque removal.  The swabs can be soaked  in warm salt water or an alcoholfree mouth rinse prior to swabbing the inside of patient's mouth.
 Daily oral hygiene is essential with modifications as needed for the palliative patient. An ultra soft  small toothbrush head can be used to promote comfort.

Candidiasis or fungal infections are common in palliative patients.  Anti fungal gels can be applied if patient cannot rinse.  Dentures can be scrubbed with soap and water and antifungal gel applied on the under surface of denture.

Preserving dignity is important part of palliative care. Maintaining a satisfactory facial appearance may be important to some patients and dentures, if needed should be made.

This concludes the series on dental care for the older adults.  Call 909 627 6699  or visit www.mydentistchino.com for more information.

Treatment Planning for Frail Older Adults (Article 3 of 4)

 Treatment planning  for frail and dependent patients should meet the objectives of preventing pain and infection, maintaining function, preventing systemic complications and improving or maintaining quality of life.

Frail adults live in the community but have varying degrees of functioning limitations.Their treatment options are guided by their level of dependency- no dependency, medium dependency or high dependency status.

For medium dependency adults, the recommendation is to treat teeth conservatively. Restore carious lesions using atraumatic techniques and floride releasing restorative materials. Dentures or removable teeth replacements should be designed to facilitate hygiene and easy removal.

Dependent older adults typically live in long term care settings and are home  bound. For homebound and long term care residents, recommendations include managing discomfort and infection and performing  only procedures necessary for social interactions and normal function.

Early in the interactions with frail or dependent patients, it is important to gauge the patients ability to comprehend treatment recommendations and independently make competent decisions. Patient's financial resources, general health, cognition and  capacity for home care must be taken into account. The benefit from the proposed treatment must be weighed very carefully against the physical discomfort and mental anguish a particular patient may experience.  The focus is to address the patient's primary concern.

For more information call 909 627 6699 or visit www.mydentistchino.com

Prevention and Disease Management for Older Adults( Article 2 of 4)

The rapid growth of population that is 65 and older will profoundly affect dental care in a number of ways.
Risk assessment for this vulnerable group  will help develop the most appropriate prevention plan and treatment strategy.

 Prevention:

Majority of older patients suffer from hyposalivation or Drymouth

Simple preventative remedies  to alleviate drymouth include-

Regular sips of water throughout the day
Limiting number of alcoholic beverages and beverages
Limiting beverages high in sugar and caffeine particularly sodas,juices and sweetened coffee and tea
Avoid spicy and salty foods
Caution using mouth washes containing alcohol
Using  salivary substitutes  such as Oralbalance gel, Biotene Moisturing spray, liquid mouthspray etc
.
In extreme cases, a salivary stimulant may be prescribed which does require consulting with patient's physician. 
Discussion with physician and or pharmacist regarding substitution of medicines causing dry mouth can also be an option.

Caries:
For patients with an increased risk of caries or dental decay, an oscillating tooth brush is best.  Automated toothbrushes remove more plaque than manual brushing alone. It is particularly helpful for patients with limited dexterity and arthritis.

Use floridated toothpaste daily and floride rinses
 Periodic topical application of 5% sodium floride varnish in severe cases of caries.
  This mode is inexpensive, non invasive and shown to reduce decay.

As the old adage goes " an ounce of prevention is worth more than a pound of...."

Visit www.mydentistchino.com or Call 909 627 6699 to contact our office. We are more than happy to help you with your question.

Dentistry for the Elderly (1st of the series)

The aging population is the most important demographic trend.  Nearly 20% of the U S population will be older than sixty five by the year 2030.  As the age of the older adult is upon us, the services rendered should be age appropriate and have lasting value. 

Older adults have the most diverse clinical and physical presentation than any other age group. We could see fully functioning independent adults, frail older adults characterized by numerous medical conditions that impair mobility and dexterity and those who are dependent on help to carry out the normal daily activities.

.  Age is often a primary consideration when developing a treatment plan but it is important to assess each patient’s individual needs and capacities instead of relying on stereotypes of aging. 

The rapid growth of the elderly population affects dentistry in a number of ways. 

1/ the elderly are retaining teeth longer than the previous generation

        Approximately 90% of the seniors who have their natural teeth have    experienced decay with 64 % suffering from periodontal or gum disease.

2/ the body changes that occur with aging often make treatment planning more complex.

3/ medical problems and medications complicate and in some cases exacerbate dental disease.

Limitations in frail older adults create barriers to achieving and maintaining optimum oral health. 

 Visit our website www.mydentistchino.com or Call 909 627 -6699 for more information.

Revisit this site next week for more on prevention and disease management of this vulnerable group.

Have A Happy and Safe Fourth of July

from

Our dental family to yours!

Dry Mouth or Xerostomia

Dry Mouth is a symptom rather than a specific disorder. Saliva cleanses the mouth and begins the digestive process as foods are chewed. Adequate saliva flow coats and lubricates the mouth. When dry mouth or xerostomia occurs, soft tissues get irritated and inflamed and are more susceptible to oral infections. Without the cleansing and shielding effects of adequate salivary flow, tooth decay and periodontal disease become more prevalent.   Constant dryness and lack of protection provided by saliva contribute to bad breath.  In denture wearers, dentures feel less comfortable without the thin film of saliva to help them adhere properly to the mouth.

Causes of Dry Mouth

Prescribed and over the counter medications have emerged as the most common cause of dry mouth.

Medications including  antihistamines, decongestants, pain killers, diuretics, anti hypertensives and anti depressants are among 400 other medications that have side effects of dry mouth.

Aging does minimally reduce the salivary flow.

Radiation of head and neck

Emotional stress 

Autoimmune disease like Sjogren’s  syndrome and diabetes

.

Hormonal alterations associated with  pregnancy and menopause have been associated with dry mouth.

Symptom Relief

Chewing sugar free gum or candy to stimulate salivation

 Drinking frequent sips of water

Use of alcohol free oral rinses

Restricted use of caffeine, alcohol and carbonated beverages

Regular check- ups and teeth cleaning are more important in mouths experiencing  xerostomia  to minimize decay and periodontal disease.  Additional fluoride products may be recommended to safeguard your dental health.

Visit www.mydentistchino.com for additional information.

Time to De-Stress

 Stress has become a common concern as more of us encounter stress in our daily lives. We do know of its negative effects on the body and mind. Our mouths too are just as likely to be affected by stressful situations as our bodies and mind.

Dental conditions associated with stress include-

Bruxism or night grinding: Teeth significantly wear and/or fracture due to heavy biting during sleep as  a result of internalizing stress.  Long term bruxism eventually can lead to facial and tempero-mandibular pain which is often debilitating.  A nightguard is recommended to protect the jaw and teeth.

Canker sores- Although the causes of these sores are still unknown, they are often brought on by stress. They are quite painful  and treatment is often symptomatic. Medications and laser treatment can  reduce the severity and duration of the sores.

Dry Mouth is often caused by stress reducing the salivary function  as well as with the use of anti depressants and other medications. Chronic dry mouth leads to a host of dental issues including increase in cavities, periodontal and gum disease, soft tissue conditions.  Improved oral hygiene and regular visits significantly reduce the potential for  loss of bone or teeth. 

Lichen Planus in the mouth is characterized by white lacy patterns, sores and ulcers. This condition is believed to be a reaction to viral infections caused by stress.

Gum disease- Long term stress suppresses the immune system  which in turn increases the susceptibility to infections including periodontal disease.

If you are feeling stressed, take proper measures to reduce the stress in your life such as eating well, exercising, getting plenty of sleep.  If you suffer from extreme anxiety or depression, seek timely professional help.

If you are concerned with stress affecting your mouth or teeth, our office can address your concerns and treat as necessary.

 Call  909 627 6699 or Visit www.mydentistchino.com to reach us.

Teeth On Vacation

Vacations mean different things for different people. Some simply want to stay home and not have a watch or schedule to dictate their day. Some others may want to visit family or go to far off destinations while some others like the pampering of cruises and resorts.  Some others may like to use the extended daylight hours to to catch up on pending projects and tasks including medical and dental check ups.

 June officially begins the summer vacation season and as preparations begin, you want to put your plan to action.

 

Tips for dental health during vacations.

If an exotic vacation spot is your destination, ensure that you and your teeth are healthy enough to travel. Schedule you annual health and semi annual dental check up well before your planned trip.  Tooth pain is exaggerated in higher altitudes and a remote island may not be the best place to be treated for excruciating tooth pain.

Even while you are on vacation, remember your dental hygiene cannot be on one as well. Stay on top of your brushing, flossing and rinsing routines and enjoy a bright and healthy smile.

While playing outdoor sports, always wear athletic mouth guards. In the event of an injury, immediately apply ice to reduce swelling and leave severed or fractured teeth is a clean liquid medium and see dentist as soon as possible.

If you have put off making an appointment because your schedule has been busy, this may be the best time to invest in getting a routine examination out of the way or if extensive treatment with multiple appointments is needed, summer or vacation time will be the best time to get the long pending procedures like wisdom extractions or orthodontics (braces) out of the way.

Call 909 627 6699 to make an appointment or visit www.mydentistchino.com for more information.