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

Anti Aging

Describe Yourself!

Rebuilding Your Smile

Experiencing mouth pain and feeling insecure about missing teeth?

It's time to make a change! Rebuilding your smile will not only help with how you look, it will improve your oral health as well.  Full Mouth Reconstruction does not just replace missing or broken teeth, it also restores function of the jaws, gums and supporting structures of mouth.

Whether it is neglect, injury, fear of going to the dentist or even "no dental insurance",  less than optimal dental care results in-

Chipped or broken teeth
Missing teeth
Chronic jaw pain, clicking and popping of jaw
Frequent headaches, back pain and facial pain

Full mouth reconstruction begins with a comprehensive evaluation of the health of the teeth, gums and jaws including a bite evaluation. The findings are  carefully evaluated individually or with the help of a panel of specialists depending on the severity of the oral health issues.  A treatment plan is then developed and presented to the patient.  Each full mouth reconstruction is unique and is tailored to suit patient's desires, expectations, clinical conditions and medical and general health limitations.

Visit www.mydentistchino.com or Call 909 627 6699 for your Free Consultation. (mention Blogger)

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Botox and the Dentist

 

         How do you feel about your dentist delivering BOTOX ? 

Chairside Medical Screenings

Screening for diabetes, high blood pressure and high cholesterol in the dental office could save the health care system up to 102.6 million each year, according to ADA health policy resources center.

According to the Centers for Disease Control and Prevention, 7.8% of the US population has undiagnosed hypertension, 2.7 percent has undiagnosed diabetes and 8.2% has undiagnosed high cholesterol. Leaving conditions undiagnosed and untreated typically leads to more expensive procedures down the road.  If dentists can help catch some of these predisposing  and chronic conditions earlier, we are helping  the individual patient as well as the over all health care system... 

Based on a Gallup survey, chronic diseases cost  the country 153 billion annually in lost productivity.

As many as 27 million visit the dentist but not a physician  in a given year.  This presents  an opportunity for dentists to be part of an integrated health care team working to combat chronic illnesses and improve oral and overall health.

For more information on the mouth- body connection, visit http://www.chinosmiles.com/our-practice/procedures/mouth-body-connection/

"My three decades of dental experience has reaffirmed that 'The Mouth is the Mirror to the Body'" says Dr. Cherukuri, from her Chino, California dental practice. Chronic and  some terminal conditions have been diagnosed in our office through dental exams resulting in timely intervention and lives saved.

Keep Your Teeth!

Can the Body Reject Dental Implants?

Dental Implants cannot be rejected by the body because they are manufactured with bio-compatible materials like titanium. 

 However, implants can fail, 1) if the bone quality is poor, 2) the bone is over heated while preparing the site for the implant, 3) implant is under excess function, 4)infection present in the bone next to the implant, 5) poor oral hygiene as a implant is more susceptible  to gum disease than a natural tooth.

An implant could fail after it is placed if the patient's home care is not ideal and if the implant is working with unfavorable forces working against it. Implants respond well to forces in the center of the implant. 

Implant failure can also be attributed to poor patient health as well as smoking.

Appropriate case selection and treatment planning are critical to implant success
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“Making use of all the available diagnostic tools like CT scan, panorex, intra oral images, and diagnostic study models are invaluable”, says Dr Cherukuri, from her Chino,California practice.

Good post operative instructions will prepare the patient in making their contribution toward treatment success.
Visit www.chinosmiles.com for more information.

Your Oral Health Is Important

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Why did my Implant fail?

Dental Implants provide a wonderful way to replace missing teeth, but there can be implant failure. Failure is said to occur when the implant is lost, mobile or when there is significant bone loss surrounding the implant.

“Implants generally fail due to one of three reasons,” says Dr. Vijaya Cherukuri from her  Chino, California Dental Practice. “1. Poor case planning,  2. Pre-loading, or 3. Retained cement around the final restoration.”

Your dentist should evaluate carefully the proposed area where the dental implant is to be placed. Usually a surgical guide will be created, thereby making sure the implant is placed in an area that ensures the proper angulation for long-term success. Certain medical conditions like diabetes and osteoporosis, risk factors  like smoking and medications including bisphosphonates do need to be factored in to assess their role in the implant placement.

Pre-loading refers to placing the final restoration - crown, bridge, or denture - prior to proper implant integration with the bone. Generally your dentist will give you a window of time in which to allow for your implant to integrate to the bone. For some, the time may need to be extended beyond the average 4- 6 months to provide for proper bone integration. 

Finally, excess cement not removed after the placement of the final restoration can also cause failure.

“While failure is disappointing, remember, the vast majority of dental implants are successfully placed and restored,” Dr. Cherukuri says. “Dental implants provide another way to keep you smiling.”

Periodontal-Cosmetic Connection!

                           What to do with Uneven Gums?

Have you ever considered having a Periodontal-Cosmetic makeover?             

 “You can have the most beautiful looking teeth, but without the right gumline to showcase them well, your smile will fall short of ideal,” says Dr. Vijaya Cherukuri from her Chino, California Cosmetic Dental Practice. “If your gums lie too low or too high on your teeth, you may be a candidate for a Periodontal-Cosmetic makeover.”

Gums that appear too high or too low, over and under contoured  can be caused by genetics, arrangement of teeth, crowding, the result of medications that result in gingival hyperplasia or even some blood disorders.. The good news is that the cosmetic procedure can easily give you the smile you desire. http://www.webmd.com/oral-health/guide/gum-contouring-procedure)

                                                             

In the dental office of Dr. Cherukuri, many times a laser is used to perform this type of procedure.  “I have found that patients appreciate the use of lasers in the dental office. It is painless, simple to use  with almost no bleeding.  We have introduced them to our patients for periodontal treatment, cold sore and fever blister relief and also to improve the cosmetic contouring of gum tissue.”

If you think you would like more information on any of these procedures, please contact us. We are more than happy to help  .www.chinosmiles.com

"Toothbrushes Trump Seat Belts"

 As important as seat belts are as a preventative measure, toothbrushes have a far greater impact on the health and longevity of the American public.

According to NHTSA, seat belts save over 13,000 lives a year, nationwide. While few of our patients die from a car crash, many will succumb to heart attack or cancer.  Periodontal disease is a significant risk factor for heart attack, stroke, low- birthweight infants and some forms of cancer.  Estimates are that about 80% of American adults suffer either from gingvitis or periodontal disease.  Using a tooth brush and eliminating periodontal disease reduces the chances of sufferring from these life altering medical conditions.

The Oral Systemic connection has long been an established fact but it has recently been relabeled "The Theory of Focal Infection"  The bacteria  originating in mouth enter the blood stream and infect the blood vessel walls of the heart.. Bacterial products in the blood can also stimulate liver production  of C-reactive protein and fibrinogen, both directly linked to heart attacks.

Although periodontal disease is one amongst the many other risk factors like smoking, high blood pressure, obesity, high cholesterol ,stress,  lack of exercise &  genetics, the combination of these factors add layer upon layer of increased risk of suffering a heart attack.  Periodontal disease is an important risk factor for strokes. Periodontal disease increases the likelihood of a heart attack by 24-35%.

In a recent study, a direct correlation between the amount of periodontal bacteria present and blood pressure has been established.

Totally wiping out periodontal disease will eliminate 158,000 heart attacks, nearly half of which are fatal.  Add to that the thousands of lives that would be saved by reducing cancers, controlling diabetes, preamature births etc- from a public health point of view, tooth brushes save more lives than seat belts!!!
 

Dental Lasers!

Is this newer technology mandatory, elective or a hype?

While many procedures in dentistry can be accomplished with traditional methodologies, there are several instances where the use of lasers are  quicker, safer, easier and just  simply possible.

Diode or soft tissue lasers, unlike the electrosurgery units, can be used with pacemakers and used for small surgical soft tissue alterations with only topical anaesthetic.  Clinically, this feature makes use of  dental laser a very popular option with patients fearful of dental needles- says Dr. Cherukuri.

In addition, diode wavelengths are antibacterial and safe to use around metallic restorations. particularly dental implants.

Diode lasers can be safely used to remove  soft tissue around dental implants without damage to the fixtures and abutments and when used judiciously without fear of heat build up to the implants.  Simple soft tissue management to expose implant cover screws and during the final seating of implant retained crowns are much easier when a dental laser is utilized.

Laser treatment of cold sores also has significantly reduced the duration of these painful and disfiguring lesions or at times eliminated its manifestation when detected and treated early.

Lasers are an enhancement to technology today, tomorrow and beyond!!

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