Ardent Care Dental

How to Know When It’s Time for Dentures

While dentistry has made it possible for more people than ever to keep their teeth for their lifetime, there are still times when a denture may be the best solution for someone’s needs. Here are three situations that may justify making the transition from natural teeth to complete replacement of teeth:

  1. Extensive Tooth Decay

Tooth decay can be a complex disease. How many cavities someone gets is influenced not just by how well they clean their teeth. Our general health and genetics also affect our dental health. People who have medical conditions or take medications that dry their mouth are more prone to dental decay. This can make it difficult to keep teeth healthy despite their best efforts. Teeth that have been fixed many times and have minimal structure remaining may have a poor long-term outlook. If most remaining natural teeth need extensive repairs and will still be at high risk for future cavities, removing them can be the best option.

  1. Advanced Gum Disease

Periodontal (gum) disease is the loss of bone support around the roots of our teeth. This chronic infection can be hard to control and is often worsened if people smoke, have diabetes, or genetics that make them prone to the disease. The chronic inflammation present in active gum disease increases our risk of developing cardiovascular diseases. If advanced disease is present, removal of the teeth will result in the infection going away and overall improved health.

  1. Extensive tooth wear

Teeth clenching and/or grinding over many years can wear teeth down to near the gumline. Dental erosion caused by dietary acids or acid reflux disease can also leave teeth with minimal tooth structure to work with and restore. In these scenarios, removing the teeth may be a more practical option.

If you think that it may be time for dentures, your dentist can perform an evaluation and talk with you about the options available for your situation. While dentures are always an option, solutions may exist that allow you to avoid full dentures. If dentures will be the most practical solution, it is also worth considering the use of dental implants to help improve the stability and retention of dentures.  Your dentist can develop a plan to transition you from natural teeth to replacement teeth. For people who have suffered for years with extensive problems and poor dental health, it is often a relief to be out of pain and be able to smile confidently.

Wisdom Teeth

Is keeping your wisdom teeth a smart thing to do? It depends. Our ‘wisdom’ teeth, or third molars, usually erupt between the ages of 15-25. If they are positioned at an angle in someone’s jaws, they may not erupt fully, or at all. While our ancestors may have had adequate room for these teeth, often today we do not. The decision to keep or remove them at any point in our life is  made with several considerations.

Often when wisdom teeth begin to erupt, bacteria and debris can become trapped under the gum tissue around the tooth, causing pain and infection. If this occurs or it appears there isn’t enough space in someone’s mouth to accommodate the teeth, removal may be recommended. Sometimes wisdom teeth may be ‘impacted,’ or trapped under the gum, bone, or adjacent teeth due to their position. In these situations, removal may also be recommended to reduce the risk of future problems. Cysts, decay and other infections, and resorption of the adjacent tooth can all be reasons for removal of an ‘impacted’ tooth.

Some people’s third molars erupt in a normal position and they have adequate space in their mouth for them. Because they can be difficult to keep clean, the teeth can get decay and/or gum disease and this can affect the molars in front of them. If people have most of their other teeth present, removing wisdom teeth may be recommended.

If removal is recommended, the ideal time to do this is often when people are in their teenage years, before the roots are fully formed. This reduces the risk of root fracture andnerve damage during surgery. The most predictable bone healing afterward also occurs in teens and young adults. While we can wait until later adult years to have them removed if problems arise, the teeth can be more difficult to remove and bone healing is not as predictable. Your dentist can discuss the benefits and risks of the procedure with you and recommend what is best for your situation.

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Senior Adult Dental Health

Today’s senior adults are keeping their teeth longer than ever before. Thanks to improved awareness of the importance and benefits of oral health, dentures are no longer expected as part of getting older. American men have an average lifespan of 76 years and women live an average of 81 years, according to the CDC. With increasing age however, today’s seniors face unique challenges in keeping their teeth healthy. Let’s talk about a few common obstacles.

Tooth decay can increase in our later years, due to several reasons. Many commonly prescribed medications have dry mouth, also known as xerostomia, as a side effect. Adequate saliva is vital for the health of our mouth. Saliva dilutes acids produced by bacteria, contains antibodies that fight off infections and lubricates our teeth and soft tissues. If people have suffered periodontal disease or gum recession and the roots of their teeth are exposed, these areas are at increased risk for decay. Root surfaces are softer than the enamel-covered crowns of our teeth and can be more challenging to keep clean.

When not enough saliva is produced, increased cavities can be the result. Increased tooth wear and generalized soreness of the tongue and other soft tissues is also common in dry mouths, as saliva is the lubricant that reduces friction in chewing. Inadequate saliva can also make wearing dentures difficult as saliva is needed to help ‘stick’ the appliances to the roof of the mouth and gum tissue.

Managing a dry mouth is challenging and products formulated for this problem may be recommended by your dental team. Products that are soothing and contain fewer irritants or alcohol can help sore tissues feel better. Xylitol is a common ingredient in toothpaste, mouthrinses, sprays and lozenges that can feel soothing and help reduce tooth decay. Fluoride in these products will also help reduce decay and strengthen weak areas of teeth. Avoid sipping on beverages that contain sugar and acids as these can increase the risk of cavities. Smoking can also increase mouth dryness and is best avoided.

If people lose some manual dexterity in their hands due to arthritis, the simple acts of brushing and flossing become difficult to perform. Powered toothbrushes and floss holders can be helpful as they require less fine manipulation to do their jobs.

Like other areas of our health, our mouths can require more attention to maintenance over time. Our activities can become more limited in our later years. Enjoying a conversation or a meal with friends and family is much more comfortable and pleasurable with healthy teeth!

 

 

A Few of Our Favorite Things

What do dental professionals keep on their bathroom countertop at home?  It depends. Obviously, some personal preference is involved. Generally, we use products that we enjoy and that are proven the most effective in getting the job done. We (and our family members) can have dental challenges and use products tailored for certain issues, just like we recommend for patients. Here are some great basics that we like:

Nimbus toothbrushes – The fine nylon bristles of these brushes give your gums a spa-like massage. Ask us for one at your next cleaning!

Opalpix – These thin, flexible cleaners reach in between teeth. Available at our office or Amazon.

Carifree CTx3 Rinse – Formulated for cavity protection, this alcohol-free rinse contains fluoride, xylitol and has an alkaline pH to help neutralize the acidic environment created by decay-causing bacteria. Available at our office or through the Carifree website.

Tongue cleaners –  Removes the fuzzy coating of plaque off tongues without setting off your gag reflex. Ask for one the next time you’re in or order a container from Amazon to share with your friends and family!

Oral-B powered toothbrush – The brush is small and maneuverable to reach all surfaces of all teeth, just like a dental hygienist’s polisher. The brush oscillation disrupts the bacterial film on our teeth and the two-minute timer makes sure we spend enough time to get the job done. They make teeth feel fresh-from-the-dentist clean. We carry a nice model at a great price in the office; several other models at different price points are sold at retail outlets.

 

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Lasers in Dentistry

Dental laser

Lasers have been used in dental offices for over thirty years. What can they do? Lasers are used to reshape tooth, bone, and gum tissue, treat infection and relieve pain. A laser is an instrument that converts electrical energy to an intense beam of light of a specific wavelength. Our body’s tissues and dental materials attract different wavelengths of light. Because of this, several types of lasers are available, and they have different uses. They are a safe and effective adjunct for many different dental procedures.

Dental lasers can be used to:
• Reduce the pain and speed the healing of canker sores and cold sores 
• Relieve jaw joint and muscle pain
• Reshape gum tissue for cosmetic reasons
• Remove overgrown gum tissue to promote better hygiene or assist in dental filling and crown procedures
• Perform biopsies of soft tissues
• Treat infections in gum disease
• Treat infections in root canal procedures
• Remove excess gum tissue and muscle attachments in conjunction with orthodontic treatment
• Remove diseased tooth or bone

Dentists can use lasers to reduce bleeding and speed healing time in surgical procedures. While lasers aren’t useful or appropriate for every dental procedure, your dentist may recommend using one where it will be beneficial.

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Your Medical History – Why do we ask?

MedicalHistory

When people come to their dental appointment, one of the first things the dental team will do is to update their health history. Sometimes people will comment (or wonder) “Why are you asking me about that? I’m just here for my teeth cleaning.” The reasons we ask are important, although often not obvious to people. There are many relationships between our general health and our oral health. Our goal is to provide the safest and most effective care to our patients and having a complete picture of someone’s health helps accomplish this.

General health conditions, prescriptions, over-the-counter medications, and supplements can all affect the health of someone’s mouth and the treatment recommended by your dental team. Conditions present in our mouth can also give us clues to general health issues and diseases that may be undiagnosed. Diabetes, acid reflux, sleep apnea, autoimmune disorders, eating disorders, nutrition deficiencies and some leukemias all have signs that can show up in our mouth.

Knowing someone’s general health can also help provide clues to conditions we may see in the mouth and help us provide better dental care. Pregnancy can result in increased gingivitis. People who have had HPV infections or a history of tobacco use can be at higher risk for oral cancer. Diabetic patients have an increased likelihood of periodontal (gum) disease – and gum disease can make it more difficult for people with diabetes to manage their blood sugar.Your dental team also wants to be aware of conditions that may require modification to treatment they recommend. Knowing someone’s history of heart conditions, prosthetic joint replacements, allergies, surgeries, and hospitalizations provide important information that helps us reduce risks of infection and complications with dental care.

Many commonly prescribed and over-the counter medications have side effects that influence our dental health. Blood pressure medications, antidepressants, asthma inhalers and allergy medications can increase our risk of tooth decay. Drugs given to treat osteoporosis can delay bone healing following oral surgery procedures. Some cardiac medications can cause changes in our gums and soft tissues in our mouth. Several medications and supplements that affect blood clotting are important for your dental team to be aware of, especially if any planned procedures involve periodontal treatment or surgery. Interactions between supplements and medications people are already taking and those that a dental provider may prescribe can also occur and we want to be aware of any possible complications. Bringing a list or keeping a photo on your smartphone of your medications and supplements can be helpful.

Finally, should a medical emergency occur while you are in our office, having your information available can help us better manage any urgent situation, should one arise. Our goal is to provide the safest care to our patients and having a complete picture of someone’s health allows us to accomplish this. There are many other examples beyond what is described in this post. Your medical information is kept secure and used only to help us optimize your dental care. If you have concerns with how this information is used, please ask and we’ll be happy to discuss with you.

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4 Tips to Make Your Dental Appointments Go Smoothly

Your dental team wants to help make your appointments as smoothly as possible. We are always prepared and look forward to the opportunity to help someone with their dental health. Stress-free appointments make our jobs enjoyable and our days go pleasantly. Here are a few tips to help us help you:

  1. Know what to expect – Talk with your dental team ahead of time about what is involved with the procedure recommended. They will provide you with information on how long your appointment will take, the cost, and what to anticipate afterward.
  2. Come prepared – Wear comfortable clothing and dress in layers as some offices may be chilly. Take any medication that has been prescribed to take ahead of time. Arrive a few minutes early to use the restroom if you need to. It may be helpful to bring any appliances such as a nightguard that you regularly wear. As always, bring an updated list of any medications and health supplements you are taking. If any medications will be needed afterward, pick these up ahead of time if possible.
  3. Stay relaxed – If there is music or a podcast you want to listen to during the procedure, most dental teams are happy to have you bring your device and earphones. We want to have you relaxed and for the time pass quickly! Depending on the procedure, you may want to have some soft food planned for dinner and a good book or TV show queued up.
  4. Follow-up – Follow the after-care directions given by your dental team. They are meant to speed your recovery and give you the best results. Use any products as instructed. If you have had surgery, it’s best to avoid smoking/vaping for a few days afterward. Nicotine patches can help alleviate cravings. Let your dental office know if you are concerned that you may be having complications with your treatment. If they have recommended you return to the office for follow-up, be sure to keep your appointment so they can make sure all is going as planned.

Genetics & Dental Health

The state of our health at any time is influenced by several factors. Some aspects such as our diet and caring for our teeth, we can manage and control. Our genetics also play a role in every area of our health. While we cannot control our genes, knowing some of what is in our DNA allows us to make changes for our best possible health.
The condition of our mouth affects and reflects our overall health in many ways. Being able to speak and eat comfortably allows us to communicate well, get the best nutrition and enhances the overall quality of our life. Diseases of our mouth such as tooth decay, gum disease and oral cancer can decrease our comfort and increase our risk for other whole-body diseases. Gum disease is a risk factor for cardiovascular disease, some cancers and some forms of dementia.
Genetics play a part in our experience of these conditions. We now have easy testing available to identify markers in our own DNA that can predispose us to some of these oral and general health conditions. DNA testing can also identify specific types of bacteria and viruses that live in our mouth and help dental teams plan care to reduce these risks to our health.
OralDNA testing is a simple, non-invasive saliva test done in the dental office. A sample of saliva is collected with a quick swish of a mouthrinse. The cells in the sample are analyzed and a patient-friendly report is returned that summarizes the results and risks that exist for a person. If any treatment is indicated, retesting can be done to see how effective the treatment was. People who are genetically at higher risk for diseases involving chronic inflammation can make lifestyle changes to offset the risks present in their DNA.
Interested? Give us a call today at 541-465-9821.

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Vaping & E-cigarettes

Electronic cigarettes (e-cigarettes) and similar devices such vape pens and pods have grown in popularity the past several years. ‘Vaping’ is the term for inhaling the vapors of the heated liquid produced by the device, which may contain nicotine, flavors and other substances, including THC (tetrahydrocannabinol) or CBD (cannabidiol). E-cigarettes come in many shapes and styles and have common elements of a battery that heats an atomizer to turn a liquid into an aerosol (vapor) that is inhaled.

These devices were popularized by adults who began using them as an alternative to cigarettes in quitting smoking. Many users today have never smoked traditional cigarettes but use e-cigarettes recreationally or in places where smoking is not allowed. What effects do these have on our oral health?

Inhaling heated vapors can dry our mouth and change the types of bacteria that live on our teeth and gums. Although the e-cigarette vapors contain fewer harmful chemicals than tobacco smoke, they do still contain known cancer-causing substances. Much is not yet known about the components of the liquid products as they have not been extensively studied. Product labels may not list all the substances in the liquids, making it difficult for consumers and researchers to know what they contain. Some may contain sugar, increasing the risk of tooth decay. While some users believe vaping to be a safer alternative to cigarettes, the jury will be out until several more years of data can compare the two.

If someone wants to quit smoking cigarettes, e-cigarettes may be helpful, however there are other alternatives, including nicotine patches and gum. E-cigarettes should not be considered safer than regular cigarettes for long-term use.  Younger people who start using e-cigarettes may transition to smoking as they develop an addiction to nicotine. Beginning in August 2019, over 2,500 US e-cigarette users developed serious lung problems that led to emergency room visits due to one of the liquid additives. Sixty-eight deaths occurred resulting from these lung injuries.

If someone does not currently vape, it is best to not start. If someone chooses to use these products, let your health care providers know. We want to be aware of all things potentially affecting someone’s health. If you currently vape and want support in quitting, many resources are available. This is Quitting is a free mobile support program for people ages 13-24, sign up by texting DITCHVAPE to 88709 or by visiting https://truthinitiative.org/thisisquitting. The Oregon Quit Line has telephone and web-based counseling and several other resources for people interested in quitting vaping or smoking. Call 1-800-QUIT-NOW (784-8669) 24/7 or visit quitnow.net.

 

Oral Cancer – Preventing A Deadly Disease

Early oral cancer detection can happen at the dentist.

We don’t often hear about oral cancer. Roughly 53,000 new cases will be diagnosed and 10,000 lives in the United States will be lost to it this year. These numbers make it more prevalent than ovarian, cervical and testicular cancers and Hodgkin’s Lymphoma. Recently rock star Eddie Van Halen lost his life to this deadly disease. The survival rate for oral cancer is poor at 57%. This means nearly half of all people diagnosed will die within five years of detection. 

Why the poor statistics? Many oral cancers are difficult to detect. Dentists screen for signs during examinations, however as with many cancers, they can be undetectable in their early stages due to their size and location. They often start at the back of the mouth, near the base of the tongue, tonsils or pharynx. Frequently no signs are visible until lesions are larger, have invaded deeper tissue structures or lymph nodes are involved. Symptoms can include a sore such as a red, white or thickened patch of tissue or lump in or around the mouth or throat that does not heal. Difficulty chewing, swallowing or speaking and swelling or numbness in the mouth are also signs. There is currently no reliable test such as a pap smear, to detect oral cancer cells in their earliest stages. 

What causes oral cancer? In the past, tobacco and alcohol were the main risk factors and affected mainly people over age forty. While the less common causes of sunlight exposure and genetics exist, most cases were caused by exposure to the known carcinogens of cigarette, pipe and cigar smoking and frequent alcohol consumption. Men have historically had higher rates of oral cancer than women, however that has been changing in recent years.

Over the past several years, more cases of oral cancer have been caused by the Human Papilloma Virus (HPV). Oral cancer is now occurring in women and younger people more frequently. HPV is spread by human sexual contact and most people will get some variations of it in their lifetime. There are over 200 variations of the virus and while many are harmless and cleared by our immune system, some variations cause warts as well as cancer. 

How can oral cancer be prevented? Obviously, avoiding tobacco products and reducing alcohol consumption reduces risks of not only oral cancers, but also several other types of cancer, such as lung, liver and stomach cancer. Diets that are high in fruits and vegetables have also been associated with decreased risk of oral and many other cancers. Wearing lip balm with sun protection ingredients while outdoors will reduce sunlight associated risk.

One of the easiest risk reduction strategies requires virtually no behavior change at all – the HPV vaccine. Recently, the FDA approved this vaccine for prevention of oral cancers and it can reduce up to 90% of virus-related cases. The American Cancer Association recommends this vaccination for children starting at around age nine or ten. The Gardasil vaccine is has been around for fifteen years and has been well shown to prevent several other types of cancers of the reproductive system. It protects against nine different variations of the HPV, has been widely tested and is very safe. The main side effects are redness, pain or swelling at the injection site. At this time, two doses of the vaccine are recommended for the best protection.

What else? Monitor yourself for any changes in your mouth. Doing this is easy and an online guide can be found here. Many common and benign lesions such as canker sores, cold sores and lesions due to trauma can exist. These short-term conditions will usually resolve on their own within two weeks. If a suspicious area of tissue does not heal and his persistent beyond this, have your dentist evaluate it. Addditional testing may be recommended. If you have questions or have an area you’d like evaluated, give us a call. 

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