18Sep

Have you heard about biofilm? Our dental office monitors it daily. Possibly you’ll catch something on TV about biofilm as some sort of newly discovered health threat. It’s neither, really. Here are the facts:

Most of our dental equipment is connected to long, flexible tubes that deliver water to your mouth. We call these tubes dental waterlines. Every day, fresh water rushes through them. But overnight or over the weekend, water trapped in these long tubes has the potential of being colonized by a thin layer of microorganisms.

Those microorganisms are biofilm. It’s just as important we keep our waterlines free of biofilm as it is you keep your teeth free of plaque through regular brushing.

We’ve known about biofilm for years. Every morning, all our waterlines are cleared before the first patient arrives. Our dental chairs are equipped with check valves that make sure waterline delivery goes only one way-into the mouth and down the drain.

All this to combat a health hazard that is so far only theoretical-we have no evidence of illness related to water from a dental waterline. Even if it existed, the marginally higher bacteria counts wouldn’t necessarily pose a hazard to healthy patients. Bacteria is everywhere-in drinking water, the air we breathe. Getting rid of it is the job of our immune systems.

News organizations love to discover what they believe to be health threats, because it keeps viewers tuned in. But biofilm (if it exists at all) is something we’ve known about and protected patients against for years.

18Sep

The following first aid procedures are important steps for handling dental emergencies or facial injuries. They provide temporary relief and help in their proper repair or healing. As with any injury, always follow up with personal care from your dentist or physician.

Bitten Tongue/Cut Lip

Clean gently with a cloth. Apply cold compresses to reduce swelling. If bleeding is severe, go to an emergency services provider. After bleeding has subsided, rinse with warm salt water.

Broken Jaw (Possible)

Don’t move the jaw. Secure it in place by tying a scarf, necktie, or towel around the jaw and over the top of the head. Apply cold compresses to reduce any swelling. See your dentist or emergency services provider immediately.

Broken Tooth

Rinse the mouth with warm water. Try to remove any dirt, blood, or debris from the injured area using sterile gauze or a clean cloth and warm water. Apply cold compresses on the face next to the injured tooth to reduce swelling. See the dentist immediately. Place the broken piece in a small container of whole milk.

Knocked-Out Tooth

Annually, more than two million teeth are knocked out accidentally; more than 90% of them can be saved with proper treatment.

Holding the tooth from the crown (top part), rinse off the root. Don’t scrub or remove any attached tissue fragments. Gently hold the tooth in its socket. (Young children may accidentally swallow; use your judgment.) If this isn’t possible, place the tooth in a cup of cold whole milk. Avoid using low fat milk, powdered milk, or milk products like yogurt. Never put the tooth in mouthwash or alcohol. Avoid scrubbing the tooth or touching the root end. Get to the dentist immediately (within 30 minutes) and take the tooth!

Objects Trapped Between Teeth

Try gliding dental floss between teeth (dental tape is often useful in removing shredded dental floss.) Sometimes tying a small knot in the floss may help, too. Avoid using any sharp or pointed objects. See a dentist if object can’t be removed.

Toothache

Toothaches can result from different causes. Rinse mouth with warm water. Remove any food trapped between teeth with dental floss. Avoid applying aspirin on the tooth or gum tissues. If a cavity is suspected, insert a small cotton ball or cotton tip soaked in oil of cloves (eugenol). Do not cover a cavity with cotton if there is facial swelling or pus. See a dentist as soon as possible.

Always consult with a dentist if you have questions regarding any dental problem.

By Brian J. Gray, DDS, MAGD, FICO

18Sep

According to the American Cancer Society, about 30,000 new cases of mouth cancer are diagnosed annually in the U.S. About half of those who have oral cancer die within five years. Early detection can make a dramatic difference in treating the cancer at curable stages and reducing oral cancer deaths.

Early detection capabilities recently have been enhanced by a new computer-assisted mouth cancer screening tool. A nationwide study of 945 patients ranging in ages from 18 to 83 was conducted by dentists at 35 U.S. academic dental care sites.

Brush biopsy specimens were obtained from oral lesions as part of the extensive research, testing the accuracy of computer-assisted diagnostic equipment. The brush biopsy caused little or no bleeding and no anesthetic was required. The computer-assisted image analysis was used to identify suspicious cells in the samples.

The computer analysis properly identified every case of pre-cancerous and cancerous lesions as confirmed by lab tests from their traditional tissue evaluations. Additionally, it also correctly identified some lesions that were benign in appearance, but were actually found to be pre-cancerous or cancerous. Had it not been for this new diagnostic equipment, these lesions would have escaped detection and the patient would not have received any additional oral cancer testing.

“Early evaluation of oral pre-cancerous lesions can have a dramatic impact on oral cancer mortality rates,” says Dr. James J. Sciubba, DMD, PhD, professor of Oral and Maxillofacial Pathology at State University of New York at Stony Brook, who also serves as a spokesperson for the study. Early-stage mouth cancers are not easily detectable by visual inspection and may be overlooked.

The oral cancer scanner provides dentists a new evaluation tool that can lead to a significant reduction in cancer deaths. An estimated 8,100 people will die from mouth cancer this year. This new dentistry tool has shown remarkable merit as a reliable dental health device. By providing an accurate diagnosis, it has become a crucial weapon in the fight against oral cancer.

By Brian J. Gray, DDS, MAGD, FICO

18Sep

These days, computers are really changing the way we live and work. You’ve probably experienced their impact in your own home. And believe me, technology is also helping raise our dental practice to a new level of safety, accuracy, and comfort.

Keeping up with all these advances is a full-time occupation that’s as important as my work at chairside. One of the most promising of these breakthroughs is an improvement on the oldest evaluation technology we have – dental x-rays.

For close to a century, dentists have used x-rays to detect cavities and damage invisible to the eye. We’ve long been aware of the drawbacks. Though x-ray radiation is slight, many patients find it a cause for concern. And reading the negative requires a skilled, professional eye-which means my patients can’t see what I see.

That’s why my office uses a Computed Dental Radiography System as an x-ray alternative. A computer enhances a “photo” of your teeth and shows it instantly on a screen. This new system requires 90% less radiation than the old film x-rays, and can magnify the image up to 300 times. It’s as easy to read as a snapshot. When I discuss something I see in your mouth, you’ll be able to view it right along with me.

This is an exciting time to be a dentist. We’re re-thinking and refining virtually every aspect of our dental practice, and I wanted to pass a bit of it along to you.

18Sep

Uh-oh! A Dental Emergency! If a dental emergency should happen to your child, please remember to act quickly. Stay calm – a parent’s apprehension can be transmitted to the child. Bring the child to us with the tooth replanted or kept moist in transit. We’ll take care of you immediately.

A child, learning to ride a two-wheeled bicycled, loses her balance, falls, hits a rock and knocks out a front tooth. What do you do?

If the tooth is replaced in the tooth socket immediately, the chances are good that this tooth can be maintained for many years.

Do something and do it now

The success of this replantation procedure is directly related to how soon the tooth is replaced in its socket. If possible, just rinse the tooth with tap water and gently replace the tooth in its socket and come to the office. Otherwise, wrap the tooth in a clean, moistened cloth-or put it in a cup of water or milk-and get to the dentist, now. Never scrape the tooth or allow it to dry out.

Remember, time is of the essence

If the tooth is left out of the mouth for more than 30 minutes, the chance for successful replantation drops significantly.

We consider replantation successful if we can keep the tooth in position at least during a child’s growth period. By maintaining the space, the replanted tooth prevents tipping of adjacent teeth. If it’s necessary to replace the injured tooth, it’s much easier to do it when the child is older – when all the permanent teeth are in.

The good news is that we have bonding and dental implant techniques today for tooth replacement-and new materials to fill in for a lost tooth.

18Sep

During a dentistry examination, the dentist examines the mouth mucosa (soft tissues) for any abnormalities or pathology (including oral cancer), the teeth for tooth decay (dental caries) or defects, the gum tissues for periodontal (gum) disease, the neck for swollen lymph nodes, the amount of plaque, tartar (dental calculus), and debris on teeth, as well as the need to replace any missing teeth or dental prostheses.

The dental examination begins with a complete dental care and medical history, including medications the patient currently is taking. The skin of the face and neck is examined for any abnormalities, especially pigment changes. The lymph nodes in front and behind the ears, under the floor of the mouth and chin, and the midline of the neck, sides, and back of the neck are palpated to determine if any swelling or tenderness is present.

Inside of the mouth, the lips, cheeks, gums, and roof of the mouth are inspected and palpated. During this process, the tip of the tongue is placed on the roof of the mouth just behind the upper teeth for inspection of the front floor of the mouth and sides of the tongue.

The back floor of the mouth, the area behind the lower wisdom teeth, and the back sides of the tongue are inspected by grasping the tip of the tongue with a small gauze sponge and pulling the tongue forward and toward the opposite side of the mouth.

To inspect the back of the throat, soft palate, and tonsil area (sides of the throat), the tongue is depressed with a dental mirror or tongue blade and then a deep breath is taken by the patient.

To detect swelling on the floor of the mouth, the area inside the mouth is felt with the finger of one hand while a finger of the other hand feels below the chin. Salivary gland enlargement, saliva flow, or xerostomia (dry mouth) are determined by milking the major salivary glands to assess the quantity and consistency of saliva.

Today’s dentist has many analytic tools available to pinpoint dental and oral diseases. The basic tools are the dental instruments, lights, and radiographs (X-rays). Depending upon the dentist and the individual’s dental needs, additional diagnostic tests are available. Testing for essential proteins and buffering capacity can evaluate the protective ability of saliva.

To determine mouth caries risks, microbiological testing of saliva can measure the level of caries-producing organisms. Periodontal susceptibility tests, which test for the DNA of gum disease-producing organisms, can be performed to assess an individual’s risk for gum disease.

If removable dentures are present, they are checked for bite, retention, stability, and overall fit. Dental impressions or models also may be taken to study the mouth and tooth structures to initiate fabrication of prostheses. Photographs may be exposed for a variety of reasons, including before and after treatment comparisons.

The level of oral hygiene and home care practices are assessed and reviewed. Recommendations for home care devices and products may be made. Instruction and methods for maintaining a good oral hygiene regimen can also take place.

Once basic information about oral health status is gathered, the dentist will be better able to discuss dental treatment alternatives that are available.

By Denise J. Fedele, DMD, MS