Posts for: January, 2019
You may think your blood pressure is only important to your general health — but it can also affect your dental care. That’s why it’s increasingly common for dental providers to include blood pressure monitoring for patients during routine visits.
High blood pressure is a risk factor for several major health conditions including heart attack, stroke and diabetes, and is one of the most common diagnoses in the United States. Even so, many people don’t know their blood pressure is abnormally high. It may be discovered during an annual health visit, or not at all. Since many people visit their dentist twice a year for cleanings, taking a blood pressure reading during these visits increases the chance of detecting a high pressure.
In one study published in the Journal of the American Dental Association, the researchers looked at dental patients who had not seen a doctor in the previous twelve months and who underwent blood pressure screening during a regular dental visit. Seventeen percent of those studied learned they were at increased risk for cardiovascular disease.
High blood pressure can also have a direct effect on how we treat your teeth and gums. For example, we may have to adapt and become more diligent about preventing dental disease if you’re taking a blood pressure drug that could trigger reduced saliva flow (dry mouth), a factor in tooth decay. Certain local anesthetics may also contain substances like epinephrine that constrict blood vessels, which can increase blood pressure. To avoid this if you’re hypertensive, we may need to adjust the dosage of anesthetic drugs to lessen this effect.
Monitoring blood pressure in the dental office is a good example of how all healthcare services can interact with each other. At the very least, a blood pressure check at your next cleaning could alert you to a potentially dangerous condition you didn’t even know you had.
If you would like more information on the relationship of blood pressure and other medical issues to dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Monitoring Blood Pressure.”
In the battle against tooth decay, fluoride is an important weapon. Since the discovery of its dental health benefits a century ago, fluoride has been credited with saving countless teeth.
But over its history in dental care, this natural-occurring chemical has also had its share of controversy with concerns raised from time to time on potential health dangers. These run the gamut from “conspiracy theory” speculations to credible research like a 2006 National Research Council study that suggested a possible increased risk of bone fracture or cancer from over-consumption of fluoride.
Even so, there is actually little evidence or even record of incidence for such dire consequences. The only definitive health effect from fluoride found after decades of copious research is a condition called fluorosis, a permanent staining effect on the teeth. Fluorosis poses a cosmetic problem but does not harm the health of the teeth.
Moderation in fluoride use seems to be the key to gaining its health benefits while avoiding fluorosis. One influential fluoride researcher, Dr. Steven Levy, estimates 0.05-0.07 milligrams of fluoride per one kilogram of body weight (about a tenth the weight of a grain of salt for every two pounds) is sufficient to gain the optimum dental benefit from fluoride.
The real question then is whether your family’s current consumption of fluoride is within this range. That will depend on a number of factors, including whether your local water utility adds fluoride to your drinking water supply and how much. You may also be ingesting fluoride through processed foods, juices and even some bottled waters. And you can encounter fluoride in dental care including toothpastes and clinical treatments.
One way to moderate your family’s fluoride intake is to be sure all your family members are using the correct amount of fluoride toothpaste for their age while brushing. Infants need only a slight smear on the end of the brush, while older children can brush adequately with just a pea-sized amount. For other tips and advice, talk to your dentist about your family’s fluoride intake and how you might adjust it.
Even with the possibility of fluorosis, fluoride still provides an incredible benefit in preventing tooth decay. By understanding fluoride and keeping your intake within normal ranges you can maximize its benefit for healthier teeth and minimize the fluorosis risk.
If you would like more information on the role of fluoride in dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”
Drilling teeth is an essential part of repairing and restoring the damage caused by tooth decay. For generations dentists have relied on the dental drill with its rotating burr to remove decayed and damaged tooth material.
But while the dental drill is effective it also has its disadvantages. In the process of removing decayed material it inadvertently removes healthy structure near the target material. It often requires anesthesia to deaden the work area. And its noise and vibration are often unsettling to patients.
There is a growing alternative, though: air abrasion, a technology that's been around since the mid-20th Century. But recent advances in controlling the dust created by using abrasion, as well as new tooth-colored bonding materials to replace tooth structure, have sparked new interest among dentists and patients alike.
Also known as particle abrasion, this drill alternative uses a pressurized stream of fine particles to remove decayed material. Using a hand wand a dentist can precisely aim the stream of particles (usually aluminum oxide) to the specific areas of decay or softened material that need to be removed. As a result, it removes only a fraction of healthy tooth structure compared to traditional drilling. Air abrasion has also proven effective for removing staining without harming enamel.
Air abrasion also eliminates the sound and vibration associated with dental drills, and may not always require local anesthesia. On the other hand, it does have some limitations. For one, it's not as effective with larger cavities or working around older fillings. The tooth or teeth to be worked on must be carefully isolated from the rest of the mouth to keep the patient from swallowing the abrasive particles. And without a high-volume suction pump and good isolation protocols, the particles can produce something of a “sandstorm” in the treatment room.
But as air abrasion continues to advance, we may see improvements in these limitations. In a future time, the traditional dental drill may go the way of the horse and buggy.
If you would like more information on air abrasion as an alternative to drilling, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Air Abrasion Technology.”