Early Exposure to Antibiotics May Lead to Early Childhood Caries

In an article published in the the CDA Journal in August 2010 it states that an increased risk of early childhood caries has been found in children taking systemic antibiotics in their first year of life.  In a study, published in Oral Health, authors Sumer M. Alaki, DDS, Brian A. Burt, PhD, MPH, and Susan L. Garetz, MD, MS, said that after the child's first year, those who took systemic antibiotics at age 13 to 18 months demonstrated a considrable increase in the risk of early childhood caries compared to their counterparts who did not take the medication.

One explanation is that children on this medication are not as healthy as children not on antibiotics.  Additionally, some medications have a high surgar content, the authors said.  Adding another possibility for the increased risk is these antibiotics may cause environmental and ecological changes in the mouth from consistent exposure to sugar contained in the medications, thus paving the way for the colonization of mutans streptococci (the bacteria that causes tooth decay.)

Although highly preventable, dental decay is the most common chronic childhood disease.  The American Dental Association suggests the first dental visit by age one and that all dentists are encouraged to:

• accept and perform infant dental visits by age one, to assess risk in infants and to teach dental disease preventive techniques to the infant caregivers.
• educate and teach expectant mothers that dental health is an important part of prenatal care and that dental disease can affect the health of the mother and her infant.

Dental Sealants - Are they right for you?

When done well, sealants have been shown to last as long as 5 to 10 years.  But as in the case with all oral health treatment plans, it is key to have sealants checked on a regular basis.  Dental sealants are basically thin plastic coatings applied to the chewing surfaces of the back teeth to protect from decay.  These sealants protect the chewing surfaces by keeping germs and food particles out of the grooves.  If they are found not to be in place, they can be reapplied to ensure their continued effectiveness.

Matthew Messina, DDS, Consumer Advisor for the American Dental Association, said sealants have their place in caring for patients who are at risk for caries.

According to the ADA children and teenagers are obvious candidates for sealants since the likelihood of developing caries in pits and fissures begins at a young age.  But that's not to say older patients can't be protected by them.

The most critical step in placement of a sealant is to maintain isolation of the tooth.  The area has to be dry in order for the sealant to bond properly and ensure the longevity of it.

The other critical factor is the cleanliness of the surface.  Our office always pumices the teeth prior to etching and placement of the sealant in order to ensure the tooth is clean and we get maximum retention of the sealant to the tooth surface.  If not properly cleaned or bonded to the tooth, the sealant may fail and decay can easily leak under and into the grooves causing an increased risk of dental decay.

When done well and when checked on a regular basis, selants do just what they're intended to do -- that is they act as a barrier in protecting enamel from plaque and acids.  I recommend that all individuals with a risk of caries young and old have sealants placed on teeth that do not have any decay.

What is Same Day Dentistry?

Conventional methods of placing crowns and onlays usually require two appointments.  During the first one the tooth is prepared, an impression and other records may be taken and then a temporary is placed over the tooth to protect it from the oral cavity during the final restoration fabrication. The typical time frame of wearing the temporary can be anywhere form two to four weeks.  There has always been a concern that during that time lots of things can happen.  The tooth can shift in position, it can become more sensitive, and unsupported areas can become susceptable to bacteria in the mouth.  With the new digital techniques created by E4D Dr. Gunnerson is able to provide you with a same day solution.  He is able to digitally scan your tooth - no more impressions - and create your personalized permanent restoration right in his office while you wait - providing you more convenience and elminating the waiting period where only bad things can happen to your "temporary" crown and tooth.  Same-Day dentistry is healthier dentistry.  Call our office for a free consultation.  (801) 465-3233.

Oral Cancer - Diagnosis, Cause and Prevention

Oral Cancer Facts:

According to The Oral Cancer Foundation, someone dies from oral cancer every hour of every day in the United States alone. Over 300,000 new cases of oral cancer are diagnosed every year, worldwide. This serious dental disease which pertains to the mouth, lips or throat is often highly curable if diagnosed and treated in the early stages.

Oral Cancer Risk Factors:

Tobacco use is the number one risk factor in oral cancer. Studies have shown that at least 75% of those diagnosed were either current or former tobacco users.  Combining alcohol use with tobacco has been proven to have a 15% greater risk of developing oral cancer than tobacco use alone. Age and prolonged exposure to radiation or sunlight are contributing factors as well.

Oral Cancer Signs & Symtoms:

Unfortunately, in its early stages, oral cancer can go unnoticed. Oral Cancer could look like a common ulcer, cold sore or a discoloration of tissue. Fortunately, your dentist can see or feel if a lesion looks cancerous. If you have any type of lesion in your mouth, or on your lips, that doesn’t heal within two weeks, or a difficulty in swallowing for a prolonged period of time, it is very important to see your dentist right away.

Oral Cancer Treatment:

If your dentist does find a suspicious lesion in your mouth, he may remove it, but will most likely send you to a specialist for a removal and biopsy, which is a painless procedure. If oral cancer is detected early enough, it could be treated with surgery alone. Radiation combined with surgery would more than likely be used if the cancer is in its advanced stages.

Oral Cancer Prevention:

The best preventions of oral cancer are not to use tobacco of any kind and only drink alcohol in moderation. Avoid prolonged exposure to sun or use a sunscreen on your lips. Visit your dentist every 6 months for regular check ups. When your dentist examines your mouth at your routine check up appointments, he is also screening you for oral cancer. This process only takes about 90 seconds and consists of a visual examination for any presence of cancer.

Summary:

Although the number of deaths each year from oral cancer is astounding, it is highly curable if diagnosed early. Prevention is a key factor in oral cancer and a 90 second dental examination could save your life.

Osteoporosis medications and jaw complications

Osteoporosis medications and the risk of developing jaw complications

Osteoporosis is a serious skeletal disorder that weakens bones and increases the risk of developing fractures. It affects about 10 million Americans, 8 million of them women. Another 34 million are at risk of developing osteoporosis. This disorder affects more owmen than cancer, heart disease and stroke combined. Many patients are treated with a group of prescription drugs called "oral bisphosphonates." Examples include alendronate (Fosamax, Merck & Co., Whitehouse Station, N.J.), risedronate (Actonel, Procter & Gamble, Cincinnati) and ibandronate (Boniva, Roche, Nutley, N.J.).

Osteonocrosis of the Jaws
Jaw complications linked to the use of these drugs are a growing concern. That is because the drugs have been associated with osteonecrosis of the jaws (ONJ), an uncommon but potentially serious condition that can cause severe destruction of the jawbones. News reports have alarmed and confused many patients who receive these drugs to prevent or treat osteoporosis. Most cases of ONJ have been seen in patients with cancer who receive treatment with intravenous bisphosphonates. The true risk posed by oral bisphosphonates remains uncertain.
Osteoporosis and Bone Fractures
The risks of osteoporosis, especially the development of bone fractures, are serious. Fractures of the spinal column and hip are the most common osteoporosis problems, and hip fractures can be life-threatening. The National Osteoporosis Foundation reports that an average of 24 percent of patients 50 years and older with hip fractures die within one year of their injury. One in five patients with hip fracture ends up in a nursing home. Six months after experiencing a hip fracture, only 15 percent of patients are able to walk across a room without help. A woman’s risk of experiencing a hip fracture is equal to her combined risk of developing breast and ovarian cancers.

It is estimated that alendronate may reduce by 40 percent the risk of experiencing a hip fracture in patients with osteoporosis. Thus, it is possible that the drug could prevent more than 100,000 hip fractures and tens of thousands of deaths each year. Given the risks assocatied with osteoporosis and the proven benefits of oral bisphosphonate therapy, you should never stop taking these medications before discussing the matter fully with your physician.

Tell Your Dentist
If your physician prescribes an oral bisphosphonate, it is important to tell your dentist so that your health history form can be updated. Because some dental procedures, such as extractions, may increase your risk of developing ONJ, the American Dental Association (ADA) has published treatment guidelines for patients receiving bisphosphonate therapy. The medical and dental communities continue to study ways to prevent and treat ONJ to ensure the safest possible result for dental patients taking bisphosphonates.
The ADA believes your physician serves as the best source of information regarding your need for oral bsiphosphonates. Given the significant benefits of these medications for osteoporosis, your physician may recommend that you continue receiving oral bisphosphonate treatment despite the slight risk of developing ONJ. While neither your physician nor your dentist can eliminate the possibility of developing ONJ, regular dental visits and maintaining excellent oral hygiene are essential in helping to avoid this significant complication.

Teeth Grinding Can Give You A Headache

Does your partner complain, every morning, about your teeth grinding or teeth clenching keeping them awake?  The very fact that they complained about it keeping them awake made you aware about your habit.  It is always the person sleeping at the side of you who will be able to tell you.  This habit of grinding and clenching the teeth is known as bruxism.

People with irregular or infrequent bruxism do no get affected as much. It does not really show the damage done to the jaws and teeth. It is those who are habitual grinders who get affected. In severe cases it can also damage one’s jaw or hearing.

The question arises as to how would one know if he or she grinds or clenches their teeth? If detected how bruxism can be treated? It has been studied that some people make a noise when grinding their teeth thus making it detectable while some do not make a single sound making it hard to detect.

There are two ways one can know if they have bruxism, first is when your partner complains about it and second is when after a night’s sleep you get up with an ache in your jaws or a slight, persistent headache. Whatever the case, a checkup by the dentist is pertinent.

Consequences of teeth grinding or clenching:

There are many outcomes to teeth grinding two of which are mentioned above:

• Severe toothache
• Sensitive to biting food
• Sensitive to hot or cold food
• In advanced cases the teeth can break or result in fractures
• Tooth loss

Precaution And Treatment
People visiting the dentist usually complain of severe toothache. To stop this toothache the very habit has to be put to an end. Otherwise there are other factors that could cause it and have to be contained:

• Lower stress and relax daily
• Reduce alcohol consumption and intake of caffeine
• If grinding becomes a problem at night ask your dentist to recommend a nightguard
• If your dentist says it is caused because of irregular bite, he may suggest teeth alignment

If you exhibit any symptoms from clenching or bruxism, call our office for a free consultation, (801) 465-3233.  Dr. Gunnerson has extensive training in this area and can offer many different treatments to help you.

Sedation Dentistry -- Is It Safe?

Recently there have been a lot of advertisements on the radio, in magazines, on billboards and even on the television about sedation dentistry.  But what is it?  And more importantly, is it safe?

Sedation dentistry is used to provide a relaxing and anxiety-free experience for certain people receiving dental treatment.  It enables individuals too afraid to go to the dentist to receive the dental care they need while avoiding the excess apprehension known as dental phobia.

According to the Dental Organization for Conscious Sedation (DOCS), 30 percent of the population avoids the dentist due to fear.  This "dental phobia" prevents people from receiving necessary routine dental care, potentially compromising the over-all health and functionality of their mouth and smile.

Sedation is a process used to establish a relaxed, easy and calm state through the use of sedatives.  Sedative drugs (tranquilizers, depressants, anti-anxiety medications, nitrous oxide, etc.) can be administered in a variety of ways.  Nitrous oxide or better known as "laughing gas" has been the predominate way to help patients have a relaxing visit and is available to patients in most dental offices.   However, today more and more dentists are turning to oral sedation (taking medications prior to your dental visit) to help those with dental anxiety receive the dental care they need.

Though there have been reported cases of deaths from oral sedation, many dentists are seeking additional training to provide this service to their patients and it is now becoming a major advertising campaign by many offices to increase the number of patients they treat.  However, it is highly recommended that the use of oral sedation should be reserved for those individuals with severe anxiety concerning dental treatment.

When used properly by a qualified, trained dental provider and under constant monitoring, oral sedation can be a safe and effective way to receive dental care for those with dental anxiety.  I recommend that if you are seeking this type of service, review the credentials of your dental provider.  Check with the state dental board to make sure they are qualified and have received the proper training and licensure to provide this service.  Ask questions about sedation dentistry and make sure all of your questions are answered before receiving this service.

Many patients may ask if their insurance covers this procedure.  Currently most insurance companies do not pay for sedation dentistry.

Our office has always been concerned about the comfort and care our patients receive.  Our goal is to provide an atmosphere of comfort in a safe environment while receiving the best dental care available.
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What's In Your Toothpaste?

Have you ever wondered what is in toothpaste?  You may not recognize the names listed on the side of the tube, but ingredients like seaweed and detergent can be found in many toothpastes.  According to the ADA, common thickening agents include seaweed colloids, mineral colloids and natural gums.  And to create the foaming action most products rely on detergents such as sodium lauryl sulfate -- also found in many shampoos and body washes -- that are deemed 100 percent safe and effective by the ADA.

It doesn't matter what brand of toothpaste you use or whether you buy toothpaste to freshen your breath, whiten your teeth or for tartar control.  The most important ingredient is fluoride. And though it is tempting to purchase the generic brand to save money, you may be getting an ineffective and a potentially harmful product.  You should always look for the ADA seal when choosing a toothpaste.  Only the products with the seal have met the standards of safety and effectiveness as set forth by the American Dental Association.  To date there are over 50 different brands of toothpaste with the ADA seal of approval.

Choose the toothpaste that you like best.  Brushing your teeth at least twice a day along with regular dental visits is the only way to help prevent cavities and periodontal (gum) disease.

Xylitol - What Is It?

It seems that many products today contain the additive xylitol.  But what is it?  Xylitol is a sugar alcohol sweetener that is found in birch tree bark, beets, corncobs, raspberries, mushrooms and other natural sources.  Its sweetness is equal to that of sugar, but it has about 40 percent fewer calories, making it a popular sugar-free substitute.  Xylitol not only cuts calories, it also cuts cavities.

How does it work to prevent cavities?
Xylitol helps prevent Streptococcus mutans, the primary bacterium associated with dental caries, from attaching to teeth and tissues in the mouth.  Xylitol cannot be metabolized by bacteria and as a result, the process that creates harmful, enamel-eating acids is drastically reduced.  Regular use of xylitol has been shown to help reduce dental plaque - that gunky build-up that forms on your teeth which is the first stage of cavity development, tartar formation, and tooth staining - and promote better oral health.

How often must a person use xylitol for it to be effective?
Studies have shown that Xylitol gum or mints used three to five times daily (for a total intake of 5 grams) is considered optimal.  Because frequency and duration of exposure is important, gum should be chewed for approximately five mintues and mints should be allowed to dissolve.  Since brushing during the day isn't always an option, I recommend using xylitol containing products immediately after meals and snacks to help reduce palque, inhibit adhesion of bacteria to the teeth, and reduce contact time of sugar on teeth.

Has it been evaluated for safety?
Human consumption of xylitol has been confirmed for safety by a number of agencies, including the U.S. Food and Drug Administration, the World Health Organization's Joint Expert Committee on Food Additives, and the European Union's Scientific Committee on Food.  Please be aware if you are a pet owner that xylitol is poisonous to dogs.

What products contain xylitol and how do I find them?
Recently xylitol use in many products has become mainstream.  Today, xylitol can be found in chewing gums, toothpastes, mouthwashes, candies, and some pharmaceuticals.  On food labels, xylitol is classified broadly as a carbohydrate and more narrowly as a polyol.  Check your local grocery store for items with xylitol and start chewing your way to better oral health.

Sleep Apnea

What is sleep apnea?
Sleep apnea is a serious, potentially life-threatening sleep disorder that affects approximately 18 million Americans.  It refers to episodes in which a person stops breathing for 10 seconds or more during sleep.  With each episode, the sleeper's brain briefly wakes up in order to resume breathing, resulting in extremely fragmented and poor-quality sleep.  If you have been diagnosed with sleep apnea, we can work closely with your physician to implement and manage a prescribed therapy.

What are the different types of sleep apnea?
There are two major types of sleep apnea, both of which can severely disrupt the regular sleep cycle.  Obstructive apnea:  As you sleep, the muslces in the walls of your throat relax to the point where the airway collapses and prevents air from flowing into your nose and mouth, but efforts to breathe continue.  This is the most common type.  Central Apnea:  Breathing interruptions during sleep are caused by problems with the brain mechanisms that control breathing.

What are the symptoms of sleep apnea?
People with sleep apnea usually do not remember waking up during the night.  Indications of the problem may include:

• Morning headaches
• Excessive daytime sleepiness
• Irritability and impaired mental or emotional functioning
• Excessive snoring, choking, or gasping during sleep
• Insomnia
• Awakening with a dry mouth or sore throat

What's the difference between snoring and sleep apnea?
Unlike mild snoring, individuals with sleep apnea stop breathing completely for 10 seconds or more, typically between 10 and 60 times in a single night.  If your partner hears loud snoring punctuated by silences and then a snort or choking sound as you resume breathing, this pattern could signal sleep apnea.

Why is sleep apnea a concern?
Studies have shown that people with this potentially life-threatning disorder are so fatigued during the day that, when driving, their performance is similar to that of a drunk driver.  If left untreated, sleep apnea can lead to impaired daytime functioning, high blood pressure, heart attack and even stroke.

How can we help?
If we suspect you suffer from sleep apnea, we will refer you to a physician, often a sleep medicine specialist.  Diagnosis and treatment is based on your medical history, physical examination, and the results of a polysomnography -- an overnight sleep study, which measures heart rate and how many times breathing is interrupted during sleep.  If you are diagnosed with sleep apnea, we can work closely with your physician to implement and manage your therapy.

What are the treatment options?
If you have mild obstructive sleep apnea, initial treatment may include avoiding sleeping on your back, losing wedight, or cessation of smoking.  Dental appliances have been helpful to our patients with mild sleep apnea.  If you have severe sleep apnea, continuous positive airway pressure (CPAP) systems are commonly prescribed therapy.  CPAP delievers air through a small mask that covers the nose, and the constant pressure keeps the airway open, which prevents both snoring and episdoes of apnea.  For patients who have trouble tolerating CPAP, other treatments, including surgery, can eliminate sleep apnea symptoms.

Call (801) 465-3233 toschedule an appointment for more information on how we can help you get a better sleep.

Research Supports Link Between Gum Inflammation and Alzheimer's Disease

In a recent article published by the NYU College of Dentistry researchers found that periodontal (gum) disease may increase the risk of cognitive dysfunction associated with Alzheimer's disease in healthy individuals as well as in those who already are cognitively impaired.

The research team was led by Dr. Angela Kamer, Assistant Professor of Periodontolgoy & Implant Dentistry.  The article states, "the research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation."

Dr. Kamer's latest findings are based on an analysis of data on periodontal inflammation and cognitive function in 152 subjects.  Dr. Kamer examined data spanning a 20-year period ending in 1984, when the subjects were all 70 years of age.  The findings were presented by Dr. Kamer at the 2010 annual meeting of the International Association for Dental Research July 16, in Barcelona, Spain.

Dr. Kamer used the Digit Symbol Tests, or DST, a part of the standard measurement of adult IQ to measure cognitive function at ages 50 and 70.  He states that subjects with periodontal inflammation were nine times more likely to test in the lower range of DST scores compared to subjects with little or no periodontal inflammation.

This recent evidence suggests that regular check-ups with your dentist and professional cleanings could lead to decreasing the risks and symptoms of Alzheimer's Disease in individuals over the age of 50.

Dr. Kamer plans to conduct a follow-up study involving a larger, more ethnically diverse group of subjects, to further examine the connection between periodontal disease and low cognition.