Posts for: August, 2014

CertainDrugsTakenforOsteoporosisCouldAffectDentalCareOutcomes

If you have osteoporosis, one of the drugs you may be taking is alendronate, more commonly known by the brand name Fosamax®. Alendronate is a member of the bisphosphonate drug family, which inhibit bone resorption (the loss of bone mass). While an effective treatment of osteoporosis, alendronate may cause an opposite side effect in other areas of the body, the inhibition of new bone growth. This effect on the jaw in particular could result in an adverse reaction after dental surgery.

The main concern is a condition called osteonecrosis, or literally “bone death.” Bone tissue normally goes through a cycle of resorption (the dissolving of bone tissue) and new growth to replace the cells that have been lost through resorption. Osteonecrosis disrupts the growth phase so that the bone doesn’t recover properly after resorption. This results in the bone becoming weaker and less dense.

There have been a number of cases of increased osteonecrosis in patients on alendronate after experiencing trauma to the mouth. This includes dental surgery, particularly tooth extractions. In addition, patients with certain risk factors like diabetes, tobacco use or corticosteroid therapy appear more vulnerable to osteonecrosis.

Although the risk of osteonecrosis after dental surgery is small, many dentists recommend stopping the use of alendronate for three months before the procedure if you’ve been taking the drug for more than three years. This recommendation is based on a number of studies that seem to indicate three or more years of bisphosphonates therapy makes patients especially vulnerable to osteonecrosis. These studies also indicate stopping the therapy for three months significantly reduces the risk of developing the condition.

There’s still much to be learned about this link between alendronate therapy and dental health. It’s a good idea, then, to let us know what medications you’re taking (especially bisphosphonates) whenever you visit us for an exam. Knowing all your medications will help us develop the safest and most effective treatment plan for your dental care.

If you would like more information on bisphosphonates and their effect on oral 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 “Fosamax and Surgery.”


By John W. Cox DDS
August 14, 2014
Category: Dental Procedures
HowardSternOpensUp-AboutHisTeeth

Is there anything that radio and TV personality (and self-proclaimed “King of All Media”) Howard Stern doesn’t want to talk about in public? Maybe not — but it took a caller’s on-air question to get the infamous shock jock to open up about his own dental work.

When he was directly asked if his teeth were capped, Stern said no. “I redid ‘em [some time] ago… I had bonding and um… veneers… over my real teeth. But I don’t get that ‘Hollywood white’ though,” he said, before adding his uncensored opinion on the subject of proper tooth shades.

As we’re sure Stern would be the first to point out, everyone has a right to their own opinion. But we’re pleased that Howard brought up an important point about veneers: They are custom-made in a whole range of different shades, from a more ‘natural’ tooth color to a brilliant white shine. Which one you select depends on what look is right for you — and that’s your choice.

In case you aren’t familiar with veneers, they are fingernail-thin coverings made of porcelain, which are bonded onto the surfaces of the teeth. This enables them to hide a number of defects — like chips, discoloration, and even small irregularities in spacing. They can also be used to lengthen teeth that seem out of proportion to the gums, lips or other facial features.

Veneers are among the cosmetic dental treatments most favored by Hollywood stars… as well as regular folks who want a dramatic improvement in their smile. Unlike crowns (caps), which generally require extensive reshaping of the tooth, standard veneers require the removal of just fractions of a millimeter of tooth surface. That makes them a minimally invasive method of smile enhancement that can make a big difference in your appearance. In fact, veneers are often a major part of a complete “smile makeover.”

Dental veneers are custom made in a laboratory from a mold of your teeth. They are designed to fit your teeth perfectly — and to be just the shade you want. When you come in for a consultation, we will discuss what you like and don’t like about your smile, and how we might improve it. Will you opt to get the brilliant “red-carpet” smile you always wished for… or go for a subtle, more natural tooth color? Only you can decide.

Howard Stern’s veneers may be the most restrained thing about him… but we’re just glad that veneers helped him get the kind of smile he wanted. You can, too. If you would like more information on dental veneers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Crowns & Veneers.”


By John W. Cox DDS
August 01, 2014
Category: Oral Health
Tags: oral hygiene   oral health  
AnOralIrrigatorisanEffectiveAlternativetoFlossing

The main strategy in fighting dental disease is to try to prevent it in the first place. The success of this strategy depends largely on effective oral hygiene with three essential elements: daily brushing, daily flossing, and semi-annual checkups with professional cleaning.

Many people have little trouble incorporating brushing into their daily routine; flossing, though, is a different matter for some. They may feel it’s too time-consuming or too hard to perform. Patients with orthodontic appliances especially may encounter difficulty navigating the floss around the appliance hardware.

Flossing, though, is extremely important for removing bacterial plaque, the primary aim of oral hygiene. This thin film of food remnant that builds up and sticks to the teeth is the breeding ground for bacteria that cause both tooth decay and periodontal (gum) disease. It’s important that as much plaque as possible is removed from the teeth and gum surfaces every day. While brushing removes plaque from the open surfaces of the teeth, flossing removes plaque clinging between teeth and around the gums that can’t be accessed with a toothbrush.

If traditional flossing is too difficult, there’s a viable alternative using an oral irrigator. Also known as a water flosser, an oral irrigator directs a stream of pressurized, pulsating water inside the mouth to blast away plaque in these hard to reach places. The hand applicator comes with a variety of tips that can be used for a number of dental situations, such as cleaning around braces or implants. In home use since the early 1960s, the latest versions of oral irrigators have proven to be very effective, especially for orthodontic patients — research shows an oral irrigator used in conjunction with brushing can remove up to five times more plaque than just brushing alone.

That being said, traditional flossing is also effective at plaque removal when performed properly. Sometimes, resistance to flossing can be remedied with a little training during dental checkups. We can work with you on techniques to improve your flossing activity, as well as train you to use an oral irrigator.

Whichever method you choose, it’s important for you to incorporate flossing (or irrigation) into your daily routine. Removing plaque, especially in those hard to reach places, is essential for reducing your risk of developing destructive dental disease.

If you would like more information on flossing or oral irrigation, 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 “Cleaning Between Your Teeth.”




420 Harper Ave
Lenoir, NC 28645

405 Main Street
Valdese, NC 28690

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