Posts for: March, 2019
The development of antibiotic drugs is widely considered one of the greatest medical achievements of the last century. Their widespread use has turned life-threatening diseases like cholera, strep throat or bacterial meningitis into manageable, treatable ones. It’s no exaggeration to say antibiotics changed the face of healthcare, including dentistry.
But this gleaming sword for fighting dangerous diseases has a double edge because our biological “enemies” can adapt to the microscopic attacks against them.Â This has created an ironic conundrum: as antibiotics have proliferated in both the amount and frequency used they’ve become less effective against ever-resistant organisms.
This unfortunate situation has been helped along by a widespread, misguided practice in the medical profession, created by a “better safe than sorry” philosophy, to use them to treat any illness. This has morphed in recent decades into using antibiotics as a preventive measure in those not even exhibiting signs of disease, which then evolved into using antibiotics as a feed additive for livestock. As a result, antibiotic drugs have made their way into the food chain to accelerate, in many people’s opinion, bacterial and viral resistance.
What can we do then as “super-bugs” are on the rise, like Methicillin-Resistant Staphylococcus Aureus (MRSA) which is resistant to the most common antibiotics?
Certainly, continuing research into creating new antibiotics that address resistance is vital. But it won’t be enough: we — both healthcare providers and patients — must also change our approach and attitude toward antibiotics. This means putting in place better prescription guidelines that reduce the application of antibiotics for only those conditions where it’s absolutely necessary. And, we must restrict their use as a preventive measure, particularly in regard to their use in livestock feed.
This will take a change in everyone’s mindset, our professional standards and guidelines, and perhaps our laws. Thankfully, many are seeing the looming danger, and change is already happening. But time is of the essence, and the future depends on it — not just for people today but also for tomorrow’s generations.
If you would like more information on prudent antibiotic use, 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 “Antibiotics: Use and Abuse.”
If you're over 30 your chances for developing periodontal (gum) disease are better than half. And it's not a minor matter—untreated gum disease can lead not only to tooth loss, but to an increased risk of cardiovascular disease and other inflammatory conditions.
Fortunately, we have effective ways to treat gum disease, even in advanced stages. But the best approach by far in avoiding a devastating outcome for your teeth is to prevent gum disease from developing in the first place.
It helps first to know how gum disease begins. The most common cause is dental plaque, a thin biofilm of food particles on tooth surfaces that harbors the bacteria that triggers the disease. If you keep your teeth clean of built-up plaque and tartar (calcified plaque) with daily brushing and flossing and regular dental cleanings, you'll minimize the growth of disease-causing bacteria.
If you don't practice effective oral hygiene, however, within a few days you could develop an initial infection called gingivitis. This form affects the outermost layers of the gums and triggers a defensive response from the body known as inflammation. Ordinarily, inflammation helps protect surrounding tissues from infection spread, but it can damage your gums if it becomes chronic. Your weakened gums may begin to detach from the teeth, forming voids filled with inflammation known as periodontal pockets. Eventually, the infection can spread to the supporting bone and lead to tooth loss.
In addition to a dedicated oral hygiene and dental care program, you should also be on the lookout for early signs of gingivitis. Infected gums can become red, swollen and tender to the touch. You may notice they bleed easily while brushing and flossing, or a foul taste or breath that won't go away even after brushing. And if some of your teeth feel loose or don't seem to bite together as they used to, this is a sign of advanced gum disease that deserves your dentist's immediate attention.
Practicing preventive hygiene is the best way to stop gum disease before it starts. But if gum disease does happen, catching it early can be a game-changer, both for your teeth and your smile.
If you would like more information on preventing and treating gum disease, 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 “How Gum Disease Gets Started.”
As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.
Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb). It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.
It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.
We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.
Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.
At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.
If you would like more information on diagnosing and treating root resorption, 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 “Root Resorption: An Unusual Phenomenon.”