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Certain medications can influence dental treatment decisions and it’s important to let your dentist know about all the medications that you take. 

In the case of antiresorptive agents—medicines that help strengthen bones—these medications have been associated with a rare but serious condition called osteonecrosis (OSS-tee-oh-ne-KRO-sis) of the jaw (ONJ) that can cause severe damage to the jawbone.

Some bone strengthening medicines, such as Fosamax, Actonel, Atelvia, Didronel, and Boniva, are taken orally to help prevent or treat osteoporosis (thinning of bone) and Paget’s disease of the bone, a disorder that involves abnormal bone destruction and regrowth, which can result in deformity. Others, such as Boniva IV, Reclast or Prolia, are administered by injection. Higher and more frequent dosing of these medications are given as part of cancer therapy to reduce bone pain and hypercalcemia of malignancy (abnormally high calcium levels in the blood) associated with metastatic breast cancer, prostate cancer, and multiple myeloma.

How do these medications affect dental treatment plans?

While osteonecrosis of the jaw can occur spontaneously, it more commonly occurs after dental procedures that affect the bone or associated tissues (for example, pulling a tooth). Be sure to tell your dentist if you are taking any medications for bone health so he or she can take that into account when developing your treatment plan.

It’s not possible to say who will develop osteonecrosis and who will not. Most people (more than 90 percent) diagnosed with ONJ associated with these medications are patients with cancer who are receiving or have received repeated high doses of antiresorptive agents through an infusion. The other 10 percent (of people with ONJ) were receiving much lower doses of these medications for the treatment of osteoporosis. It may be beneficial for anyone who will be starting osteoporosis treatment with antiresorptive agents to see their dentist before beginning treatment or shortly after. This way, you and your dentist can ensure that you have good oral health going into treatment and develop a plan that will keep your mouth healthy during treatment.

Continue regular dental visits

If you are taking antiresorptive agents for the treatment of osteoporosis, you typically do not need to avoid or postpone dental treatment. The risk of developing osteonecrosis of the jaw is very low. By contrast, untreated dental disease can progress to become more serious, perhaps even involving the bone and associated tissues, increasing the chances that you might need more invasive treatment. People who are taking antiresorptive agents for cancer treatment should avoid invasive dental treatments, if possible. Ideally, these patients should have a dental examination before beginning therapy with antiresorptive agents so that any oral disease can be treated. Let your dentist know that you will be starting therapy with these drugs. Likewise, let your physician know if you recently have had dental treatment.

Talk to your physician before ending medications

It is not generally recommended that patients stop taking their osteoporosis medications. The risk of developing bone weakness and a possible fracture is higher than those of developing osteonecrosis.

Talk to your physician before you stop taking any medication.

Symptoms of osteonecrosis of the jaw include, but are not limited to:

• pain, swelling, or infection of the gums or jaw
• injured or recently treated gums that are not healing
• loose teeth
• numbness or a feeling of heaviness in the jaw
• exposed bone

Contact your dentist, general physician or oncologist right away if you develop any of these symptoms after dental treatment.

“Osteoporosis and Oral Health”. Mouth Healthy

https://www.mouthhealthy.org/en/az-topics/o/osteoporosis-and-oral-health

Good oral health involves more than having a beautiful smile; it is key if we are to enjoy food, feel confident about interacting with others and avoid oral pain. Statistics however show that many Americans could improve in this department. Over 90% of Americans have had at least one cavity, and one in four has untreated tooth decay. Meanwhile, around half of all adults above the age of 30 have gum disease – according to the Center for Disease Control and Prevention’s Oral Health report. Dentists recommend brushing and flossing twice daily, but for those with gum disease and frequent plaque build-up, one gadget that should be present on your bathroom countertop is a water flosser.

How does a Water Flosser Work?

Water flossers usually consist of a small nozzle that sprays pressurized water, connected to a water reservoir by a tube. Water flossers  clean teeth and gums through a combination of water pressure and pulsations, which remove food residue and plaque from teeth. They work similarly to dental floss, but the pressure means that tiny pieces of food you don’t even notice can be efficiently removed. Water flossers can reach areas that floss cannot get into; for instance, beneath the gum line at the front of teeth. Users can alter the pressure according to their needs. Therefore, those with sensitive gums may use a lower setting, while those after a power clean can set their flosser on high pressure.

Are Water Flossers Effective?

The effectiveness of water flossers was put to the test in a study published in the Journal of Clinical Dentistry. Participants in the study were assigned to one of two groups. Group One used a manual toothbrush plus a water flosser, while Group Two used a manual toothbrush and waxed dental floss to clean between teeth. The results showed that the water floss group had a 74.4% reduction in whole mouth plaque and an 81.6% reduction in plaque between teeth. The dental floss group meanwhile, had a 57.7% and 63.45% reduction in plaque in these respective areas. The scientists noted that the water flosser was, therefore, a superior way to keep plaque at bay. It also indicates that dental floss is still a good way to improve oral health, even though it was less effective than the water flosser. 

When Might Your Dentist Recommend a Water Flosser?

Your dentist may recommend this method of daily cleaning if you have frequent plaque build-up or if your gums tend to become inflamed. If you have a condition like gingivitis, you may be recommended to wait until bleeding has stopped to use a water floss. However, a water flosser is not enough to treat more serious periodontal disease, and you should always consult with your dentist. You may be recommended a root scaling and planing treatment and perhaps later, a water flosser can play a role in the maintenance of your gum health. Water flossers also work well for teeth that are difficult to clean. For instance, if you have wisdom teeth that have not been removed, then teeth may be very tight and it may be very difficult to get dental floss in between then, but a water flosser may be a good alternative.

Because a water flosser cleans plaque and removes trapped food so effectively, it is ideal for teeth in odd positions, but it can also form part of a daily oral health routine for anyone wishing to obtain an optimal clean. Studies have shown that it is more effective than standard brushing and flossing, so if you are worried about decay and gum inflammation and disease, ask your dentist if a flosser is suitable for you. Flossers have removable tips, so one machine can be used by more than one family member.

Fallon, Jacqueline. “Is Water Flossing the Perfect Tool for Better Oral Health?”. The Dental Greek, 11 Dec 2018

Maintaining great personal hygiene has never been more important, given the current pandemic situation that many of us across the world find ourselves in.

Advice around how to do this is something that we all should take note of. Especially, regular handwashing with soap for at least 20 seconds or using hand sanitizer gel when this is not possible.

It is important to remember that being as hygienic as possible doesn’t just help protect you, but it also protects those around you.

The Oral Health Foundation has provided the following advice to help avoid catching or spreading the coronavirus (COVID-19).

Do not share a toothbrush

You should never share your toothbrush with anybody else, no matter how close you are to them.

This is one way that viruses and blood-borne diseases can be caught from other people.

You should make sure that toothbrush heads are also kept apart from each other wherever you and the rest of your household store your toothbrushes.

Keep the toilet lid closed before you flush

If you store your toothbrush anywhere near your toilet, every time someone flushes, some of the toilet sprays will fly out and land on your toothbrush.

There has already been research conducted that suggests that the virus can be spread via faecal matter (poo).

Make sure you close the lid before you flush and keep your brush at a safe distance away from the toilet.

Change your toothbrush regularly

It’s important to change your toothbrush, or brush head, at least every three months. Perhaps even earlier if the bristles become frayed.

This helps to ensure you are brushing your teeth effectively. A worn brush can’t do the job it needs to.

Changing your brush regularly also helps prevent the spread of bacteria. 

Clean your bathroom regularly

Many of us store our toothbrushes, towels, flannels and other intimate items in our bathrooms.

Due to this reason, it is important to keep the bathroom clean at all times to ensure that there is no spreading of germs and viruses. 

Visiting the dentist

It is important to maintain regular visits to your dental team. It’s best to always call ahead before any appointments, especially during this period of uncertainty. You can ask about any special check-in procedures your dental office may have, or if they have any paperwork you can complete online before your visit.

Be prepared for your appointment to either be delayed or canceled. This is for the safety of both staff and patients. Emergency treatment may still be available but other, more routine procedures, may be postponed for the foreseeable future. Communicate with your dentist about your needs to make sure you receive essential care, without putting yourself or others at unnecessary risk.

Don’t forget the basics

Our oral health should always be a priority. In addition to visiting your local dental team when possible, don’t forget the simple day-to-day habits that will help you keep a healthy mouth.

Brush daily with a fluoride toothpaste last thing at night and at least one other time during the day.

Cut down on how much and how often you have sugary foods and drinks and drink plenty of water. 

Consider using a mouthwash and clean between your teeth every day with interdental brushes or floss. 

Bushel, George. “COVID-19: our guide to looking after yourselves and others through better oral hygiene”. Oral Health Foundation, 23 Mar 2020 https://www.dentalhealth.org/blog/covid-19-our-guide-to-looking-after-yourselves-and-others-through-better-oral-hygiene

You’ve probably heard someone tell you about getting wisdom teeth removed irrespective of whether you are an adolescent, parent, or grown adult.

If your wisdom teeth haven’t been removed yet, you’re probably wondering the following:

Do I really need my wisdom tooth removed?

Not everyone needs to get their wisdom tooth extracted. There are specific reasons why a wisdom tooth needs to be removed and this article will explain them. 

What are wisdom teeth?

Wisdom teeth get their name because they usually come in when you are older and you can expect these teeth around the ages of 17 to 21.

These teeth are located in the very back of your mouth. You can expect two on the top and two on the bottom although, this isn’t the case for everyone.

Wisdom teeth are molars and complete your set of 32 adult teeth. These molars are the toughest of them all, used to grind food, which is why they are wide and also cause a lot of problems.

Why do I need my wisdom teeth removed?

Here are the four main reasons why your dentist may say you need your wisdom teeth removed:

1. They are impacted: This means your wisdom teeth cannot come in properly and can cause a lot of pain. Most often they lie horizontally and remain below the gumline instead of being upright. 
2. They come in at the wrong angle: Wisdom teeth can push against and damage your surrounding teeth if they don’t come in straight and upright. 
3. Your mouth isn’t big enough: Some people have smaller jaws that do not have enough room for an extra set of molars. 
4. You can’t maintain optimal oral health: You are going to be more susceptible to cavities and gum disease, If you can’t reach your wisdom teeth with your toothbrush and floss

Common wisdom teeth problems

Over 10 million wisdom teeth are removed in the United States every year.

Watch out for these common problems associated with a Wisdom tooth:

• They can cause pain and bite problems: If your extra set of molars do not grow in properly, they can push your other teeth, causing mouth pain and bite problems. 
• Jaw damage: Cysts can form around unsuitable wisdom teeth. If left untreated, they can destroy bones, roots, and nerves. If a cyst turns into a tumor, you may require surgery.
• Sinus pain: Wisdom teeth in your upper jaw can push against your sinuses, leading to pain, pressure, headaches, and congestion.
• Cavities and gum disease: Inflamed gums can be hard to clean. As pockets between the teeth and gums form, bacteria can grow, which can cause cavities and gum disease 

When should you get your wisdom teeth removed?

The earlier the better.

Your bones become harder as you become older which can make the removal and recovery process more difficult.

Your dentist will use x-rays to determine:

• If you have wisdom teeth – you may not even know if they are hidden
• If you need to have wisdom teeth removed
• How many wisdom teeth need to be removed
• When you should have your wisdom teeth removed
  

Do you need to get your wisdom teeth removed?
You don’t need to get your wisdom teeth removed just because you have them. Contact your dentist today to schedule an appointment or bring it up at your next six-month cleaning.