November is Alzheimer’s Awareness Month!

alzheimers-awareness

Did you know November is Alzheimer’s Awareness Month?

In honor of Alzheimer’s awareness month, I decided to blog about Alzheimer’s and its relationship with oral hygiene. Alzheimer’s is a fatal disease that destroys brain cells and causes memory loss, erratic behaviors, and loss of bodily functions.  People can be diagnosed with Alzheimer’s as young as their 30’s, 40’s or 50’s, which is known as younger-onset Alzheimer’s. This disease slowly and painfully takes away ones identity, ability to connect with others, think, eat, talk, walk or even find their way home. Did you know Alzheimer’s is the sixth leading cause of death in the United States, and it’s estimated that there are more than 5 million people in the U.S. living with Alzheimer’s? This devastating disease is fatal, as there is no current treatment to cure, delay or stop the progression of Alzheimer’s. There are some FDA approved drugs that temporarily slow down worsening symptoms for about 6 to 12 months, on average, but this is only successful in about half the individuals who take them (1).

What happens in the brain to cause Alzheimer’s? Microscopic changes in the brain start long before the disease is diagnosed. The brain has 100 billion nerve cells and each nerve cell connects with several others to form a communication network.  Each of these groups have special jobs that control our everyday function of thinking, learning, remembering, seeing, hearing  and sense of smell. These groups work like tiny factories in your brain and when they stop working properly due to Alzheimer’s disease, the damage spreads and cells lose their ability to do their job. These cells will then eventually die causing irreversible changes in the brain.

Why is good oral hygiene important in relation to Alzheimer’s disease? There is still a lot of research to be done, but a study conducted by Dr. Singhrao in 2013 and 2014 showed that a bacterium known as Porphyromonas gingivalis (P. gingivalis) was present in Alzheimer’s brain samples, but not present in the samples of brain from non Alzheimer’s people. This was interesting because P. gingivalis is associated with chronic gum disease. The study that was conducted in 2013 was followed up by the same team in 2014 with a study using mice and the results were published in the Journal of Alzheimer’s Disease. Dr. Singhrao, who conducted this study, said in his interview with Medical News Today that “there is sufficient scientific evidence to show that two of the three gum disease -causing bacteria are capable of motion (or “motile”) and have consistently been found in brain tissues (2).”  These motile bacteria can leave the mouth and enter the brain via two main routes.  The two possible roots are:  they crawl up the nerves that connect to your brain and the roots of your teeth and the second is through your blood stream. The bacteria P. gingivalis enters your blood stream on a daily basis from eating, chewing, and tooth brushing but does not always reach the brain. If it does reach the brain, this bacterium can trigger the immune system response to release more chemicals to kill neurons (2).  Dr. Singharo placed P. gingivalis in the mouths of mice and watched as the bacteria found its way to the brain. During the study Dr. Singharo observed that when the P. gingivalis found its way to the brain, the chemicals released by the brain’s immune system, in response to the P. gingivalis, damaged functional neurons on the area of the brain related to memory. Although, this research is still new and continues to be ongoing it gives another example of how your dental health is linked to your overall health, and reminds us about the importance of good daily oral hygiene and routine dental cleanings.

Additionally, there has been a lot of research done about Amalgam “silver” fillings over the years and there is no evidence showing that it is a major risk for Alzheimer’s. There was reason for concern because amalgam is made up of a mixture of 50% mercury, 35% silver and 15% tin and mercury in certain forms is known to be toxic to the brain and other organs.  Many public health agencies, including the FDA, World Health Organization, and U.S. Public health services say that is a safe, strong, and an inexpensive material for dental restorations. We no longer do amalgam fillings in our office. We feel the composite “white” fillings are a better option because the material bonds to your tooth making the tooth stronger.

There is lots of research being done daily to help uncover as many aspects of Alzheimer’s disease as possible. The goal of all this research is to help better understand it and its effects on the brain that will lead to new treatments.  I have close family friends and patients who have suffered from Alzheimer’s and it’s devastating to them and their families. I do hope one day they find a way to cure it, or slow down the progress of it.  All I can do for now is make sure I keep the bacteria levels down in my mouth with proper homecare, inform my patients, and continue to donate to the Alzheimer’s Association to the keep the progress of research going.  If you wish to donate or participate in one of their fundraising events visit their website alz.org for more information.

References:

  • alz.org  (Alzheimer’s association)
  • Medical News Today / Journal of Alzheimer’s Disease

 

Halloween Fun

 

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Halloween is a fun annual season that is known for its elaborate costumes and delicious treats!  It is fun for the entire family deciding on costumes, decorations and Halloween parties. The big night is October 31st when children go out with their friends and family “Trick –OR- Treating” and stockpile a ton of candy. It’s ok to eat candy but it’s important to have a plan to keep yours and your children’s teeth healthy and safe from cavities.

As most people know candy contains lots of sugar. Did you know that most candies have close to 15 ingredients in them and most of them being a variety of different sugars?

I’m going to share some fun Halloween candy tips to help you

  • When buying candy look for treats that can be eaten quickly, like mini candy bars.
  • Have a smaller bag or bucket for Trick –Or- Treating & limit the number of houses you go to
  • Put a new toothbrush in your child’s bag of candy to encourage good brushing during this time.
  • Candy that melts quickly, such as chocolate, is recommended more because your saliva can wash it away easier than sticky candy which clings to your teeth and harbors plaque.
  • Discard hard or sticky candies, like sugared fruit snacks, gummy bears, taffy, caramels, popcorn balls or lollipops. These all overload the teeth with sugar for a long period of time and take longer to get washed away by the saliva increasing the risk of tooth decay.
  • Eat the piece of candy with a meal or shortly after a meal as saliva production increases during meals. This will help cancel out the acid that is produced by bacteria in your mouth and flush out food particles.
  • Eat a small amount in one sitting and drink water during and right after, if possible brush thoroughly right away.
  • It’s not a good idea to graze on candy for a long duration of time as it increases the amount of time sugar comes in contact with your teeth.
  • Create a plan on what to do with all the candy before you go out treat or treating. Examples include:
  • Pick your family favorites and donate the rest
  • Find a candy buyback program
  • Look for an organization that donates and sends candy to troops over seas
  • Give your child the option to give up the majority of their candy and trade it for something else they have been really wanting.
  • Give them the daily option when they want candy to choose a piece, and trade it for something simple like a sticker or a quarter for their piggy bank.
  • This also is a great time to discuss and explain to your children how to make healthy choices for their body and teeth.

Fight the risk of decay from candy with extra good homecare!
Everyone wants to enjoy a little bit of candy during the Halloween season. Here are a few dental tips on ways to step up your homecare, and give yourself and your children some extra protection.

  • Continue brushing your teeth for 2 minutes twice daily, and brush after eating candy as well.
  • Increase flossing from 1, to 2 times daily for the week following Halloween.
  • If you don’t normally use mouthwash, now is the time. Starting with Halloween through the holidays as your teeth are exposed to unusual eating habits and sugars. I recommend using ACT fluoride rinse daily to help keep sugars at bay, and strengthen the enamel of your teeth to fight against cavities.
  • Drink lots of water daily
  • Eating healthy foods will help balance out your sugar intake. This is a wonderful way to keep blood sugar from spiking and your teeth free from decay. Eating fresh apples, carrots, celery, and other fibrous produce will also help scrub away plaque buildup and sugars in your mouth

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What and Why: Dental X-Rays

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Dental X-rays are pictures of the teeth, bones, and soft tissues around them to help diagnose problems in the oral cavity that are not visible during your dental exam. X-rays are invisible beams of energy that pass through the body to make black and white pictures (1).  They are used to diagnose cavities, show bone loss and missing teeth as well as hidden structures such as cysts & wisdom teeth.  How often dental X-rays are taken is based on individual patient needs and risk. New patients are usually required to have X-rays taken to determine their present baseline status unless they provide current X-rays from their previous dental office. Digital X-rays make forwarding them to other offices much easier for the patient and the dentist.  Digital X-rays have been a great addition to dental technology.

Digital technology began in 1988 with RVG (radio/visio/graphy) and the first film sensor came out in 1994 (2). Not only was there a decrease in exposure, but it allowed for efficient electronic communication and eliminated the environmental concern of silver and chemicals used to develop old traditional film. Many people are concerned about radiation exposure of X-rays. I will say it is important to watch how often you are exposed cumulatively with all forms, but “radiation exposure associated with dentistry represents a minor contribution to the total exposure from all sources, including natural and man-made” (2). X-rays are extremely important for proper chairside dental diagnosis, the ADA and the FDA have come up with proper guidelines for dentists to follow based on a patient’s risk, and their professional judgement. There are also additional radiation safety requirements that have been put in place to protect patients. These requirements are as follows; inspection and testing of X-rays units yearly, use of exposure monitoring badges, proper training or certification of staff, and lead aprons with thyroid collar. If you are pregnant be sure to tell your hygienist or dentist before X-rays are taken. Although, there has been no proof that X-rays effecting your baby (fetus) we like to take extra precaution and take them after the baby is born. “Dental X-rays do not need to be delayed if you are trying to become pregnant or are breastfeeding” (3). They also do not need to be delayed if you have a toothache during pregnancy as long as a lead apron and thyroid collar is worn. It’s better to have the dental problem diagnosed and treated during pregnancy than to leave it untreated and become a source of infection during pregnancy causing greater risk to the baby.

There are a few different types of dental X-rays you may hear dental professionals discussing. I am going to give a brief description of them below for you to have a better understanding.

Bitewings– Focus on posterior teeth, they show top and bottom teeth on the same film. They are used to check specifically for cavities between your posterior teeth and to check for bone loss. BWXS

Periapical (PA’s) – Are used to look at the roots of your front and back teeth and only show 2-3 teeth in one film.

Digital-dental-periapical-xray

Full Mouth Series – A series that is taken every 3-5 years depending on your periodontal status. It is a combination of bitewings and periapical’s that show the crowns of your teeth, roots of your teeth and the bone that hold your teeth in place. We use this as a baseline to monitor for any changes in your dental health. Fmx

Panoramic X-ray – This is the machine that rotates around the outside of your head and shows a street view of your mouth. It shows your jaw bone, teeth, roots, and sinuses. It is most commonly used by Orthodontists and Oral Surgeons.  Pan

Cone Beam CT- This is similar to a medical CT Scan but it uses less X-rays. It makes a 3D image needed for more difficult treatments. This is usually found in a specialist’s office.

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Dental X-rays have given dental professionals the ability to diagnose interproximal decay, as well as other dental concerns in the early stages. If we wait until we can see the decay clinically, then the decay is usually deeper and the patient has a higher risk for the need for a crown or root canal. Our office is aware and considerate of our patients’ X-ray exposure, but we do believe in the importance of X-rays. We have seen firsthand many times how one’s mouth and risk of decay can change over a 12-month span.  So, if you have any questions or concerns please feel free to discuss with your dental professional or please feel free to leave a comment.

References:

 

Pacifier Use & Thumb Sucking

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Babies love their pacifiers, but pacifier use can cause dental problems. The presence of a pacifier can cause developing mouths to grow improperly in some situations, leading to abnormal tooth development and other issues along the way. The long-term use of a pacifier influences the shape of the mouth and the alignment of the teeth, because as babies and toddlers mature physically, their jaws grow around anything held inside on a repeat basis. In fact, overusing pacifiers affects mouth and teeth development in the same way as long-term thumb-sucking, according to the American Academy of Pediatric Dentistry (AAPD). As the child’s upper front teeth tip forward, teeth may become crooked and he or she can experience bite problems. There may also be changes in tooth position and jaw alignment. The American Dental Association (ADA) suggests other symptoms of pacifier teeth include the front teeth not meeting when the mouth is closed, and changes to the shape of the roof of the mouth. This can lead to mouth breathing and also sleep apnea. Nevertheless, pacifiers are still beneficial for young babies, and parents can avoid the risk of pacifier teeth by weaning their baby from his/her pacifier by the age of 6 months. Doctors publishing with the American Academy of Family Physicians (AAFP) explain that pacifiers actually have a positive influence on kids between one and six months old. Young babies who use pacifiers have a reduced risk of sudden infant death syndrome; though introducing a pacifier to a baby less than one month old can interfere with the establishment of breastfeeding. The AAFP also warns that pacifiers increase the risk of ear infections in babies older than six months.

Pacifiers safety Tips:

  1. Use one-piece pacifiers without liquid interiors, gadgets or moving parts and make sure wider than babies mouth.
  2. Clean/ Sanitize them regularly and replace when looking worn
  3. Do not attach them by strings to babies’ clothes, crib or car seat as they become a choking hazard
  4. Avoid dipping pacifiers in sweet liquids, which can cause tooth decay.
  5. Do not use in place of meals or to delay meals, only use when you are sure baby is not hungry
  6. Use when putting down to sleep, do not force infant to use or re-insert into sleeping babies mouth.

Intervention Techniques:  * with younger children and older children

  1. Binky Fairy – Comes at night and snatches up all the binky’s in the house and leaves a present for the child to have as a reward for giving it up.
  2. Binky Bear- Go to Build A Bear workshop and put the binky in the bear. This way they can have it but cannot physically get it to put in their mouth.
  3. Have a conversation with a child. Explain the problems it can cause in an easy for them to understand why.
  4. Remind the child- this is good for those children who want to stop the habit, but just needs a reminder. Ideas: put a waterproof bandage on thumb or finger or sock or mitten of hand at bedtime. Make sure your child understands this is a reminder not a punishment.
  5. Use rewards- encourage your child to stop sucking thumb by using something that motivates them to stop.
  6. If none of the above has worked then discuss with your dentist, an appliance can be placed on older children to keep them from sucking on their thumb.

~National Dental Hygiene Month~

Did you know October is National Dental Hygiene Month?  This is when we celebrate the hard work of dental hygienists, who help raise awareness on the importance of good oral health.  In honor of this month I thought I would share my story on how I became a dental hygienist.

When I was younger, I always thought I would become a teacher or own a business, but my senior year of high school my career path took a different route.  My dentist at the time, who is also a family friend, asked me if I ever thought about being a dental hygienist.  He told me I would thrive as a hygienist because I’m a people person; caring and passionate.  I started thinking about it and realized that it was something I was interested in. I had already been accepted to my number one school; University of New England, which also happened to have one of the top dental Hygiene programs in New England. I transferred my application from business, to dental hygiene and was accepted!  I started college in the fall of 2004, when the red sox won the World Series for the 1st time in 86 years.  It was a long, hard three years to earn my Associates Degree in Dental Hygiene, but I had the support of my family, faculty, and fellow classmates, and  learned that anything is possible if you work hard enough.  That spring of 2007, I took all my board exams, “nerve –racking”! For those of you who do not know, Dental Hygiene Board exams consist of a 2 hour computerized test, 8 hour written exam and a 4 hour clinical exam.  After passing all my board exams, I applied for my individual state licenses in MA, ME & NH and had to take a jurisprudence exam for each before I could start working. I started my 1st job in August 2007, at the same time I continued on to get my bachelor’s degree in dental hygiene, graduating in the spring of 2008. It’s rare to find a full time job when starting out as a Dental Hygienist with no experience. I started with one, part-time hygiene position and worked my way to three, part- time hygiene positions. I now work one, full time position here at Parker River Dental.  When I was working at three different offices, sometimes it would get confusing, but overall I think it was a great learning experience. Every practice is different, so you learn different techniques, computer systems, and ideas which in the long run makes you more of a well-rounded hygienist.  As I stated above, I thought I would become a teacher or own a business when I grew up, but instead I became a hygienist and I get to be all three daily. Although, I might not specifically have a business or teaching degree, I do teach proper oral care daily to adults and children and I use my business skills to help continue to grow and represent Parker River Dental.  I believe everything in life happens for a reason, you just need to take advantage of opening doors.

I have been a hygienist now for 10 years! During those 10 years I’ve met so many wonderful people and have expanded my knowledge within the field and truly feel I’ve made a difference in so many people’s lives.  I’m honored to be a hygienist and be part of such a loving family and community. So many doors have opened and paths have been taken and I can’t wait to see what the next 10 years bring.

I want to say thank you to all my fellow hygienists out there for all your hard work and dedication! Happy National Dental Hygiene Month!

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Denture Adhesives

When Denture Adhesives should or shouldn’t be used:

They should be used to enhance the retention, stability and bite force as well as to help with one’s sense of security. They can also be used to help individuals who suffer from dry mouth which lessen denture adherence. Other people who may need to use denture adhesive are people who place unusual demands on facial muscles; such as musicians and public speakers as well as those who have neurologic disabilities; such as strokes and the elderly.

They should not be used as a permanent fix for those individuals who have a poor fitting denture. Loose dentures can cause sores to develop.  Also, dentures rest on the gum tissues and the jaw bones, which shrink and deteriorate overtime, so the real problem may be that you need a hard reline or new dentures, not more adhesive.  Other times denture adhesive should not be considered is when oral hygiene practices cannot be sustained, and when any known allergy exists to the ingredient.

How are they applied?

  1. Use a minimal amount necessary to provide the maximum benefit (tips: less is more, easier to add then remove)
  2. Apply or reapply when necessary to provide the fit you find most comfortable
  3. Make sure your denture is thoroughly clean before applying adhesive
  4. They work best when your denture fits properly

There are many types of denture adhesives but the following two are the most common:

  1. Paste Application:

Apply to a dry or wet denture (wet is preferred), be sure to avoid placing near borders as you do not want it to ooze out. If it does ooze out be sure to use less next time.

  1. Powder Application:

Sprinkle a thin, uniform layer throughout the tissue- bearing surface of the denture. Then shake off the extra powder and press the denture into place. * Powders may be preferred over paste because they are easier to clean off the denture and tissue.

Poligrip and Fixadent are two of the top brands on the market for denture adhesives

 Are they safe?

Dental adhesives are safe as long as you use them properly. If the denture fits well and you are only using adhesives for stability, there should be no concern. If you are using adhesives excessively to fill voids for dentures that do not fit properly, then you could be causing damage to under lying soft and hard tissues. In addition, because of the movement on the soft tissue and underlying bone, bone loss can occur due to the ill-fitting denture.

Why Dentures?

Dentures have been around since as early as the 7th Century, BC. They are a wonderful option for those who have suffered from tooth loss due to gum disease, tooth decay or trauma.  Dentures are removable appliances that replace your missing teeth and restore your smile. They also help with chewing and speech.  There are two main types of dentures available, complete and partial. Complete dentures are used when all your natural teeth are missing; partial dentures are used when some healthy natural teeth remain. When possible it is always best to save and use your natural teeth.

Complete dentures can be either conventional or immediate.  Conventional dentures are placed several months after remaining teeth have been extracted and tissues have had time to heal. An immediate denture is inserted the same day as the teeth are extracted, so you don’t have to be without teeth during the healing period.  Immediate dentures are made in advance so more adjustments need to be made for them to fit properly, and more relines are done as tissues shrink during the healing process.

conventional-inmediate-full-denture

Partial Dentures usually consist of replacement teeth that are attached to a pink or gum colored plastic base, which sometimes is connected by a metal framework that helps hold it in place. These dentures are usually the best options when you have more healthy remaining natural teeth.

partial-denture

New dentures naturally will feel awkward for a few weeks until you become accustomed to them. They may feel loose while your cheek and tongue muscles learn how to keep them in place. You may also experience areas of soreness and irritation. If this happens be sure to contact your dentists for a denture adjustment.  As your mouth becomes accustomed to the denture, and adjustments are made for a better fit, these problems should decrease and eventually go away.

Dental Hygiene is still very important when you have dentures. It’s important to brush your gums, tongue, and roof of your mouth every morning and every night. This will help stimulate tissues and help remove plaque & bacteria.  Denture homecare is also very important. I have listed some good tips to follow:

  • When handling your dentures, stand over a folded towel or basin of water so if you drop them you decrease the risk of cracking them as they are very delicate. *If you do crack or chip them see your dentists, do not try to repair them yourself.
  • Rinse them before brushing to remove any loose food debris- brushing also prevents staining
  • Use a soft bristle brush and a non- abrasive cleaner to brush them to prevent scratching
  • Remove before bed- this allows tissues to rest and decrease risk of irritation
  • See your dentists every 6 months or 12 months (if you have complete upper and lower dentures) for an oral tissue exam and check up on your dentures.
  • When you’re not wearing them store them in a safe place, covered in water or a denture cleaner soaking solution (Polident or Efferdent) to keep them from drying and becoming brittle. (Do not use hot water) * Denture cleaners are important because they help control the growth of microorganisms on your dentures.

Choosing to have your teeth extracted and having a denture made can be a difficult decision but we are here to help and guide you to make the best choice for you and your overall health and appearance.

Link on how to clean your dentures from Polident:

https://www.mydenturecare.com/en-us/getting-used-to-dentures/cleaning-dentures/