By Randall J. Bartoe, DDS, PLC
January 17, 2019
Category: Oral Health
Tags: oral health   seniors  
4DentalCareAreastoKeepinMindfortheSeniorAdultinYourLife

Like many people, you might be caring for an elderly parent or family member. That care should include a focus on their teeth and gums — a healthy mouth is vitally important to their overall health, nutrition and well-being. Because of the aging process, this can be challenging.

Here are 4 areas where you should focus your attention to assure the senior adult in your life has the healthiest mouth possible.

Make adjustments for hygiene. As we grow older, arthritis and similar conditions make brushing and flossing difficult to perform. You can help your senior adult keep up these vital tasks by switching to a powered toothbrush or refitting their brush with a bike handle or tennis ball to make gripping easier. Pre-loaded floss holders or water irrigators are effective alternatives to manual flossing if it becomes too difficult.

Have dentures or other appliances checked regularly. Many older people wear full or partial dentures. Due to the nature of these appliances, the risk of bone loss over time is greater, which can eventually affect their fit. Their dentist should check them regularly and reline or repair them if possible. Eventually, they may need a new appliance to match any changing contours in the mouth.

Be aware of age-related dental issues. Age-related conditions of both the mouth and the body (like osteoporosis, which can affect bone density) can impact dental health. For example, an older person can develop lower saliva flow, often due to medications they’re taking. This, as well as gastric reflux common in older people, increases acidity and a higher risk of tooth decay. Past dental work like fillings, crowns or bridges may also make hygiene and additional treatment more difficult.

Keep up regular dental visits. In light of all this, it’s crucial to keep up with regular dental visits for continuing teeth and gum health. Besides cleanings, these visits are also important for monitoring signs of tooth decay, periodontal (gum) disease and oral cancer. It’s also a good opportunity to gauge the effectiveness of their hygiene efforts and suggest adjustments.

If you would like more information on dental care for older adults, 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 “Aging & Dental Health.”

By Randall J. Bartoe, DDS, PLC
January 07, 2019
Category: Oral Health
Tags: osteoporosis  
ManageYourOsteoporosisMedicationtoAvoidJawboneProblems

Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.

Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.

Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax™, and denosumab or Prolia™. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.

In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.

The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.

Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.

Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.

If you would like more information on the effect of osteoporosis treatment on dental 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 “Osteoporosis Drugs & Dental Treatment.”

By Randall J. Bartoe, DDS, PLC
December 28, 2018
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Randall J. Bartoe, DDS, PLC
December 18, 2018
Category: Oral Health
5WarningSignsYouMayHaveGumDisease

Periodontal (gum) disease, a bacterial infection caused by plaque, is one of the most prevalent and destructive dental conditions. Left untreated it can eventually lead to tooth and bone loss.

Although people are often unaware they have gum disease, there are a few warning signs to look for. Here are five gum disease signs that should prompt a dental visit.

Gum Swelling and Redness. Like all infections, gum disease triggers an immune system response that releases antibodies into the gums to attack the bacteria. The ensuing battle results in inflammation (swelling) and a darker redness to the gum tissues that don’t lessen with time.

Gum Bleeding. It isn’t normal for healthy gum tissue, which are quite resilient, to bleed. In a few cases, bleeding may indicate over-aggressive brushing, but more likely it means the tissues have weakened to such an extent by infection they bleed easily.

Tooth Sensitivity. If you notice a shot of pain when you eat or drink something hot or cold or when you bite down, this could mean infected gums have “drawn back” (receded) from the teeth. Gum recession exposes the tooth roots, which are more sensitive to temperature and pressure changes in the mouth.

An Abscess. As weakened gum tissues detach from the tooth, the normally thin gap between them and the tooth deepens to form a void known as a periodontal pocket. This often results in an abscess where pus collects in the pocket and causes it to appear more swollen and red than nearby tissues. An abscess needs immediate attention as bone loss is greatly accelerated compared to normal gum disease.

Tooth Looseness or Movement. As diseased gum tissue causes loss of gum and bone attachment, the affected teeth will start to feel loose or even move to a different position. This is a late and alarming sign of gum disease — without immediate intervention, you’re in danger of losing the tooth.

If you encounter any of these signs, contact us for an examination as soon as possible. The sooner we can diagnose gum disease and begin treatment, the less damage it will cause — and the better your odds of regaining healthy teeth and gums.

If you would like more information on gum disease, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Warning Signs of Periodontal (Gum) Disease.”

By Randall J. Bartoe, DDS, PLC
December 08, 2018
Category: Oral Health
Tags: tooth decay  
WillieWonkasChocolateFactoryWasNotSoSweettoCastsTeeth

The classic movie Willie Wonka & the Chocolate Factory, starring Gene Wilder, still brings back sweet memories of childhood to people everywhere. Recently, the news broke that a remake of the beloved 1971 film is in now development in Hollywood. But at a reunion of the original cast members a few years ago, child star Denise Nickerson revealed that her role as gum-chewing Violet Beauregard caused a problem: she ended up with 13 cavities as a result of having to chew gum constantly during the filming!

It should come as no surprise that indulging in sugary treats can lead to cavities: The sugar in your diet feeds harmful bacteria that can cause tooth decay and other dental problems. Yet lots of kids (not to mention the child inside many adults) still crave the satisfaction that gum, candy and other sweets can bring. Is there any way to enjoy sweet treats and minimize the consequences to your oral health?

First, let’s point out that there are lots of healthy alternatives to sugary snacks. Fresh vegetables, fruits and cheeses are delicious options that are far healthier for you and your kids. Presenting a variety of appealing choices—like colorful cut-up carrots, bite-sized cheese bits and luscious-looking fruits and berries can make it easier (and more fun) to eat healthy foods. And getting kids off the sugar habit is a great way to help them avoid many health problems in the future.

For those who enjoy chewing gum, sugarless gum is a good option. In fact, chewing sugarless gum increases the flow of healthful saliva in the mouth, which can help neutralize the bacteria-produced acids that cause cavities. Gums that have the ADA (American Dental Association) Seal of Acceptance have passed clinical tests for safety and effectiveness.

But if you do allow sugary snacks, there are still a few ways to minimize the potential damage. Restrict the consumption of sweets to around mealtimes, so the mouth isn’t constantly inundated with sugar. Drink plenty of water to encourage saliva flow, and avoid sugary and acidic beverages like soda (even diet soda) and “sports” or “energy” drinks. Brush twice daily with fluoride toothpaste and floss once a day. And don’t forget to visit our office regularly for routine checkups and cleanings. It’s the best way to get a “golden ticket” to good oral health.

If you would like more information about sugar, cavities and oral health, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”





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