Dentist - Andover
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Posts for: July, 2020

TalkWithYourDentistAboutAntibioticTherapyBeforeImplantSurgery

Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.

To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.

One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.

In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.

These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.

As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.

If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.

If you would like more information on getting dental implants, 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 “Implants & Antibiotics.”


By Browell & Murphy
July 19, 2020
Category: Oral Health
Tags: oral hygiene  
FlossFirstorBrushFirstYouBetheJudge

Brushing and flossing are two of the best things you can do to fight dental disease and maintain healthy teeth and gums.

Or is it flossing and brushing? What we mean is, should you floss first or brush first?

There's virtually no debate among dental professionals about whether or not to perform both hygiene tasks. While brushing removes disease-causing plaque from the broad surfaces of teeth, flossing gets to deposits of this disease-causing, bacterial film lodged between the teeth that brushing can't reach. You don't want to neglect one task over the other if you want to fully minimize your risk of tooth decay or gum disease (and don't forget semi-annual dental cleanings too).

But where there is some debate—good-natured, of course—among dentists is over whether it's better hygiene-wise to brush before flossing or vice-versa. For those on Team Brush, you should pick up your toothbrush first for the best results.

By brushing before you floss, you'll remove most of the plaque that has accumulated since your last cleaning session. If you floss first, the flossing thread has to plow through a lot of the plaque that otherwise might be removed by brushing. For many, this can lead to an unpleasant sticky mess. By removing most of the plaque first via brushing, you can focus your flossing on the small amount left between teeth.

Team Floss, on the other hand, believes giving flossing first crack at loosening the plaque between teeth will make it easier for the detergent in the toothpaste to remove it out of the way during brushing. It may also better expose these in-between areas of teeth to the fluoride in your toothpaste while brushing. And because flossing is generally considered a bit more toilsome to do than brushing, tackling it first could increase the likelihood you'll actually floss and not neglect it after brushing.

So, which task should you perform first? Actually, it's up to you: Weighing both sides, it usually comes down to which way is the most comfortable for you and will give you the greatest impetus for flossing. Because no matter which “team” you're on, the important thing is this: Don't forget to floss.

If you would like more information on personal dental care, 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 “Daily Oral Hygiene.”


By Browell & Murphy
July 09, 2020
Category: Oral Health
Tags: orthodontics   oral hygiene  
HowtoAvoidWhiteSpotDecayWhileWearingBraces

Straightening your teeth with braces or other orthodontic gear is a positive step toward a healthier and more attractive smile. You'll likely be pleased with your smile when they're removed.

But you may also notice something peculiar once the braces are off—dull, white spots on your teeth. These spots, usually located under or around braces hardware, are where mouth acid has “demineralized” calcium and other minerals in the enamel. As beginning tooth decay, these spots are a sign your hygiene efforts weren't sufficient in cleaning your teeth of plaque.

In many cases, the spots will improve on their own after the braces are removed. We can also strengthen the enamel with fluoride pastes or gels, or inject tooth-colored resin within the spot to restore the enamel's translucence and improve appearance.

But the best approach is to try to prevent white spots from occurring at all. Here's what you need to do.

Keep up your oral hygiene. Even though more difficult with braces, you still need to brush and floss to protect your teeth from tooth decay. To make it easier, take advantage of special brushes designed to clean around orthodontic brackets and wires. A floss threader can also help you better access between teeth—or switch to a water flosser instead of floss thread.

Practice a “tooth-friendly” diet. A diet high in sugar and acid could short-circuit your best hygiene efforts. Certain beverages are big offenders: sodas, energy and sports drinks, and even “natural” juices. Instead, eat foods high in vitamins and minerals like fresh fruits and vegetables, lean proteins and low-fat dairy.

Get your teeth cleaned regularly. While you're seeing your orthodontist for scheduled adjustments, don't neglect regular cleanings with your family dentist. Professional cleanings at least every six months reduce the risk of dental disease. These regular visits are also a good time for your dentist to check your teeth for any signs of dental problems associated with your braces.

It's not easy to keep your teeth clean while wearing braces, but it can be done. With help from a few handy tools and continuing care from your dental professionals, you can avoid unsightly white spots.

If you would like more information on dental care while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”