Dental Questions: Can Bisphosphonates Affect Dental Care?

Some Common Brands of Bisphosphonates

If your physician has diagnosed you with osteoporosis, there is a good chance you have been (or will be) prescribed bisphosphonates such as Reclast or Fosamax. There is a possibility that long term use of these drugs can make it difficult for the jaw bone to heal when a tooth is removed.  If you are about to start using a bisphosphonate, it is recommended you have a dental evaluation to identify any teeth that might need to be removed now or in the future. This provides a better long term prognosis for your jaw's healing.  If you have been on a bisphosphonate for some time and need a tooth removed, then you will need to consult with both your medical doctor and dentist to discern the best way to proceed. The impact of Bisphosphonates on dental care highlights the importance of disclosing your complete medical history (including any changes) during a check up or examination. 

CDA Presents

This weekend, our social media developer and former dental assistant Dean attended CDA Presents- the California Dental Association’s yearly convention and trade show. CDA Presents is a great way to keep up-to-date with new technologies and the latest developments in the dental industry. In addition to vendors, the convention offers educational opportunities, training classes and great networking events. All of this translates to improved patient care and streamlined service. Dean is eager to report back with tons of great new ideas and products!

Dental Questions: Why Does Flossing Make My Gums Bleed?

A common complaint among patients is that “Flossing causes my gums to bleed, so I don’t floss.” In actuality, the reverse is true: not flossing on a regular, once-a-day basis will cause the gums to bleed when flossed occasionally. Plaque and tartar buildup beneath the gum surface leads to inflammation which in-turn causes bleeding. When you use a toothbrush, the bristles can effectively clean the tops and sides of the teeth. However, the interproximal space (space between two teeth) is impossible to reach with brushing alone.  Hence, we recommend using some sort of dental cleaning device between the teeth once a day. Floss, Butler Soft Picks, handle flossers and water picks can all be used to “brush” this space. There are a number of great options- even if you don't like traditional dental floss!

Dental Questions: Why are my Gums Bleeding?

Sometimes gums will bleed for obvious reasons, like cuts from flossing or abrasion from brushing. Other times, the root cause is less clear. The most common reason for gums to bleed randomly is due to calculus or tartar build up beneath the gum surface. Our office often sees patients that haven’t had their teeth professionally cleaned in a number of years. The number one complaint of these patients is that their gums bleed when brushing, when touched, or even while they are sleeping. A professional cleaning from a hygienist or dentist will remove the tartar, allow gums to heal and end the bleeding. 

Another common complaint is that gums bleed upon flossing. Interestingly, this is generally caused by not flossing enough. We recommend flossing or using some sort of hygiene instrument below the tooth contact once a day. This will help keep the gum tissue healthy and free of any plaque or tartar build up.

Baptism of Baby Duke

Duke John Warren was baptized Sunday April 19th, 2015 at St. Matthews Episcopal Church. He was joined by his godparents Aunt Vicki and his Daddy's best friend Bruce. Duke didn't mind the water from the baptism and made it through the service with minimal cooing. He is almost 11 weeks old now! We hope everyone got to enjoy this weekend with their friends and family! 

Dental Questions: What can I do to make a toothache feel better?

Generally, toothaches are caused by inflammation of the nerve inside the tooth. The best way to temporarily relieve the pain is by taking a nonsteroidal anti-inflammatory over-the-counter medication such as naproxen sodium (Aleve) or ibuprofen (Motrin).  If the tooth is sensitive to temperature and biting pressure, then it likely needs a root canal to completely resolve the pain.  If there is swelling around the tooth or in the face, then the nerve inflammation has progressed to an infection and antibiotics and a root canal are required to fix the situation. 

You may be tempted to use over-the-counter toothache remedies such as topical anesthetic (Orajel). However, these medications are best used to treat sore gum tissue caused by ulcers or canker sores and will do little to remedy actual tooth pain. Remember, a toothache is caused by an inflammatory process that is occurring within the tooth (and not in the surrounding gums). Additionally, do not try crushing aspirin or other medications and placing them against the tooth area. These medications are only meant to be taken orally, and can cause serious chemical burns on the gum tissue and mucosa. 

Dental Questions: Are sinus infections and pain on upper teeth related conditions?

In this X-Ray, the floor of the maxillary sinus (yellow line) and the roots of the molars (blue lines) are highlighted. Note how close they are in proximity to each other. 

            The roots of the upper molars are frequently embedded in the floor of the maxillary sinus. As such, the nerves supplying the upper teeth can "pick up" pain signals from an inflamed or infected sinus. Since the size of the maxillary sinus grows with age, this phenomenon can become more prominent in later years. However, it is still important to consult a dentist about severe tooth pain or changes in the size or shape of your teeth and gums. This can be a potential sign of an infection that needs to be treated immediately. 

Dental Questions: What Does It Mean If My Face Is Swollen?

Dental abscesses start small but can have very serious effects.

A swollen face in relation to tooth discomfort means that the tooth has an abscess that has not found a way to drain on it’s own.  An abscess forms when the body has detected a bacterial infection and “walled off” the affected area, but cannot naturally eliminate it. The associated swelling signifies a serious infection that has caused inflammation of the facial tissues. This is a health emergency and requires antibiotics and drainage of the abscess. 

Dental Questions: Can decay on an x-ray look smaller than it actually is in the mouth?

Dental x-rays are a case of "more than meets the eye."

Not only can the decay be bigger, it almost certainly will. Cavities on a tooth are always slightly larger in size than they would appear on an x-ray. For a standard dental radiograph, enamel has to loose about 40% of its mineral content before you can visualize the decay. In other words, the x-ray shows us a dark spot over the most demineralized areas, but the entire effected space will extend beyond this epicenter.  

Furthermore, it is important to remember that an x-ray is only a 2D image. When looking at a radiograph, we can only make accurate judgements in one axis (from the part of the tooth closest to the throat to the part closest to the front of the mouth). We can gather some information on the dimensions from the cheek side to the tongue side, but it is less reliable. Thus, it can become difficult to judge the extent of decay as an entire 3D "space."

Happy Easter from Thousand Oaks Family Dentistry!

We hope you had a great Easter Sunday surrounded by your family and loved ones. For those still in school, enjoy your spring break. Just one more semester/quarter until summer! This year, Dr. Kari Hong and her family traveled to Maui, Hawaii for a much deserved vacation. Here, they are photoed in front of the Lahaina United Methodist Church where they attended Easter Service. Locally, the Hongs are very involved with the United Methodist Church of Thousand Oaks. Consider this a big "Aloha" from our office to you!