The Research

The studies conducted at Virginia Commonwealth University and Yale University School of Medicine suggest that patients who practice good oral health and visit their dentists regularly are less likely to develop pneumonia than those who don’t. Data from over 26,000 patients was used to determine the link between oral health and pneumonia. Of the 26,000 patients followed, 450 were diagnosed with pneumonia at least once during the 2 years of the study. Lack of dental insurance and the “inability to access needed care” were found to be associated with the instances in which patients developed pneumonia.

Interpreting the Findings

“There is a well-documented connection between oral health and pneumonia, and dental visits are important in maintaining good oral health,” stated lead study author Michelle Doll, MD, MPH, in an ID Week press release. “We can never rid the mouth of bacteria altogether, but good oral hygiene can limit the quantities of bacteria present.”

A Recent Review Confirms Benefits of Fluoride

As I discussed in my post, Bottled Water and Tooth Decay, not all water is created equal; most tap water in the US has fluoride added which helps prevent tooth decay. Dental professionals witness the impact of fluoride in their daily work. However, studies on the benefits of fluoride are very helpful in demonstrating its value to patients. A recent review by the Cochrane Oral Health Group published in July confirmed that regular fluoride intake can reduce cavities in children and adolescents.

The Review

The review by Cochrane was made up of 37 trials assessing over 15,000 children and adolescents. The trials tested the benefits of fluoride, and the majority of studies included children who were prone to cavities. Trial duration was about 2 to 3 years.

Results

In reviewing the findings it was established that fluoride reduces decay in children and adolescents.

“The combined results of the 35 trials showed a 27 percent reduction in decayed, missing and filled tooth surfaces in permanent teeth compared to no rinse or a placebo rinse.”

Whether your children receive fluoride from tap water or a mouthwash with fluoride added, its benefits are without question. It’s important to instill good oral health practices in children at a young age, and in light of this study, that includes regular brushing, flossing, and using a fluoride mouthwash.

Periodontal disease (gum disease), which is most often caused by bacteria in dental plaque, has been linked with other chronic health problems. A new study by the University at Buffalo’s School of Public Health and Health Professions, the largest of its kind, found that periodontal disease is correlated with breast cancer in postmenopausal women. While oral-associated microbes have been found in breast tumors, very little research has been presented about the relationship between relationship between periodontal disease and breast cancer until now.

The Study

The study, which began in 1991, monitored over 73,000 postmenopausal women who had never had breast cancer. At the time of the study, 26% of the women were found to have gum disease. After almost 7 years, 2,124 of the women had been diagnosed with breast cancer. Researchers found that women with periodontal disease had a 14% higher risk of being diagnosed with breast cancer.

Making Sense of the Data

Researchers have proposed several possible explanations for the association between periodontal disease and breast cancer. There’s a possibility that a systemic inflammation from periodontal disease could affect breast tissue, or that oral bacteria that enter the circulatory system could affect the tissue.

What impact do these findings have?

Robert Genco, a co-author on the paper and SUNY Distinguished Professor in the Department of Oral Biology in UB’s School of Dental Medicine, noted that, “Since periodontal disease affects half or more women in this age range, the increase in risk, although small, may be important on a population base. Further study of mechanism and effects of periodontal intervention are necessary to more fully understand this relationship.” Researchers are uncovering more and more information about how our individual microbiomes affect our health.

Coffee, one of the most popular beverages, is consumed by over 80% of adults in the US. When it comes to getting the day started, it’s a necessary part of the equation for many people. There’s a lot written today about both the positive and negative effects of your favorite caffeinated beverage. So how is your morning routine affecting your teeth?

Cosmetic Considerations

When you think of coffee and oral hygiene, one of your first thoughts should be “yellow teeth”. Coffee has long been recognized for causing the enamel of teeth to become discolored. Coffee contains ingredients called tannins which are  a plant based compound that allow stains to more readily stick to your teeth. Regular  coffee consumption can lead teeth to become more yellow in color.

A Healthy Habit

Despite coffee’s unwanted cosmetic effects, it may provide more dental benefits than one might think. Coffee’s polyphenols can have positive effects on tooth health by acting  to inhibit the production of teeth eroding acids and biofilms. Biofilms that adhere to tooth surfaces can wear away the tooth structures and cause permanent decay.

Systemic Benefits

In addition to protecting teeth from decay, coffee has been found to have many systemic health benefits. Coffee has been found to:

• Boost metabolism
• Decrease risk of cancer
• Keep the mind sharp
• Prevent heart disease

While coffee can alter the appearance of teeth in a negative way, many beneficial side effects continue to be discovered. So, to enjoy that cup of joe and avoid oral damage, drink in moderation. Dentists suggest you drink no more than two cups a day, and follow up with regular brushing and water consumption.

As we frequently hear, hydration with eight glasses of water is good for our overall health and for our oral health. Municipal water supplies in the US should be safe and for the most part are very safe, but because of the reports of a few notable exceptions like the water problems in Flint Michigan, there is a huge market for bottled water.

Bottled Water v. Tap Water

All water is created equal right? When it comes to bottled water vs. tap this is not always the case. The EPA is responsible for monitoring public drinking water supplies and the FDA is responsible for bottled water beverages including “flavor and nutrient added water beverages”, other water beverages, carbonated water, and soft drinks.

Tap water is regulated to ensure it has a neutral pH of about 7 (water quality regulations specify that the pH of tap water should be between 6.5 and 9.5). Because of this it normally doesn’t contribute to the erosion of tooth enamel. In addition, most public drinking water has fluoride added which helps prevent tooth decay. The Centers for Disease Control and Prevention (CDC) ranks water fluoridation among the top ten public health achievements of the 20th century because it has proved so effective in helping to reduce tooth decay.

Most bottled waters do not contain fluoride and the additives, minerals, salts, sugar, sugar substitutes, etc. in many bottled water products can substantially alter their pH. When it comes to your teeth, some bottled water can increase plaque buildup, and lead to tooth decay especially when consumed in excessive amounts.

Maintaining Oral Health

If you decide to go the route of consuming bottled beverages be sure to read the labels. Consume bottled water, flavored beverages, and soft drinks in moderation, and make sure you’re getting enough fluoride. As always practice good oral health to protect your beautiful smile!

Don’t be sensitive about your tooth sensitivity

According to the American Dental Association 1 in 8 Americans may suffer from sensitive teeth. Tooth sensitivity often occurs when the enamel that protects teeth wears away, exposing small tubes that connect nerves inside the tooth to outside triggers. The study conducted by the ADA found that young adults, women and people with receding gums were most likely to have sensitivity. So what should you do if you have sensitive teeth?

Avoid certain foods

Very acidic foods can aggravate sensitivity in the mouth by removing small amounts of enamel overtime. Orange juice, tomato sauce and carbonated beverages are some of the culprits. Try limiting your intake of these foods and if you’re going to enjoy that glass of juice, use a straw to limit contact with your teeth. Be sure to drink water immediately after enjoying acidic substances to balance the acid levels in your mouth.

Consider a new toothpaste

Over the counter desensitizing toothpastes, such as Sensodyne, can help mitigate sensitivity. They work by blocking pain signals to the nerve of the tooth and usually require several applications before the sensitivity is reduced.  Desensitizing toothpaste is great for feeling better, but it does not cure sensitivity. Be sure to treat the cause of your pain so it does not get worse.

Accessorize at night

If you grind your teeth at night you are slowly wearing down the enamel that protects teeth. Wearing a mouth guard while you sleep can prevent grinding and keep teeth healthy.

Talk to your dentist

If your sensitivity does not improve, talk to your dentist. A crown, or bonding might be used to correct the tooth decay that is causing your sensitivity. More invasive procedures include a surgical gum graft to protect the root of the tooth or a root canal.

Good oral hygiene is the best way to prevent tooth sensitivity. Ask your dentist if you have any questions about your daily routine or concerns about your teeth.

The majority of us spend most of our time at work. Whether you love your job or you see it as just a paycheck, we all develop habits while on the job. What you may not realize is that some of your “work quirks” could actually be harming your teeth. Be sure to correct any of the habits below if they’ve become part of your routine!

Grinding & clenching

We all have different coping mechanisms for dealing with stress. If your job causes you to feel tense throughout the day you might catch yourself grinding your teeth or clenching your jaw. Bruxism is a condition in which you grind, gnash or clench your teeth either during the day or at night while you sleep.

It’s natural for the body to react to increased stress –  however these tendencies can lead to long term dental health problems. In some cases, Bruxism can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear teeth down to stumps resulting in the need for crowns, root canals or implants.

Severe grinding can also affect your jaws, causing a condition known as Temporomandibular Joint disorder or TMJ. Symptoms of TMJ include pain in the jaw, difficulty chewing, headaches and sometimes a change to the appearance of your face. If you feel you need some kind of coping mechanism when you’re feeling tense at work, try squeezing a stress ball instead of clenching your jaw!

Using your teeth as scissors

When you’re moving quickly throughout the day sometimes you might occasionally use your teeth as a tool, Don’t! Tearing off a piece of tape or holding a pen or pencil in your mouth may seem like no big deal, but you can actually chip away at the enamel of your teeth and risk breaking them. Take the extra time to find a pair of scissors, risking the health of your teeth is not worth it!

Coffee breaks

For many of us, the daily caffeine fix is a vice we just simply cannot live without. Coffee, however, is notorious for staining your pearly whites. We’re not going to ask you to break the habit, just be smart about how you consume that cup of joe. Try to maintain teeth whiteness by drinking your coffee through a straw and be sure to drink water after you finish that latte.

Smoking

Smoking is a habit with a laundry list of serious health implications. When it comes to dental health, smoking causes people to have more dental plaque and increases the risk of gum disease. Smoking causes a lack of oxygen in the bloodstream, so gums that become infected aren’t able to heal. And, gum disease is the most common cause of tooth loss in adults. Smoking also can cause bad breath and yellow teeth.

While there are things your dentist will advise you to do at home to keep your teeth healthy (i.e. brushing & flossing) some procedures and tools are best left to the hands of a trained professional. Miss-using dental devices can cause more harm than good. So before you pick up those dental forceps, read on!

With sites like Amazon and eBay, medical and dental instruments are readily available for purchase by any consumer. While tools like Scalers (used by dentists and dental hygienists to remove plaque and tartar) may seem easy to use, the improper use of these instruments can lead to serious problems for your teeth. Tooth sensitivity, infection of the gums, and tooth chipping are all potential risks.

Teeth-whitening is another area in which we see patients attempting treatment at home. While there are great products out there today that are designed to be used at home, other products, often sold online, are meant for professional use. Speak with your dentist before purchasing a whitening product; she’ll be able to advise you on the best option for your teeth. Whether you choose a product from the local drug store, or buy something directly from your dentist, be sure to follow the directions! Side effects of whitening include tooth sensitivity and gum irritation.  [How to get a whiter, brighter smile]

The best way to ensure the health of your teeth is to visit your dentist regularly. Be sure to address any concerns you have during your appointment. In between dental visits, remember to brush and floss!

Antibiotics are widely overprescribed today with very few people understanding what’s at risk. According to the Journal of the American Medical Association (JAMA), “Approximately 30% of all oral antibiotics prescribed in US outpatient settings are unnecessary.” Within the dental community this is especially evident as we see patients requesting antibiotic prescriptions before dental procedures without any medical justification.

Understanding the role of antibiotics

According to The Centers for Disease Control and Prevention (CDC), studies suggest that 47 million needless prescriptions are written each year. That is a huge number! Part of the problem is that there’s a general misconception among patients about the role antibiotics should play, and so we see requests for antibiotics when they’re not actually necessary.

Antibiotics are chemicals that kill or inhibit the growth of bacteria. They are used to treat bacterial infections. Antibiotics are not painkillers and they cannot be used to treat viral infections. When you take an antibiotic to treat a virus like the flu, instead of fighting the infection, it’ll destroy a wide variety of bacteria in your body, including some of the “good” bacteria that help you digest food, and stay healthy.

When it comes to managing dental conditions, antibiotics can actually do more harm than good. Many patients request antibiotics when they have a toothache or dental abscess because they think it will alleviate the pain. Dental pain comes from the nerve of the tooth – to remove the pain you must remove the source, either by extraction, or doing a root canal. Only when soft tissue is involved and you begin to see facial swelling does an antibiotic become necessary; however the source of the pain still must be treated as well (i.e. extraction, etc.).

What’s at risk?

The over-prescribing of antibiotics can put patients at unnecessary risk for complications associated with their use. Allergic reactions, vomiting, and diarrhea are all common side effects of antibiotics. Some side effects can be more severe, especially those associated with stronger antibiotics, including deafness, numbness in the extremities and a deadly form of antibiotic-associated diarrhea, known as Clostridium difficile.

The larger systemic issue is that the overuse of antibiotics has caused some bacteria to become drug resistant over time. “Each year, more than 2 million people in the U.S. are infected with a bacterium that has become resistant to one or more antibiotic medication designed to kill it,” (Federal Centers for Disease Control and Prevention). At least 23,000 people have died as a direct result of these “superbugs”.

You can help slow the spread of resistant bacteria by taking antibiotics only as directed and following all instructions. Listen to your doctor when it comes to prescriptions, they’ll know when antibiotics are appropriate and when they are not.

Taking a precautionary antibiotic before a trip to the dentist isn’t necessary for most people and, in fact, might do more harm than good, according to updated recommendations from the American Heart Association.

The new guidelines

The AHA’s updated guidelines say that many patients who have taken preventive antibiotics regularly in the past no longer need them. The AHA now recommends that only people who are at the greatest risk of bad outcomes from infective endocarditis (IE) should receive short-term preventive antibiotics before routine dental procedures. IE is an infection of the heart’s inner lining or the heart valves, which results when bacteria enter the bloodstream and travel to the heart.

Risks outweigh the benefits

The new guidelines are based on current evidence that shows the risks of taking preventive antibiotics outweigh the benefits for most patients. These risks include adverse reactions to antibiotics and the development of drug-resistant bacteria.

The overuse of antibiotics has caused a huge increase in the number of bacteria that are now resistant to them. When this happens, new antibiotics must be created to treat these drug resistant bacteria.

The guidelines emphasize that maintaining good oral health and practicing daily oral hygiene are more important in reducing the risk of IE than taking preventive antibiotics before a dental visit.

Some patients still need preventive antibiotics

However, there are some patients who should still take antibiotics prior to dental procedures, specifically patients who have the highest likelihood of negative outcomes from developing a cardiac infection.

Patients should ask their primary care doctor or their cardiologist if there is any question whether they should take preventive antibiotics. They should also be aware that overuse of antibiotics many times can lead to a worse outcome than if they were not used at all.