the right smile

Educating Patients on their Oral Health Options

Daily Archives: September 22, 2011


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Dentist Serving Dunwoody – Older patients have special dental needs

Mouths, like people, are affected by years as well as by genes. If you’re over 60, your oral chemistry is changing—and thorough examinations of gums and salivary glands can be a lifesaving early detector of oral cancer or other disease.  Older Americansare becoming a larger segment of our population and suffer disproportionately from oral diseases, with the problembeing particularly acute for individuals in long term care facilities.  They generally requiremultiple medications, and common side effects of the more than500 medications used to treat their overall health issues usually reduce salivary flow.[1]   Usually the reduction in salivacan adversely affect their quality of life, the ability to chew, and lead to significant problems of the teeth andtheir supporting structures.

The elderly may also have difficulty performing routine oralhygiene procedures because of physical limitations, such as Parkinson’s or rheumatoid arthritis.   In addition,oral infection is now recognized as a risk factor for a numberof systemic diseases, including cardiovascular diseases, cerebrovascular diseases,diabetes, mellitus, and respiratory disorders.  Also,it is important to note that once people have lost their teeth and are using complete dentures, their oral healthneeds do not decrease.   Our jaws are not static and may continue toresorb over time.  Besides the continued resorption of bone, improperly fitted dentures can adversely affectchewing, leading to poor nutrition.  In addition, those without teeth remainsusceptible to oral cancer, mucosal diseases, and alterationsin salivary gland function.

As early as 55 patients are developing twice as many cavities as children do. All these health issues and their medications that create reduced saliva and cause dry mouth have become an open invitation for tooth decay and periodontal disease.  Does the patient have to make a choice between his or her general health verses their oral hygiene?  They shouldn’t have to.

What should you expect from a visit to your dental hygienist?  Along with your dental cleaning you may need professional scaling and root planing to remove harmful plaque and calculus deposits.  Your hygienist should also record the depths of your periodontal pockets (that space between your teeth and gums where decay and periodontal disease flourish).

Keeping track of you is a key part of the hygienist’s job. It includes keeping your dental chart and health history current, making preliminary oral inspections, and creating tooth impressions.

Your hygienist is also an educator—someone who can teach you preventive dentistry skills—brushing and flossing techniques that make for healthy, trouble-free gums and teeth, regardless your age or your onset of other health issues. Together, you two can make an unbeatable team!

Specializing in Geriatric Patients, Dr. Scheinfeld was trained in prosthodontics at Emory University School of Dentistry.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A                                     

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com

[1] Fox PC, Eversole LR. Diseases of the salivary glands. In: Silverman S, Eversole LR, Truelove EL, eds. Essentials of Oral Medicine. Ontario, Canada: BC Decker; 2002:260–276.

 

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Dentist Sandy Springs: Oral Health Care of Our Aging Population

Two important oral health care concerns emerging in the United Statesare disparities in the oral disease burden and the inabilityof certain segments of the population to access oral healthcare.[1]  Older Americansare becoming a larger segment of our population and suffer disproportionately from oral diseases, with the problembeing particularly acute for individuals in long term care facilities.  Populationprojections for the United States indicate that the elderlywill constitute an increasing percentage of the population aswe proceed into the 21st century.  In 2001, the population ofthe United States was almost 278 million, and 12.6% of the populationwas 65 years of age or older. By 2015, the population is expectedto increase to 312 million (3.08 million in 2010) and 14.7% of the population willbe aged 65 years or older.  In 2030, which is within the practicelives of students currently enrolled in dental schools, thepopulation will have increased to more than 350 million, and20% of the population—1 of every 5 members of the US society—willbe 65 years of age or older.  This large segment of our population is further compounded by the elderly populationcontinuing to become increasingly diverse in terms of race, ethnicity,financial resources, and living conditions.[2]

The challenges faced by both the dental profession and the nationas a whole regarding provision of oral health care servicesto older adults were the subject of a recent report preparedby Oral Health America.[3]  All 50 states were surveyed to determine the level of Medicaidcoverage for dental services, and the report concludes thatfinancing oral health care services for the elderly will be a majorchallenge to our future.  Medicare does not provide any coverage for dentalservices, and only 1 of 5 Americans aged 75 years or older hasany type of private dental insurance.  Given our current economic circumstances it will be highly unlikely that our government resources will be adequate to gear up for the impending problem of oral health for the elderly.

The elderly suffer from chronic disorders that can directlyor indirectly affect oral health, including autoimmune disorderssuch as pemphigus and pemphigoid.[4] They generally requiremultiple medications, and common side effects of the more than500 medications used to treat their overall health issues usually reduce salivary flow.[5]   Usually the reduction in salivacan adversely affect their quality of life, the ability to chew, and lead to significant problems of the teeth andtheir supporting structures.

The elderly may also have difficulty performing routine oralhygiene procedures because of physical limitations, such as Parkinson’s or rheumatoid arthritis.  In addition,oral infection is now recognized as a risk factor for a numberof systemic diseases, including cardiovascular diseases, cerebrovascular diseases,diabetes, mellitus, and respiratory disorders.  Also,it is important to note that once people have lost their teeth and are using complete dentures, their oral healthneeds do not decrease.   Our jaws are not static and may continue toresorb over time.  Besides the continued resorbtion of bone, improperly fitted dentures can adversely affectchewing, leading to poor nutrition.  In addition, those without teeth remainsusceptible to oral cancer, mucosal diseases, and alterationsin salivary gland function.

So for the vast majority of seniors who will reside in a long term care facility, financingof oral health care services will be a formidable challenge.Given that medicare does not provide coverage for routine dental services including exams,and in the absence of private insurance or personal resources,a large portion of this group will not be able to afford anydental services whatsoever, let alone the most appropriate treatments.  Clearly, there must be a response to the increasing oral healthconcerns of the elderly who present with special needs, especiallythose who are homebound or living in long term  facilities burdenedwith other chronic disorders.

While effective preventive measures exist for younger populations(water fluoridation, dental sealants and parents), no preventive measureshave been devised to address the expected increase in oral healthneeds of the aging population.  And the need for a coordinated effort to address the oral healthcare needs of the elderly suggested by demographic trendsand epidemiological data necessitates our planning for what might be considered a crisis or at least a paradigm shift in oral health care delivery for the elderly.  Such a plan must consider contributions from the dental profession, possibly through the efforts ofthe American Dental Association (ADA) and its state and localassociations; the dental schools, with involvement of the American Dental Education Association; federal, state, and local health authorities; and assistance from national organizations andfoundations that focus on health care.  The dental profession has an opportunity to take a leadership role in the delivery of health care services to the seniorswho have contributed so vitally to our society’s well-being and who deserve to be treated with the best oral health care we have to offer.

Dr. Scheinfeld is a prosthodontist specializing in geriatric care.

Novy Scheinfeld, DDS, PC                                                                                          

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com

Related Articles

[1]Oral Health in America: A Report of the Surgeon General. Rockville, Md: National Institute of Dental and Craniofacial Research; 2000.

[2] Wikipedia and 2010 Census.                                                                                

 

[3] A State of Decay: The Oral Health of Older Americans. Chicago, Ill: Oral Health America; 2003:1–8.

[4] Stoopler ET, Sollecito TP, De Ross SS. Desquamative gingivitis: early presenting system of mucocutaneous disease. Quintessence Int.2003;34:582–586.

[5] Fox PC, Eversole LR. Diseases of the salivary glands. In: Silverman S, Eversole LR, Truelove EL, eds. Essentials of Oral Medicine. Ontario, Canada: BC Decker; 2002:260–276.

 

 

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Sandy Springs: Dental: Teeth Grinding (Bruxism)

Most people probably grind and clench their teeth from time to time. But occasional teeth grinding does not usually cause harm. It’s when teeth grinding occurs on a regular basis the teeth can be damaged and other oral health complications can arise.

Why Do People Grind Their Teeth?[1]

Although teeth grinding can be caused by stress and anxiety, it often occurs during sleep and is more likely caused by an abnormal bite, missing or crooked teeth.

How Do I Find Out if I Grind My Teeth?

Because grinding often occurs during sleep, most people are unaware that they grind their teeth. However, a dull, constant headache or sore jaw is a telltale symptom of bruxism. Many times people learn that they grind their teeth by their loved one who hears the grinding at night.

If you suspect you may be grinding your teeth, talk to your dentist.  He or she can examine your mouth and jaw for signs of bruxism, such as jaw tenderness and abnormalities in your teeth.

Why Is Teeth Grinding Harmful?

In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear their teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures, and even complete dentures may be needed.

Not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaws, result in hearing loss, cause or worsen TMD/TMJ, and even change the appearance of your face.

What Can I Do to Stop Grinding My Teeth?

Your dentist can fit you with a mouth guard to protect your teeth from grinding during sleep.

If stress is causing you to grind your teeth, ask your doctor or dentist about options to reduce your stress.  Attending stress counseling, starting an exercise program, seeing a physical therapist, or obtaining a prescription for anti-anxiety or muscle relaxants are among some of the options that may be offered.

Other tips to help you stop teeth grinding include:[2]

  • Avoid or cut back on foods and drinks that contain caffeine, such as colas, chocolate, coffee and so-called energy drinks.
  • Avoid alcohol. Grinding tends to intensify after alcohol consumption.
  • Do not chew on objects that are not food. So avoid, finger nails, pencils and pens. Also avoid chewing gum as it allows your jaw muscles to get used to clenching and may tend to make you more likely to grind your teeth.
  • Train yourself not to clench or grind your teeth. If you notice that you clench or grind during the day, position the tip of your tongue between your teeth. This practice trains your jaw muscles to relax.
  • Relax your jaw muscles at night by holding a warm washcloth against your cheek in front of your earlobe.

 

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

http://www.rightsmilecenter.com

[1] Webmd was utilized as a source.

[2] Ibid.

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Dentist Serving Dunwoody: Dental Advice for Moms-To-Be

Expecting a baby is a very exciting time, and you’re already on the right path if you’re staying on top of your dental health. With the proper dental care measures, you’ll increase your chances of having a smoother pregnancy, full-term delivery and healthy baby.

If you’re planning to get pregnant, consider having your teeth cleaned and any restorative dental treatment done first. If you are already pregnant, be sure to tell your dentist before getting any work done. You should also have a dental checkup at least once during the pregnancy. Although dental cleanings aren’t harmful, it’s recommended that expecting mothers get them done during the second trimester to reduce the risk of complications.

According to the American Dental Association (ADA), it’s best to postpone dental work during the first and third trimesters as well, as these are critical periods for the baby’s development. Your dentist will let you know what dental treatments can be performed during the second trimester, but more complicated procedures will probably be postponed, if possible. Unnecessary treatments, such as cosmetic dental work, should be avoided altogether.

If you do have an unexpected dental problem or emergency, make an appointment with your dentist as soon as you can. Your dentist will look for signs of infection and determine the need for treatment. Dental X-rays are usually avoided during pregnancy, but if photos are necessary, your dentist will take extra precautions to protect your baby.

Just as dental health is connected to your overall health, dental care is important to the health of your unborn baby. It’s extremely important to take care of your teeth during pregnancy, as some dental problems can increase the risk of complications.

The best advice is to make sure your dentist is part of your baby’s pre-natal care team from the beginning.  If we can answer any questions or concerns please feel free to contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A                                                                                       

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com

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Dentist Sandy Springs: Women and Oral Health Issues

As a woman, why do I have to worry about oral health?

Everyone needs to take care of their oral health. But female hormones can lead to an increase in some problems, such as:

•Cold sores and canker sores

•Dry mouth

•Changes in taste

•Higher risk of gum disease

Cold sores are small, painful sores are caused by herpes simplex virus type 1.  Once you are exposed to the virus, it can hide in your body for years. Things that trigger the virus and lead to cold sores include:

•Getting too much sun

•Having a cold or infection

•Having your period

•Feeling stressed

 

Cold sores can spread from person to person. They most often form on the lips and sometimes under the nose or chin. The sores heal in about 7 to 10 days without scarring. You can buy over-the-counter drugs to put on cold sores to help relieve pain. If you get cold sores a lot, talk with your doctor or dentist about a prescription for an antiviral drug. These drugs can help reduce healing time and the number of new sores.

Canker sores are small ulcers inside the mouth. They have a white or gray base and a red border. Women are more likely than men to have canker sores that recur. The cause of canker sores is unknown. Risk factors include:

 •Fatigue

•Stress

•Having your period

•A cut on the inside of your cheek or on your tongue

•Allergies

•Celiac disease

•Crohn’s disease

 

Canker sores most often heal on their own in one to three weeks. See your dentist if you get a large sore (larger than a half inch, or about the size of a dime). You may need medicine prescribed to treat it.

To help with pain:

•Avoid hot, spicy foods

•Use mild mouthwashes or salt water

•Try over-the-counter pain medicines

No proven way exists to prevent canker sores.  If you get them often, talk with your dentist.

Another issue women experience is burning mouth. It is most common in postmenopausal women.  Women with this condition describe a burning feeling in the mouth or tongue.  Unfortunately, the cause is unknown, but given that it occurs in the mouth, it might be linked to:

 •Hormones

•Dry mouth (which can be caused by many medicines and disorders such as Sjögren’s syndrome or diabetes)

•Taste problems

•Nutritional deficiencies

•Use of ACE inhibitors (blood pressure medicines)

•Anxiety and depression

•Dentures that do not fit

•Infections (especially fungal infections)

Talk to your doctor or dentist if you have burning mouth.  Treatment depends on the cause — if it can be determined — and might include adjusting your dentures, vitamin supplements, or pain or other medicines or referring back to physician for a global diagnosis.

Taking good care of your teeth and gums can help you avoid or lessen these oral health problems.  If we can be of service, please do not hesitate to contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

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