the right smile

Educating Patients on their Oral Health Options


Dentistry Sandy Springs – New directions in oral health care

American Dental Association

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The hygienist plays an intricate role in the oral health care of the patient.  The role includes periodontal disease evaluation, taking x-rays and a patient’s periodontal probing and charting.  In the old days, they engaged in cleaning and flossing the teeth under the theory that at healthy mouth was primarily necessary for the patient to keep their teeth.  But discoveries in the last decade have uncovered the correlation between periodontal disease and other health related issues such as diabetes, Alzheimer’s, cardiovascular disease, pregnancy related problems that assigns new priorities to the role of the hygienist and your dental visits.  These correlations have caused a new focus on evaluating a dental patient and new signals related to their overall health.   “The American Academy of Periodontology seeks to educate the public about research findings which support what dental professionals have long suspected: Infections in the mouth can play havoc elsewhere in the body. For a long time it was thought that bacteria was the factor that linked periodontal disease to other infections in the body; however, more recent research demonstrates that inflammation may link periodontal disease to other chronic conditions. Research has shown, and experts agree, that there is an association between periodontal diseases and other chronic inflammatory conditions, such as diabetes, cardiovascular disease and Alzheimer’s disease. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.” (www.perio.org).

The U.S. Surgeon General agrees that oral health is a strong indicator of one’s overall health and well-being (CDC, 2006).  Often, diseases give their first warning signs in the form of a patient’s oral problems.  Without consistent care and monitoring, several oral health problems can result.  Immediate risks include gingivitis, cavities, tooth decay, and other gum diseases which can eventually result in various types oral cancer.  There is a “silent epidemic” (U.S. Surgeon General) that can be avoided by regular treatment at home and dental visits at least twice each year.  While practicing good oral hygiene at home is vital to your health, there is only so much that personal oral maintenance can do.  A normal person can easily overlook conditions that could greatly complicate or even end one’s life.  Thus, visiting your dentist for regular checkups is vital to a healthier smile.

“Routine dental exams uncover problems that can be easily treated in the early stages, when damage is minimal” (American Dental Association [ADA], 2008).  Now that it is known that gum disease can be a major risk factor for heart disease, stroke, and certain forms of cancer, regular visits to your dentist can help prevent and treat this disease.  By treating conditions early and learning from your dentist how to prevent oral diseases, you can achieve better health and ultimately better quality years of life.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com

Serving residents in East Cobb, Roswell, Alpharetta, Johns Creek, Dunwoody, Buckhead and surrounding communities.


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Dentistry Sandy Springs – Considering Dental Implants?

Important Facts to Help Make Your Decision

Many people are unaware of the consequences of losing their teeth or the effects of wearing partial or full dentures upon their jaws and bones. When teeth are lost, the surrounding bone immediately begins to shrink [atrophy]. Implant treatment, for tooth replacement therapy, can be the optimal treatment plan. Here are some important facts to take into consideration.

 Wearing dentures [plates] accelerates bone loss, and old dentures become loose because of this bone loss. It is possible to watch and wait for bone to disappear to the point where treatment success of any kind is in doubt.

 At the end of a five-year period, only 40% are still wearing the original partial denture made for them. This is not a great testimonial for value and utility. Those lucky enough to have a functioning partial denture after 5 years are still losing valuable supporting bone.

 Of those patients who wear a partial denture, 50% chew better without it.

 One study showed that after 8 years, 40% of the supporting teeth [abutments] that the partial hooks onto were lost through tooth decay or fracture.

 Patients with natural teeth can bite with about 200 pounds of force. Denture wearers can bite with approximately 50 pounds of force. Those wearing dentures for 15 years or more can bite with only about 6 pounds of force, and their diet and eating habits have had to been modified accordingly.

 The average lower full denture shifts from side to side during chewing and is a significant problem that new denture wearers must get use to and accept.

 Denture wearers have decreased nutritional intake, a ten year shorter life span, and 30% of denture wearers can only eat soft foods.

 The single tooth implant success rate is above 98%, and unlike a bridge, the teeth adjacent to the implant are no more at risk than if no teeth were missing.

 Implant-supported bridges or dentures have 95% success rates over 10 years without the severe loss of supporting bone.

                                                                                                          

For bone maintenance, the health of adjacent teeth, the longevity of the restoration and patient comfort, implant therapy is the treatment of choice. Implants can restore chewing function to the equivalent of someone with natural teeth. If you have questions or want to know if you are a good candidate for implant tooth replacement therapy, please call our office.

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 – Older patients have special dental needs

A dental hygienist demonstrates scaling.

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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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Oral Health Care of Our Aging Population

Cover of "Oral Health in America: A Repor...

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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 contributionsfrom the dental profession, possibly through the efforts ofthe American Dental Association (ADA) and its state and localassociations; the dental schools, with involvement of the AmericanDental Education Association; federal, state, and local healthauthorities; and assistance from national organizations andfoundations that focus on health care.  The dental profession has an opportunity to take a leadershiprole in the delivery of health care services to the seniorswho have contributed so vitally to our society’s well-beingand who deserve to be treated with the best oral health carewe 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


[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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Dentist Sandy Springs – Symptoms and Signs of Oral Cancer

Biopsy of a highly differentiated squamous cel...

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April is Oral Cancer Awareness Month, so learn more about it.  If you or a loved one have any of the following symptoms please take the time to see your dentist. These common signs and symptoms could indicate you have oral cancer, particularly if you have seen these symptoms persist for two weeks or longer:

1.  a sore in the mouth that bleeds easily or doesn’t heal

2.  a color change in any of the oral tissues, including gums, lips or tongue

3.  a lump, thickening or a small eroded area

4.  any pain, tenderness or numbness in the mouth, throat or lips

5.  possible trouble chewing, swallowing or moving your jaw or tongue

In the U.S. in 2010, 37,000 people were diagnosed with oral cancer. .But remember, oral cancer doesn’t always present symptoms in the early stages.  That’s why it’s important to get screened annually.  When detected and treated early, oral cancer patients have a nearly 90% survival rate.

I have written about this twice this month, but I want to make sure I get the point across.   They say 3 times the charm.  Please make an appointment to see your dentist if you have any of the symptoms described above. It really could save your life.  We offer free screening to anyone during the month of April.  We think every little bit counts and would like to give back to the community where we can.  So if we can be of assistance please feel free to contact us and make an appointment.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com


4 Comments

April – Oral Cancer Awareness Month.

You can be assured that as a prosthodontist, I understand the functional mechanics as well as the cosmetic artistry needed to evaluate and create the right smile for you. Your goals for achieving the smile you want and the dental health you need are my first priority. But April is Oral Cancer Awareness Month and I urge you to move beyond your smile and exam your overall health. Please make sure you see your dentist or physician and check for any signs of oral cancer. It’s a matter of life and death. We offer free screenings whether you are a patient or just in the neighborhood. Have a great month.


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Dental Sandy Springs- Oral Cancer Awareness

Most common cancers in the United States 2008....

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According to The Oral Cancer Foundation, there are two distinct causes of oral cancer. One, which I have mentioned in an earlier article is through the use of tobacco (and alcohol), a long time historic environmental cause, and the other is through the exposure to the HPV-16 virus (human papilloma virus version 16), which is a newly identified etiology, and apparently the same one which is responsible for the vast majority of cervical cancers in women.  And a small number (under 5 %) of people acquire oral cancers from no currently identifiable cause, presumably caused by some genetic predisposition similar to other cancer causing agents.

While most think this is a rare form of cancer, mouth cancer (popularly thought to be the result of chewing tobacco) is diagnosed in about 100 individuals each day here in the US alone, and one person dies from oral cancer every hour of every day.  If you add the sub category of laryngeal throat cancers like Michael Douglas was recently treated for (and most likely a result of his smoking and consumption of alcohol), the rates of occurrence accounting for about 10,000 additional new cases per year, then the death rate is significantly higher.   But these statistics can be drastically reduced when found at the early stages of development.  With early diagnosis, oral cancer patients have an 80 to 90 % survival rate.

Unfortunately at this time, the majority of cases are found as late stage cancers, and this accounts for the very high death rate of about 45% at five years from diagnosis.  The reason for these late stage diagnoses is not because these cancers are hard to discover, rather it is because of a lack of public awareness.  The American Dental Association states that only 60% of the US population sees a dentist every year, which leaves 40% to happenstance.    If heightened public awareness were coupled with a national program for screenings, diagnosis of oral cancers would yield early discovery by both medical and dental professionals.

Ironically, it is potentially easier to obtain public compliance to oral cancer screenings, because unlike many other cancer screening procedures, there is no invasive technique required to look for it, no discomfort or pain involved, and it is very inexpensive to have your mouth examined for the early signs of disease.  Realistically, it only costs about $35.00, usually 10 times less than a blood test at your annual physical.

It is important that patients realize that a visit to the dentist is no longer about a filling, a crown, or a postponable cleaning, but actually an exam that is a matter of life and death.  It’s important for patients and dentists to start a dialog today.  Even if talking about cancer is difficult, there are mechanisms around this.  Creating awareness, discovery and diagnosis is the purpose of April being Oral Cancer Awareness Month.  So when it comes to oral cancer and saving lives, these are primary responsibilities of the dental community.  The most important step in reducing the death rate from oral cancer is early discovery.  And no group has a better opportunity to have an impact than members of the dental community.   If our practice can be of help we are offering free cancer screening during the month of April.

Some Research and statistics provided by: The Oral Cancer Foundation.  Kuper H, Adami HO, Boffetta P (June 2002). “Tobacco use, cancer causation and public health impact”. Journal of internal medicine 251 (6): 455–66. Seitz HK, Pöschl G, Simanowski UA (1998). “Alcohol and cancer”. Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism. “Screening for Oral Cancer”. U.S. Preventive Services Task Force. 2004. http://www.uspreventiveservicestaskforce.org/uspstf/uspsoral.htm.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A                                                             

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com