Do you check in with your internist at six-month intervals to tell him how you’re doing? Does your GP regularly monitor your general health and habits? I doubt it.
It seems that since the passage of Obamacare, the general internist is becoming an increasingly emergency based service; attending only in your darkest, sinus-ridden hours and to be forgotten once you hobble out the door with their overprescribed prescription.
We probably know you better than your physician. You’ve probably been seeing us since you were a teen. Some of us have seen you grow up. We know your occupation. We know your dietary habits and how much you drink every week. We know about your family history of cardiovascular disease. We noticed that time you started to feel short of breath when we laid you back in the chair, even if you didn’t think much of it.
Our six-month chats can be key to identifying issues requiring further medical investigation, facilitating referral to relevant specialists and the consequent early diagnosis of disease. We are paying a lot more attention than you realize – because we care.
Older Americans are becoming a larger segment of our population and suffer disproportionately from oral diseases, with the problem being particularly acute for individuals in long term care facilities.
Not only do we see elderly patients in our Sandy Springs who are usually brought here by assisted living and nursing home facilities, but Dr. Orland visits numerous assisted living facilities outside of our immediate area. By 2030, 1 of every 5 members in the US will be 65 years of age or older. This large segment of our population is further compounded by the elderly population continuing to become increasingly diverse in terms of race, ethnicity, financial resources, and living conditions.
The challenges faced by both the dental profession and the nation as a whole regarding provision of oral health care services to older adults needs a specialized and experienced team of dentists to address the issues.Medicare does not provide any coverage for dental services, and only 1 of 5 Americans aged 75 years or older has any type of private dental insurance and 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 directly or indirectly affect oral health, including autoimmune disorders such as pemphigus and pemphigoid. They generally require multiple medications, and common side effects of the more than 500 medications used to treat their overall health issues usually reduce salivary flow. And the reduction in saliva can adversely affect their quality of life, the ability to chew, and lead to significant problems of the teeth and their supporting structures.
In addition, particularly for geriatric patients, oral infection is now recognized as a risk factor for a number of 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 health needs 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.
While effective preventive measures exist for younger populations (water fluoridation, dental sealants and parents), no preventive measures have been devised to address the expected increase in oral health needs of the aging population. We have developed the expertise to take a leadership role in the delivery of health care services to the seniors who 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.
Do you have tension headaches or pain in your jaw from grinding during the day or when you sleep? Do you suffer from migraines?
No matter what the theory is that causes these issues, studies show that clenching and grinding your teeth leads to the destruction of otherwise healthy dentition, exacerbates periodontal diseases and often causes TMD, headaches and facial pain.
We often use bite appliances as the treatment of choice, however, on occasion the grinding will not stop or the headaches just will not go away.
We now use BOTOX routinely as one of our treatment choices to help our patients.
In our never-ending efforts to widen our services, keep up with technological changes, and perform procedures as well as, if not better than, any other health care provider, we offer therapeutic uses of Botox to treat these issues.
We can treat migraines, bruxism and TMJ patients with painless bilateral injections of Botox into muscles. Using the correct amount of Botox will reduce the intensity of contraction of these muscles and the relief and re-programming of these muscles can help eliminate facial pain, reduce TMJ symptoms, eliminate headaches, and generally reduce the effects of bruxism. Over about 9 months of treatment the patient will begin to ween off of Botox and at the same time abate from clenching, particularly during sleep.
If these are issues you are experiencing contact or call us to see Dr. Orland and Dr. Scheinfeld for a complimentary consult.
According to research presented at the American Academy of Periodontology conference in 2004,
gum disease is linked to women who
use infertility treatments. The study said women undergoing infertility treatment for more than three menstrual cycles experience increased inflammation and bleeding of the gums. These women also have increased levels of gingival crevicular fluid, which contains tissue breakdown products that may be markers for the progression of gum disease.
The lead author Dr. Cenk M. Haytac, from Cukurova University in Adana, Turkey, postulates that these effects occur because these agents increase body levels of estrogen and the gums apparently are a target for estrogen since they contain estrogen receptors. Though not definitive, several studies have shown evidence that gum infections are associated with unsuccessful embryo development or the failure of in-vitro fertilization. Poor oral health is as bad for
fertility as obesity – delaying conception by about two months says latest research.
Experts at the annual meeting of the European Society of Human Reproduction and Embryology in Sweden were presented with evidence how women with gum disease took over seven months to conceive, compared to the usual five months. The researchers believe the underlying cause is inflammation. Unchecked, this can set off a chain of reactions capable of damaging the body’s normal workings.
Periodontal disease has already been linked with heart disease, type 2 diabetes and miscarriage, plus poor sperm quality in men. An Australian study involving over 3,700 women indicated that those with gum disease had raised blood levels of markers for inflammation. Although speculative, as a precaution researchers suggest that the treatment of gum disorders might influence the outcome of infertility treatment. According to Dr. Michael P. Rethman, president of the AAP, “[i]t is reasonable to assume that if low levels of plaque are established and maintained during the infertility treatment, gingival inflammation would not affect the success of infertility treatment,” “[which] would require meticulous oral hygiene and routine professional cleanings, perhaps at the beginning of each menstrual cycle to ensure the presence of healthy gums.”
Professor Roger Hart advises women trying to get pregnant to get a check-up by their dentist along with other measures like stopping smoking and drinking, maintaining a healthy weight and taking folic acid supplements. UK fertility expert Dr. Allan Pacey said, “It’s common sense advice really to make sure you are in a healthy condition [including good oral health] if you want to try for a baby.” Around 10% of the population is believed to have severe periodontal disease.
So if you are trying to get pregnant and are unsure of your oral health please see your dentist.
There are times when dentists recommend a patient take antibiotics before certain dental procedures.
Essentially, you have bacteria in our mouths that certain procedures might allow or facilitate the entry of bacterium into the bloodstream. For most of us, this isn’t an issue. A healthy immune system prevents these bacteria from causing any harm. Yet, for some people bacteremia can cause an infection elsewhere in the body.
Antibiotics are recommended to be taken in advance of treatment for a small number of people who have specific heart conditions.
According to the American Heart Association guidelines, antibiotic prophylaxis should be considered for people with:
Artificial heart valves.
A history of an infection of the lining of the heart or heart valves known as infective endocarditis.
A heart transplant in which a problem develops with one of the valves inside the heart.
Heart conditions that are present from birth, such as:
Unrepaired cyanotic congenital heart disease, including people with palliative shunts and conduit.
Defects repaired with a prosthetic material or device—whether placed by surgery or catheter intervention—during the first six months after repair.
Cases in which a heart defect has been repaired, but a residual defect remains at the site or adjacent to the site of the prosthetic patch or prosthetic device used for the repair.
Antibiotic guidelines have also been developed for people who have orthopedic implants. In 2012, the ADA and American Association of Orthopedic Surgeons updated the recommendations and no longer recommend antibiotics for everyone with artificial joints. As such, your provider may rely more on your personal medical history to determine whether or not antibiotics are appropriate for people with orthopedic implants.
In addition, antibiotic premedication might be appropriate for patients who have compromised immune systems due to diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use, all of which increase the risk of infection. If you have a heart condition, a compromised immune system or an orthopedic implant, talk with your dentist or physician about whether antibiotic pre-treatment is right for you. If we can be of assistance, feel free to contact us.