Posts for: December, 2017
Although periodontal (gum) disease is the most common cause of bone loss in the mouth, women at or past menopause face another condition that could cause complications with their oral bone health — osteoporosis.
While normal bone goes through a balanced cycle of resorption (the dissolving of bone tissue) and re-growth, osteoporosis, a hormone-induced disease, tips the scale toward resorption. This reduces bone density, which weakens the bone and makes them more susceptible to fracture.
Some studies have shown a link between osteoporosis and existing gum disease; however, the greater concern at present from an oral health standpoint regards the side effects of a certain class of drugs called bisphosphonates used in the treatment of osteoporosis. Bisphosphonates slow excessive bone resorption, which helps restore normal balance to the bone growth cycle.
Some long-term users of bisphosphonates, however, may develop a complication in their jaw bone known as osteonecrosis in which isolated areas of the bone lose vitality and die. This can complicate certain types of oral surgery, particularly to install dental implants (which rely on stable bone for a successful outcome). While research is still ongoing, it does appear individuals at the highest risk of osteonecrosis are those with underlying cancers who receive high-dose intravenous bisphosphonate treatment every month for an extended period of time.
It’s important then that you let us know before any dental procedure if you’ve been diagnosed with osteoporosis and what treatment you’re receiving for it. If you’ve been taking a bisphosphonate for an extended period of time, we may recommend that you stop that treatment for three months (if possible) before undergoing oral surgery. While your risk of complications from osteonecrosis is relatively small, adding this extra precaution will further reduce that risk and help ensure a successful outcome for your scheduled dental procedure.
If you would like more information on osteoporosis and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Osteoporosis & Dental Implants” and “Good Oral Health Leads to Better Health Overall.”
Dental implants are considered today’s premier method for restoring missing teeth. Obtaining an implant, though, is often a long process and the implants themselves must be surgically placed within the jaw bone. Nothing to worry about, though: implant surgery is a minor to moderate procedure akin to a surgical tooth extraction.
Still like any surgery, this procedure does involve cutting into the soft tissues of the gums and could allow oral bacteria to enter the bloodstream. While most bacteria in the mouth are harmless (and even beneficial) a few strains can cause disease. For some people, especially those with certain heart conditions or joint replacements, this could potentially cause serious issues in other parts of their body that might be highly susceptible to infection.
To guard against this, it’s been a long-standing practice in dentistry to prescribe antibiotics to certain high risk patients before a procedure. Although this departs from the normal use of antibiotics for already occurring infections, due to the circumstances this has been deemed an acceptable measure to prevent disease.
In the past, the categories of patients for which preventive antibiotics were appropriate had been more extensive. In recent years, though, both the American Dental Association and the American Heart Association have adjusted their recommendations. Today, your dental provider may recommend antibiotic pre-treatment if you have a prosthetic (artificial) heart valve, a history of infective endocarditis (inflammation of the inner linings of the heart), a heart transplant or certain congenital heart conditions.
While physicians may still recommend premedication with antibiotics for patients with joint replacements, it’s not as blanket a standard as it might once have been. It’s now only recommended for certain cases, such as patients who’ve received a prosthetic joint within the last two years.
There’s still an ongoing debate about the effectiveness of antibiotic pre-medication. However, there’s evidence medicating before procedures with antibiotics can be beneficial in avoiding infection. If you fall into one of the categories just mentioned or are concerned about infection, feel free to discuss with your dentist if using antibiotics before your implant surgery is wise move for you.
If you would like more information on antibiotic treatment before oral surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implants & Antibiotics: Lowering Risk of Implant Failure.”
Sometimes a tooth extraction is the best option. Find out when it’s necessary.
Teeth are pretty resilient, so it can be rather stressful and surprising as an adult to find out that a permanent tooth actually needs to be removed. Of course, there are cases in which a tooth extraction is truly the ideal way to maintain a healthy smile in the long run. From the office of our Albuquerque, NM, periodontist, Dr. Petra Mayer, find out when we might recommend a tooth extraction.
Impacted Wisdom Teeth
This is one of the most common reasons our Albuquerque periodontic specialist will recommend getting a tooth extraction. In most cases, this third and final set of molars won’t grow in properly, may cause overcrowding or may not fully erupt through the gums (also known as impacted wisdom teeth). If x-rays determine that the wisdom teeth could end up leading to cavities, gum disease or damage to neighboring teeth, then they will need to come out.
Severely Damaged Tooth
Our goal is to preserve a tooth as often as possible; however, there are moments when decay, an infection or even a crack is so severe and has damaged an extensive portion of a tooth that it is no longer viable. If the tooth’s structure can no longer stand on its own or be supported by a dental crown then it will need to be extracted and replaced. We would be happy to talk to you about your tooth replacement options to replace the extracted tooth.
Prior to Orthodontic Treatment
If you are dealing with severe crowding and are getting braces to fix the issue, then a dentist may actually recommend having one or two teeth removed prior to getting orthodontic treatment in order to provide enough room for teeth to more easily shift into the proper position.
There are other scenarios in which removing teeth may be necessary. If you are undergoing radiation or taking certain cancer medication you may end up dealing with an infected tooth that will need to be removed to prevent the infection from spreading. Children whose baby teeth don’t fall out naturally and prevent permanent teeth from coming will also need to be removed.
Do you have questions about an upcoming tooth extraction? Are you wondering whether you need your wisdom teeth removed? If so, then it’s time you called our periodontal specialist in Albuquerque, NM for a consultation.