Friday, March 30, 2012

Dental Woodstock - April is Oral Cancer Awareness Month


Each year more than 30,000 Americans are diagnosed with oral cancer and approximately 8,000 will die of the disease.  According to the National Cancer Institute (NCI)  oral cancer, which is more common than leukemia, Hodgkin’s disease, and cancers of the brain, liver, bone, thyroid gland, stomach, ovaries, and cervix, is a major cause of death and disfigurement in the United States.

                           

According to the Centers for Disease Control and Prevention (CDC) located here in Atlanta, GA., approximately 75% of all oral cavity and pharyngeal cancers—mouth, tongue, lips, throat,  nose, and larynx— can be attributed to the use of  tobacco related products.  Those who choose to use cigarettes, cigars, pipes, chewing tobacco, or snuff, place themselves at a much higher risk of developing oral cancer and other diseases, such as heart disease, emphysema and chronic bronchitis.



With the level of prevalence described above, the oral cancer screening routinely  performed during one's hygiene and dental examination is one of the most critical preventative  components of  your bi-annual visits to the dentist .

                                                 

If you find anything out of the ordinary during a self-examination—particularly anything that does not heal or go away in two weeks, or that has recently changed— make sure you discuss it with your dentist or physician.   April is Oral Cancer Awareness Month and we offer free cancer screening, so please feel free to contact us if you have any questions or concerns.



Source: National Institute of Dental and Craniofacial Research’s (NIDCR) National Oral Health Information Clearinghouse in partnership with the National Cancer Institute, the National Institute of Nursing Research, the Centers for Disease Control and Prevention, and the Friends of the NIDCR.



Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road

Suite 200

Acworth, GA 30102

770-928-7281





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Dentist Acworth: Women and Your Oral Health


As a woman, you know that your health needs are unique and this includes your oral health needs. And because your needs are unique, you need to take extra care of yourself.  While women tend to take better care of their oral health than men do, women's oral health is not significantly better than men's.  This is because hormonal fluctuations throughout a woman's life can affect many tissues, including gum tissue.  These fluctuations occur when you mature and change, as you do during puberty or menopause, or other times when you have special health needs, such as menstruation and particularly during pregnancy.

According to the Journal of Periodontology[1] at least 23 percent of women between the ages 30 to 54 have periodontitis.[2]  And, 44 percent of women ages 55 to 90 who still have their teeth have periodontitis.  Yet many women do not realize they have it until it reaches an advanced state, which is why regular hygiene check-ups are so important.

Stages of your life - steps to protect your oral health.

Puberty - an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum's sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. Signs to look for in your teenage daughter are swollen, red and/or tender gums.[3]

It is particularly important during this time in your daughter’s life to make sure she follows a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.[4]

Menstruation – can result in menstruation gingivitis.  Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman's period and clears up once her period has started.  Sometimes it occurs concurrent with stressful situations and menstruation.

Pregnancy - increase gingivitis or pregnancy gingivitis beginning in the second or third month of pregnancy that increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.[5] As a result of varying hormone levels, between 50%-70% of women will develop gingivitis sometime during their pregnancy - a condition called pregnancy gingivitis.[6] In some cases, gums swollen by pregnancy gingivitis can react strongly to irritants and form large lumps. These growths, called pregnancy tumors, are not cancerous and generally painless.

Studies have shown a possible relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be more likely to have a baby that is born too early and too small!

To prevent pregnancy gingivitis it's especially important to practice good oral hygiene habits, which include brushing at least twice a day, flossing once a day, and using an antimicrobial mouth rinse. If you are due for a professional cleaning, don't skip it simply because you are pregnant.  Now more than ever, professional dental cleanings are particularly important.

Oral contraceptives – while women are taking drugs to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.  So be sure and consult your dentist about all the medications you are taking.

Menopause and Post-Menopause – not surprising given all the changes happening within your body, but you may experience changes in your mouth as well.  You may notice discomfort such as dry mouth, pain and burning sensations in the gum tissue and altered taste, particularly to salt and pepper.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny or bleed easily and range from abnormally pale to deep red may indicate this condition. Most women find that estrogen supplements help to relieve these symptoms.[7]

Bone loss is potentially associated with both periodontal disease and osteoporosis. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth and your jawbone as well as other parts of the body.

What Should You Do?

See a dental professional for cleaning at least twice a year – you need to monitor your oral health.

If referred, see a periodontist in your area. Problems may include: Bleeding gums during brushing, red, swollen or tender gums.   Other issues such as persistent bad breath or pus between the teeth and gums.  If you’re a denture wearer a change in the fit of your dentures may occur.

Keep your dentist informed about any medications you are taking and any changes in your health history.

Brush and floss properly every day.  Review your techniques with a dental professional.

If there any questions that you might have, please contact or call us at our Sandy Springs or Acworth office to discuss them.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road, Suite 200

Acworth, Georgia 30102

770-928-7281


info@rightsmilecenter.com

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[1] January 1999 issue of the Journal of Periodontology
[2] Periodontitis is an advanced state of periodontal disease in which there is active destruction of the periodontal supporting tissues.
[4] Ibid.
[5] Ibid.
[6] WebMd. Pregnancy Gingivitis and Pregnancy Tumors.
[7] Women and Gums: American Academy of Periodontology Journal. http://www.perio.org/consumer/women.htm.

Thursday, March 29, 2012

Dentist Acworth: Mouthwash and Oral Cancer


There appears to be controversy with respect to whether or not mouthwash containing alcohol may be related to oral cancer.  This controversy arises out the studies that show a link between oral cancer and those that drink alcohol.  Michael Douglas is the most recent case in point.  He has been reported to be a heavy smoker and imbibe alcohol on what is rumored to be on frequent occasions.  The obvious link in theory is that most mouthwash formulas contain alcohol, so the conclusion is that a link to mouthwash must exist here also.  The problem is there are no conclusive studies and at this time there appears to be insufficient evidence to alter the ADA’s approval of mouthwash containing alcohol as an effective method for the prevention and reduction of gingivitis and plaque above the gumline when used as directed.  The ADA Council on Scientific Affairs awarded the ADA Seal of Acceptance to these products after a thorough review of data on their safety and effectiveness.

Of all the studies published on this topic, beginning in 1979, four studies reported some positive results while five found no association. (citations omitted)  What we know is that none of the criteria for causality have been fulfilled by the studies that have been published so far.  The International Agency for Research on Cancer, an extension of the World Health Organization, now identifies the consumption of ethanol in alcoholic beverages as a carcinogenic risk.[1] Alcohol abuse is associated with cancers of the mouth, pharynx, larynx and esophagus. Ibid.  However, the reason for this association is not fully understood – it may be due to a direct effect of alcohol on these tissue.[2]  Because of the conflicting studies and endorsements I could advise you to keep using alcohol formulated mouth rinses.  But if you are concerned and wish to stay on the safe side of the debate, there are non-alcohol based mouth rinses available that appear to be effective in the prevention of gingivitis and plaque.

Our job is to try and educate you on the contemporary issues we face in addressing your oral health and if there are any questions you would like to pose, please feel free to contact us for a free consultation.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta, GA 30328

404-256-3620





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[1] International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 96. Alcoholic beverage consumption and ethyl carbamate (urethane). Lyon, France: 6-13 February 2007.
[2] Lachenmeier DW. Safety evaluation of topical applications of ethanol on the skin and inside the oral cavity. J Occup Med Toxicol 2008;3:26.

Dentist Acworth: How Much Does a Root Canal Cost?


The cost of having a root canal done depends upon where you live, the type of dentist and whether or not you have dental insurance.  The procedure is usually done by a specialist known as an endodontist, but can be performed by a general dentist.  The procedure can range anywhere from $900 to 1500.00 depending on the tooth location and the number of root canals involved.  The diagnosis will require an initial x-ray, which can be performed by your general dentist and forwarded to the endodontist’s office.  Sometimes there are issues that arise where the endodontist wants to charge for an initial consultation.  This may or may not be necessary depending on the relationship the endodontist has with your referring general practitioner.  If you have insurance it will usually cover about half to eighty percent of the cost.  One of the added costs to a root canal that should be taken into account is either an amalgam (or composite) or crown restoration of the tooth by your general dentist upon completion of the procedure.

The root canal involves opening the tooth and removing the pulp of the tooth, which contains the tooth nerve that’s causing you so much pain.  What necessitates the procedure is the root of the tooth being infected and no known treatment to preserve the nerve from further deterioration.  The two most common causes of infection of the pulp are deep cavities and fractures or broken teeth. As treatment, the pulp tissue is removed, the root is cleaned with files and filled with an inorganic material that keeps bacteria out of the root and tooth.   Generally, a root/nerve involved tooth only gets worse over time without treatment.  And the longer you wait, sometimes results in the loss of the entire tooth.

Prices don’t always reflect the quality of your treatment.  Having a sense of trust in your general dentist will usually result in the referral to an endodontist that’s also worth trusting.  If we can be of service or you have further questions please don’t hesitate to contact us by phone or by email.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road

Suite 200

Acworth, GA 30102

770-928-7281





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Wednesday, March 28, 2012

Dentist Acworth: The Mercury Filling Controversy


Whenever I hear a patient ask about amalgam restorations (usually referred to as mercury fillings), I wonder why this question refuses to go away.  For decades, amalgams have been considered the primary restorative material for posterior teeth (the ones in the back) because of their long time success.  After enormous amounts of study the World Health Organization, the FDI World Dental Federation, and the American Dental Association continue to endorse the use of amalgam to restore teeth.   Yet it continues to be demonized by the public, in particular in urban legends over the internet.

As a result the trend is towards the less and less use of amalgams and the greater use of composite resins to restore posterior teeth.  One of our consultants, Tom Limoli of Limoli and Associates notes that US third-party payment data reflects that 65% of direct posterior restorations last year were resin-based composite, while 35% were amalgam.  So regardless of the empirical evidence to the contrary, the patient pool is demanding composite restorations.

Every dentist will need an alternative material to use in the restoration of posterior teeth as this trend continues.  The challenge for the dentist is that composite resins only have a life expectancy of 5 to 8 years.  Given the patient’s desire to be rid of the potential or theoretical health hazards that have been formulated in recent years, amalgam restorations will ultimately be eliminated by the slow and natural death of attrition.  While amalgam has been the material of choice for decades and still remains the primary source of teaching in dental schools today, it may not be in the future.  Given the patient demand for composite restorations and what appears to be the dentist’s propensity to capitulate, we are going to need a better solution to posterior restorations if we want to achieve the same longevity that is achieved through amalgam restorations.

The internet has continued to create an uncertainty on the part of the lay public about amalgams similar to the controversy that surrounds cell phones and brain tumors.  It is interesting to note the dilemma faced by dentists today, when we know that amalgam is the better choice for the restoration, but the popular demand or path of least resistance is a composite restoration.  This disconnect creates some interesting food for thought.[1]

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road, Suite 200 

Acworth, GA 30102

770-928-7281


info@rightsmilecenter.com

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[1] Additional sources of information came from Gordon J. Christensen, DDS, James F. Simon, DDS, and Howard E. Strassler, DMD. Compendium of Continuing Education in Dentistry, July/August, 2011.

Friday, March 23, 2012

Dentist Acworth: Wisdom Teeth Removal


An oral surgeon or a general dentist (even a prosthodontist) can extract a wisdom tooth, also known as third molars.  Ninety-nine percent of the time we refer out to one of our participating oral surgeons.  The procedure can be done in the dentist’s office and most of the time that is the case.  However, it is possible that you could have the surgery in the hospital, if you are having all your wisdom teeth pulled.  If the latter is the case, you may be at a higher risk for complications.  So in the oral surgeon’s judgment, the use of a hospital is for precautionary measures.  Patients with infections, their surgery will be delayed in order to avoid other health related complications.  There is empirical evidence of the link between periodontal disease and heart related issues.  Dental surgery may cause the periodontal bacteria in the mouth to enter the bloodstream and cause infections in other parts of your body.  Usually this can be cleared up by the prescription of antibiotics before and after surgery.

Wisdom teeth are usually the last teeth to erupt in your mouth and can cause crowding or food pockets which lead to undesired gum infections.  About 35% of the population never develops wisdom teeth at all.[1]  For those that do, it is often recommended that people from the ages 17 to 25[2] will need to have this extraction, but we judge each patient on a case by case basis.  If your wisdom teeth are not causing any noticeable problems, then it may be difficult to determine whether to have them removed to prevent future problems.[3]  It is quite possible that you may never have any problems.  But is also possible that they fail to erupt and cause problems like cysts, crowding or decay or hygiene issues.[4]

As a part of the procedure, the tooth and the surrounding tissue are numbed with a local anesthetic prior to having the extraction.  Some people prefer to use nitrous oxide (otherwise known as “laughing gas”).  In some cases, there is the use of a mild sedation, where the patient is still conscious but truly unaware of the procedure.  It is even possible that you receive general anesthesia.  If you decide to use the nitrous or sedation dentistry then you will need someone drive you home from the procedure.  The recovery time is usually 12 to 24 hours of rest, but usually no more than 48 hours.

One of the more interesting or notable post procedure recommendations is not to use a straw to drink.  The sucking through the straw may dislodge the blood clot in the socket area and delay the healing process.

If you feel you are a candidate for wisdom teeth removal, or we can be of service, please feel free to contact us for a complimentary consultation.

Novy Scheinfeld, DDS, PC

5471 Bells Ferry Road, Suite 200

Acworth, GA 30102

770-928-7281



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[1] http://health.howstuffworks.com/human-body/parts/no-wisdom-teeth2.htm.
[2] http://www.aaoms.org/wisdom_teeth.php, Wisdom Teeth, American Association of Oral and Maxillofacial Surgeons. Retrieved 2011-26-08. "This generally occurs between the ages of 17 and 25".
[3] The Right Smile Center doesn’t push to have them extracted, we recommend you read up on the subject at http://www.aaoms.org/wisdom_teeth.php, to help make the final decision.   Please remember that an oral surgeon is going to have a bias towards removal.
[4] Pediatric Dentistry: Infancy Through Adolescence, 4th Edition.