Posts for: February, 2020

CertainPeoplemayBenefitfromAntibioticsBeforeImplantSurgery

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.”


By Robert Rousseau DMD
February 11, 2020
Category: Dental Procedures
Tags: veneers  
VeneersMayNotBetheBestOptionforYourTeenagersTeeth

Just like adults, teenagers experience chipped, stained or disfigured teeth. And during a life stage where issues with appearance can be acutely painful, these defects call out for a solution.

And, there is one: porcelain veneers. These thin wafers of custom-made porcelain are bonded to the front of teeth to cover dental flaws. They’re one of the least invasive—and most affordable—methods for smile enhancement.

There is one caveat, though: The affected teeth will most likely need alteration. Veneers can look bulky when bonded directly to teeth, so we compensate for this by removing some of the surface enamel. This changes the tooth permanently, to the point that it will always require a veneer or some other form of restoration.

But although this may be a minor issue for an adult, it could pose a problem for a teenager. That’s because the pulp, the innermost layer of a tooth containing nerves and blood vessels, is larger in a younger adolescent tooth than in an older adult tooth. Because of its size, it’s closer to the tooth’s surface. During enamel reduction for veneers on a young tooth, this could lead to inadvertent nerve damage. If that happens, the tooth may need a root canal treatment to preserve it.

If the adolescent tooth needing a “facelift” has already been root canaled or sustained significant structural damage, then altering it for veneers may not be too concerning. Likewise, if the teeth are smaller than normal, the bulkiness of a veneer may actually improve appearance and not require alteration. We’ll need to examine a young patient first before making any recommendations.

There are also alternatives to veneers for improving smile appearance. Enamel staining could be enhanced temporarily with teeth whitening. Small chips can be repaired with bonded dental material, or in skilled hands be used to “build” a veneer one layer at a time with no enamel reduction. Although not as durable as regular veneers, these bonding techniques could buy time until the tooth is more mature for veneers.

Whichever path we take, there are effective ways to transform a teenager’s flawed tooth. And that can make for an even better smile.

If you would like more information on dental restorations for teenagers, 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 “Veneers for Teenagers.”


By Robert Rousseau DMD
February 01, 2020
Category: Oral Health
Tags: smoking  
QuittingSmokingcanImprovetheHealthofYourTeethandGums

While cigarette smoking has been linked with lung cancer and heart disease, it, can also contribute to dental disease. You can reduce these risks by doing one thing — quitting smoking.

But that’s easier said than done: forty-six percent of smokers try to quit every year, but only one in ten are successful long term. The difficulty is tied to tobacco’s active ingredient, nicotine, an addictive substance that triggers chemical and behavioral dependence. Nicotine “re-wires” the brain to feel pleasure when it encounters the chemical, and to feel bad when it’s deprived. Social, occupational or recreational activities can further reinforce the habit.

Many smokers try to quit through sheer willpower or “cold turkey.” Because of nicotine’s addictive properties, this rarely works — instead, you need a comprehensive strategy tailored to you.

You should begin first with trying to understand your individual smoking patterns: when do you smoke, how frequently, or during what activities? To help with this you can use a “wrap sheet”, a piece of paper you keep wrapped around your cigarette pack. Each time you take out a cigarette, you would record how you feel on the sheet. This also slows down the action of taking out a cigarette and lighting it, which can help you become less mechanical and more mindful of your habit.

You can also break your dependence by gradually introducing restrictions to your smoking: smoke only in certain locations or at certain times; substitute other stress-relieving activities like a walk or other physical exercise; or gradually reduce the number of cigarettes you smoke. You can do the latter by setting a goal, say to smoke 20% fewer cigarettes each successive week; this will force you to increasingly make choices about when you smoke.

Finally, don’t try to go it alone. You can benefit greatly from professionals, including your dentist, to help you kick the habit through Nicotine Replacement Therapy (NTR) with prescription medication, counseling or smoking cessation support groups.

Quitting smoking isn’t so much stopping a behavior as it is “unlearning” one and establishing new, healthier ones. The first step, though, is accepting you need a change, one that will benefit your whole life.

If you would like more information on quitting smoking, 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 “Strategies to Stop Smoking.”