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Antibiotic Premedicationfor Dental Treatments

FAQ 1. Is Flossing REALLY Important?

Honesty is the best policy! Here at Clatskanie Dental, we won't judge you. We're here to educate you & help you reach your oral health goals!

So...is flossing REALLY important?

Flossing cleans the surfaces in between the teeth that you can't reach with a toothbrush. The American Dental Association recommends people clean in between their teeth daily, but flossing is just one modality. When used correctly, people can achieve the same oral hygiene using small interdental brushes or oral irrigators (aka 'water flossers").

Cleaning between the teeth can reduce harmful inflammation and therefore lower your risk of PERIODONTAL DISEASE, which is said to affect at least 50% of Americans.

Still unsure? Ask your Dentist before implementing any new oral hygiene regimen.

Learn more here:
http://www.ada.org/en/science-research/science-in-the-news/the-medical-benefit-of-daily-flossing-called-into-question

 


FAQ 2. How Can I Make Dental Care More Affordable?

How a Health Savings Account (HSA) May Reduce Your Dental Costs*

WHY open a HSA?

To help save you money on dental or medical care!

WHAT is a HSA?

A Health Savings Account is a separate account you or your employer can put money into before taxes are taken out, which may save you money on your dental care.

WHO can open a HSA?

You may ask your employer if they offer HSA to employees or you may apply for your own HSA through your financial institution or bank.

Interested in opening a HSA? Contact your employer or financial institution/bank for more information!

To learn more, see article: click here


FAQ 3. Painless Dental Injections: Fact or Myth?

Can getting a dental injection really be a 'painless' experience?

At Clatskanie Dental Clinic, we think it can! Let's explore why we believe this and why you should care.

What do most people dread about going to the dentist: the injection! However, there are actually quite a few techniques your dentist can implement to make the injection 'painless.' Here at Clatskanie Dental, Dr. Ross uses 3 distinct methods to ensure you have the most comfortable injection possible:

  • We Warm It Up: We warm the dental anesthetic so that it is near body temperature. Your body can interpret cold substances as pain, so this helps the body absorb the anesthetic more comfortably.
  • We Go Slow: We administer the anesthetic very slowly, which gives the body more time to adjust and therefore reduces the chance of it feeling painful.
  • Remember To Breath: Most people forget to breathe during dental injections because they're afraid. We gently remind you to breathe during the injection, which calms our patients. Also, the body interprets pain less during exhalation so you don't feel it as much.
  • Topical Agent: Our topical agent is very effective at "pre-numbing" the area, making the injection even more painless!

We strive to make our patients feel as comfortable as possible and we know dental fear is real. If you're suffering from dental pain and are avoiding going to the dentist because you're afraid, you're not alone!

We want to help you in any way we can. Let us help you by calling us today to schedule a complimentary DENTIST MEET AND GREET so you can get to know us!

FAQ 5. Can a Dental cleaning really lower my risk of heart disease?

For decades, medical researchers have hypothesized the link between oral health and whole-body systemic health. Is this link still considered ambiguous in the medical community or is there hard evidence to prove that poor oral health leads to systemic deterioration? Recent studies published in the Journal of Clinical Periodontology (2013), Journal of Oral Science (2016) and Journal of Cardiology (2010) suggest the answer is clear in regards to the link between oral health and cardiovascular disease (CVD).

Oral Disease

Have you or a family member ever been told by your dentist that you need a “deep cleaning?” According to the CDC (2010), 1 in 2 Americans (47.2%) have moderate to severe periodontitis. Once you hit age 65 your odds of developing periodontitis skyrocket to 70%. Periodontitis is caused by harmful bacteria such as Porphyromonas gingivalis that, through multiple complex processes, illicit production of host immune and inflammatory chemicals that lead to the deterioration of the endothelial cells of the gums and subsequent bone supporting the teeth, similar to the way termites eat and destroy wood, potentially leading to serious acute infections and eventual tooth loss. Although periodontitis is an incurable condition, treatment modalities have shown to be effective long-term in slowing the progression and stabilizing the condition. The traditional treatment for periodontitis is non-surgical periodontal therapy, aka a “deep cleaning”, performed at your dentist’s office. Periodontal therapy, depending on the severity and presence of co-morbidities such as diabetes, may include adjunctive treatments such as local antibiotics that help treat the diseased tissue directly or even laser therapy.

Cardiovascular Disease

Heart disease is the number one cause of death in Americans, killing over 600,000 people every single year (CDC 2017). Atherosclerosis, an immune and inflammatory disease that presents as dysfunctional thickening of blood vessels, presents in patients with cardiovascular disease (CVD). The process by which atherosclerosis, or blood vessel thickening, takes place is multifaceted. Basically, as plaques build up in the arteries, endothelial cell breakdown leads to foam cell formation that narrows the blood vessel leading to blood flow blockage. These atherosclerotic plaques may burst open, potentially causing a blood clot that can block the flow of blood causing a thrombotic stroke. The destructive inflammatory processes involved in CVD lead to increased cardiovascular risk markers such as destructive inflammatory blood markers (CRP, fibrinogen, interleukin-6), increased systolic and diastolic blood pressure, increased left ventricular mass (an enlarged heart), and arterial stiffness (thickened blood vessels). Biomarker interleukin-6 is especially correlated with cerebral ischemia (stroke).

Oral-systemic Link

So, what is the connection between periodontitis and the number one killer, heart disease? Both diseases exhibit a mechanism of endothelial (blood vessel wall) breakdown which leads to increased inflammatory biomarkers CRP, IL-6, haptoglobin and leukocytes, which present as bone and soft tissue destruction around teeth (periodontitis) and blood vessel thickening and subsequent heart blockage or stroke (atherosclerotic cardiovascular disease). The microbiological processes and components involved in both processes are analogous and the bacteria P gingivalis is present in most (64%) atherosclerotic plaques seen in patients with cardiovascular disease. Because research to find a causal relationship between oral bacteria and heart disease is extremely difficult and complex, as technologies improve medical researchers are finding more and more correlative and causative relationships between certain biomarkers. In a 6-month randomized clinical trial, non-surgical periodontal therapy was shown effective in reducing levels of systemic inflammatory markers such as ESR and triglycerides (significant reduction), as well as reduction in CRP and total cholesterol (moderate reduction). Periodontal therapy helps to stabilize these biomarkers up to 6-months post-operatively in patients with periodontitis.

In a 2013 study published by the Journal of Clinical Periodontology, non-surgical periodontal therapy (deep cleaning) was shown to significantly reduce all cardiovascular risk markers evaluated, including systemic inflammation plasma markers (CRP, fibrinogen and interleukin-6), systolic and diastolic blood pressure, left ventricular mass (heart enlargement) and arterial stiffness, which lead to a lower cardiovascular risk. Scaling and root planing, aka “deep cleaning”, was shown to produce an even greater systemic reduction of inflammatory markers seen in patients who receive adjunctive therapies such as local administration of antibiotics such as minocycline.

Rainier Dentist


Online Dental Education Library

Our goal here at Clatskanie Dental Clinic is to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Feel free to use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.  Call us today at (503) 728-2137

Have questions for Dr. Ross?  Call her at (503) 728-2137

 

Antibiotic premedication for dental treatments.Antibiotics are widely prescribed to control bacterial infections. Sometimes they are given before a medical or dental procedure, to prevent a possible infection from occurring; this practice is called "antibiotic prophylaxis." In the recent past, physicians and dentists advised that people with certain medical conditions - including a number of heart problems and several types of bone or joint replacements - should always take antibiotics before many routine dental procedures. Today, their advice may be different.

A growing body of evidence now indicates that far fewer patients need to take this preventive step than was previously thought. As a result, the guidelines for prescribing antibiotic prophylaxis have recently changed - and they may do so again in the future. Why are the recommendations changing - and what do you need to know about taking antibiotics before coming to the dental office?

The Risk of Infection

We all know that bacteria - both helpful and harmful types - thrive in many parts of the body, including the mouth. Whenever circumstances make it possible for these microorganisms to enter the bloodstream, there's a slight risk that a bacterial infection may develop. This could occur in many dental procedures - and it could also occur during routine activities like chewing, brushing and flossing. In most cases, the risk is so small that the chance of a having bad reaction to antibiotics (while rare) is far greater than the chance of developing an infection; therefore, antibiotics aren't routinely used.

Some people, however, need to take extra precautions before having dental procedures. If you have been treated for some types of heart disease, or have had certain orthopedic procedures (including total joint replacement), we may advise taking antibiotics to protect against even a remote chance of infection. Recommendations are made on an individual basis, taking into account your medical history and a clinician's healthcare experience.

Guidelines for Antibiotic Premedication

Prophylactic antibiotics might be recommended before dental procedures if you have one or more of the following heart conditions:

  • A heart transplant
  • Artificial heart valves
  • A history of infective endocarditis
  • Some types of congenital heart problems - particularly if they haven't been completely repaired, or if their treatment involves prosthetic material

If you have undergone a joint replacement procedure, prophylactic antibiotics might be recommended if you also have one or more of the following risk factors:

  • A systemic inflammatory disease such as rheumatoid arthritis or lupus erythematosis
  • A weakened immune system resulting from HIV, cancer, radiation or chemotherapy, or another cause
  • Insulin-dependent (type I) diabetes or hemophilia
  • A history of previous infection in a prosthetic joint
  • Undernourishment or malnourishment

There are other circumstances where taking prophylactic antibiotics would be a prudent step; there are also a number of situations where these medications might have been recommended in the past, but aren't currently required in all cases. For example, the presence of a benign heart murmur, a pacemaker or defibrillator, and certain heart diseases or congenital defects don't automatically mean that antibiotic prophylaxis will be needed.

In recent years, reports of drug-resistant bacteria and harmful side effects from some medications have increased public awareness of the consequences of overusing antibiotics. Fortunately, new scientific research is helping healthcare professionals make better, evidence-based treatment decisions on antibiotic use. If you have questions about whether you should take antibiotics before dental procedure, don't hesitate to ask.

Related Articles

Premedication - Dear Doctor Magazine

Premedication for Dental Treatment If you have had a total joint replacement in the past, you may be advised to take antibiotics before have dental work. That's because certain preexisting health conditions may make you more susceptible to infection during a dental procedure. Find out what the risk factors are... Read Article


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