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Facial Trauma and Reconstructive Surgery

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

 

Dental injury.When you were a youngster, did you ever get a black eye, chip a tooth or bruise your cheek? If so, you may have experienced a case (let's hope, a mild one!) of facial trauma. In many situations, however, facial trauma can be severe. Among its major causes are auto accidents, sports injuries, work-related mishaps, falls, and acts of violence. When serious facial injury occurs, it's important that you receive immediate and comprehensive care. That's why oral and maxillofacial surgeons are on call at most emergency and trauma centers.

Facial trauma in general involves injuries to the soft- or hard-tissue structures of the face, mouth or jaws — including the teeth, the bones of the jaws and face, and the tissue of the skin and gums. It can also involve treatment of particular specialized regions, such as the area around the eyes, the salivary glands or facial nerves. Because facial injuries can affect not only a person's ability to carry on basic life functions (eating, vision, etc) but also his or her appearance, there is often a strong emotional component to treatment as well as a physical one. But after completing an extensive training program, oral and maxillofacial surgeons are capable of handling the full scope of facial injuries.

Treatments for Facial Injury

Some facial traumas are relatively minor. A common one occurs when a tooth is loosened or knocked out (avulsed). Many times, if treated immediately, the tooth can be successfully re-implanted in the jaw. If that isn't possible, placing a dental implant is often the most effective way to replace a missing tooth.

Another type of relatively common but more serious injury may involve a fracture of the facial bones, including the cheekbones, upper or lower jawbones, or the eye sockets. In principle, its treatment is essentially the same as that used for a broken arm: place the bones back in their proper position, and immobilize them. But since it isn't possible to put a cast on the face, different immobilization techniques are used. One method involves wiring the upper and lower jaws together to let them heal in the correct alignment; alternatively, plates and screws may be used to permanently reattach the bones.

Severe facial trauma is often a critical condition, since over 60% of these patients also have serious injuries in other parts of the body. In fact, many of the standard techniques used in trauma centers were developed by oral and maxillofacial surgeons during the wars in Korea, Vietnam, and the Middle East. Restoring breathing, controlling bleeding and checking for neurological damage are top priorities. After that, as much of the reconstructive surgery as possible is accomplished in one operation.

Preventing Facial Trauma

Athletic mouthguards.

What's the best treatment for facial trauma? Prevention. Always wearing seat belts, using proper helmets and protective gear when playing sports, and staying out of dangerous situations (like driving while impaired, tired or distracted) can go a long way toward keeping you safe. If you're engaging in athletic activities that carry any risk of facial injury, wear a properly fitted mouthguard — this small piece of protective equipment can save you a lot of potential harm.

But if you (or someone you care for) require a trip to the emergency room for a facial injury, be sure to ask for a consultation with an oral and maxillofacial surgeon, so that you get the best care and the most favorable outcome.

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