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Bad Breath:

Bad breath, medically called halitosis, can result from poor dental health habits and may be a sign of other health problems. Bad breath can also be made worse by the types of foods you eat and other unhealthy lifestyle habits

Blood pressure

(BP) is a force exerted by circulating blood on the walls of blood vessels and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure.

Classification of Blood Pressure for Adults

Category Systolic Diastolic
Hypotension[1] <90 <60
Normal 90 – 120 60 – 80
Prehypertension 121 – 139 80 – 89
Stage 1 Hypertension[2] 140 – 159 90 – 99
Stage 2 Hypertension ≥160 ≥100

[1]Hypotension: Hypotension is a medical concern only if it causes signs or symptoms, such as dizziness or fainting.

[2]Hypertension: Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysms.Even moderate elevation of arterial pressure can lead to a shortened life expectancy.

Cancer

Research is now linking periodontal disease to an increased risk in pancreatic cancer. Men with periodontal disease had a 63% greater risk of developing pancreatic cancer

Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.

Symptoms of cancer depend on the type and location of the tumor. For example, lung cancer can cause coughing, shortness of breath, or chest pain. Colon cancer often causes diarrhea, constipation, and blood in the stool. Some cancers may not have any symptoms at all. In certain cancers, such as gallbladder cancer, symptoms often do not start until the disease has reached an advanced stage.

Canker sores

A canker sore is a painful, open sore in the mouth. Canker sores are white or yellow and surrounded by a bright red area. The first symptom is usually a tingling or burning sensation that you feel before other symptoms develop.

Pain decreases in 7 to 10 days, with complete healing in 1 to 3 weeks. Particularly large ulcers (greater than 1 cm in diameter) often take longer to heal (2 to 4 weeks). Occasionally, a severe occurrence may be accompanied by nonspecific symptoms of illness, such as fever. Canker sores often return.

Canker sores can be triggered by emotional stress, dietary deficiencies (especially iron, folic acid, or vitamin B-12), menstrual periods, hormonal changes, food allergies, and similar situations. They occur most commonly with viral infections. In some cases, the cause can not be identified.

Decay:

PPM

Here’s how you get cavities

  • Sugar in food and beverages combines with bacteria in your mouth to form acid.
  • Diet or “sugar-personal” pop contains its own acid.
  • Acid in soft drinks, whether they contain sugar or not, is the primary cause of weakening tooth enamel.
  • The acid attacks your teeth. Each acid attack lasts about 20 minutes.
  • The acid attack starts over again with every sip.
  • Ongoing acid attacks weaken your tooth enamel.
  • Bacteria in your mouth cause cavities when tooth enamel is damaged.

How to reduce decay

  • If you have a receding gum line, acid does more damage below the gum line than above it – especially for adults.
  • Drink soft drinks in moderation.
  • Don’t sip for extended periods of time. Ongoing sipping prolongs sugar and acid attacks on your teeth.
  • Use a straw to keep the sugar away from your teeth.
  • After drinking, swish your mouth out with water to dilute the sugar.
  • Never drink pop or juice before bedtime. The liquid pools in your mouth and coats your tongue and teeth with sugar and acid.
  • Read labels. Regular pop is high in sugar. And diet or “sugar-personal” pop is high in acid. Sugar and acid are bad for your teeth.
  • Drink water instead of pop. It has no sugar, no acid and no calories.
  • Use a toothpaste with fluoride in it or a prescription strength fluoride.
  • Brush your teeth at least twice a day and floss at least once.
  • Get regular checkups and cleanings to remove bacteria.
  • Talk to your dental care professional to make sure that other factors aren’t contributing to your susceptibility to decay such as dry mouth often caused by medications or digestive problems such as acid reflux.
Beverage Acid (Low = Bad) Sugar per 12 oz. Serving
Pure Water 7 (neutral) 0 tsp
Barq’s Root Beer 4 11 tsp
Orange Juice 3.8 9 tsp
Propel Fitness Water 3.4 1 tsp
Red Bull 3.3 10 tsp
Sprite 3.3 10 tsp
Mountain Dew 3.3 12 tsp
Diet Coke 3.1 0 tsp
Gatorade 2.9 12 tsp
Sobe Energy Citrus 2.6 12 tsp
Lemonade 2.6 10 tsp
Pepsi 2.5 11 tsp
Battery Acid 1 0 tsp

Diabetes:

Diabetes is not only a risk factor for periodontal disease, but periodontal disease may exacerbate or even cause diabetes. Some evidence has suggested that the bacteria causing periodontal disease may enter the blood stream and activate cytokines, the damaging factors in the immune system, which then may even destroy cells in the pancreas, where insulin is produced. One study found that treating periodontal disease reduced the need for insulin in some people with diabetes.

People with diabetes are more likely to have periodontal disease than people without diabetes, because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes. Those people who don’t have their diabetes under control are especially at risk. This is because uncontrolled diabetes impairs white blood cells, which are the body’s main defense against bacterial infections that can occur in the mouth. Since periodontal disease is a bacterial infection, diabetics with uncontrolled disease are more susceptible to destruction.

Poor healing of oral tissues is also common in patients with uncontrolled diabetes

Dry Mouth:

Lack of saliva is a common problem that may seem little more than a nuisance, but a dry mouth can affect both your enjoyment of food and the health of your teeth. The medical term for dry mouth is xerostomia (zeer-o-STO-me-uh).

Dry mouth can cause problems because saliva helps prevent tooth decay by limiting bacterial growth and washing away food and plaque. Saliva enhances your ability to taste and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

Although the treatment depends on the cause, dry mouth is often a side effect of medication. Dry mouth may improve with an adjusted dosage or a new prescription.

If you suspect that your medications may be contributing to your dry mouth additional information is available at: http://pdrhealth.com/home/home.aspx

Floss:

Floss Floss
Floss Floss

Fluoride:

Healthy teeth are important to your child’s overall health. From the time your child is born, there are things you can do to promote healthy teeth. For babies, you should clean teeth with a soft, clean cloth or baby’s toothbrush. Avoid putting the baby to bed with a bottle and check teeth regularly for spots or stains.

For all children, you should

  • Brush teeth with a fluoride toothpaste.
  • Provide healthy foods and limit sweet snacks and drinks.
  • Provide low-fat milk and dairy products high in calcium.
  • Schedule regular dental check-ups.

Forming good habits at a young age can help your child have healthy teeth for life.

http://www.adha.org/oralhealth/fluoride_facts.htm

Frenectomy

What is a frenum?
A frenum is a thin piece of tissue that limits movement of an organ or a body part.

What complications can be caused by a frenum?

A short lingual frenum (under the tongue) can restrict the movement of the tongue, can cause speech difficulties referred to as “tongue tied.”
Frenum

A thick upper labial frenum (in between the two upper front teeth) can cause a space between the two front teeth
Frenum

A short lower labial (between the two center teeth on the bottom arch) can cause the tissue to recede down the root/ exposing the root surface which can be sensitive this area is also more prone to decay and increases the odds of tooth loss.

Treatment options are available:
When a short or thick frenum is causing problems either cosmetically, functionally or dentally often times a laser frenectomy is the recommended treatment. Using a dental laser the tissue is quickly and painlessly recontoured.

Gingivitis:

Gingivitis is a very common and mild form of gum (periodontal) disease that causes swelling (inflammation) of your gums. Because gingivitis can be so mild, you may not be aware that you have the condition. But it's important to take gingivitis seriously and get it treated because it can lead to much more serious gum disease.

If your gums are swollen and bleed when you brush, you may have gingivitis. The most common cause of gingivitis is poor oral hygiene. Good oral health habits, such as daily brushing and flossing, can help prevent gingivitis.

Heart Disease:

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries.

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your dentist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures

Occlusal Screening

An occlusal screening is conducted at every appointment to make sure that your teeth are not showing any signs of distress Common signs of occlusal distress include:

Attrition:

Attrition

Abfraction:

Abfraction

Chipping:

Chipping

Tori:

Tori

Often times patients also report symptoms such as headaches and jaw joint pain.

Oral Cancer:

Cancer is defined as the uncontrollable growth of cells that invade and cause damage to surrounding tissue. Oral cancer appears as a growth or sore in the mouth that does not go away. Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat), can be life threatening if not diagnosed and treated early.

What Are the Symptoms of Oral Cancer?
The most common symptoms of oral cancer include:

Oral Cancer

  • Swellings lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, or other areas of the mouth
  • The development of velvety white, red, or speckled (white and red) patches in the mouth.
  • Unexplained bleeding in the mouth.
  • Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck.
  • Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks.
  • A soreness or feeling that something is caught in the back of the throat.
  • Difficulty chewing or swallowing, speaking, or moving the jaw or tongue.
  • Hoarseness, chronic sore throat, or change in voice.
  • Ear pain
  • A change in the way your teeth or dentures fit together.
  • Dramatic weight loss

If you notice any of these changes, contact your dentist or health care professional immediately.
Who Gets Oral Cancer?

According to the American Cancer Society, men face twice the risk of developing oral cancer as women, and men who are over age 50 face the greatest risk. It's estimated that over 35,000 people in the U.S. received a diagnosis of oral cancer in 2008.

Risk factors for the development of oral cancer include:

  • Smoking . six times more likely than nonsmokers to develop oral cancers.
  • Smokeless tobacco users. 50 times more likely to develop cancers of the cheek, gums, and lining of the lips.
  • Excessive consumption of alcohol. six times more common in drinkers than in nondrinkers.
  • Family history of cancer.
  • Excessive sun exposure, especially at a young age.

It is important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally.

Patient Links:

http://www.mayoclinic.org/

Rochester Advanced Dentistry uses Oral ID fluorescence technology as part of our oral cancer screening. We understand that early detection of oral cancer significantley increases the survival rate and results in less invasive treatment options.  The light shows normal tissue as bright and radiant while abnormal tissue shows up dark. This technology allows us to identify abnormal tissue before it is identifiable with the human eye.

Osteoporosis

Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation. However, hormone replacement therapy may offer some protection

Periodontal Screening:

A periodontal screening is a documentation of the current status of your teeth and the surrounding structures.

We carefully measure the bone support and tissue height around each tooth allowing us to identify any abnormal changes as soon as possible allowing us to intervine and stop any further changes. If periodontal disease is detected it may be recommended that you have laser gum treatments.

Periodontitis

Denchart-Diagram

Denchart-Diagram

Periodontal Disease
What is periodontal disease?

Periodontal disease is the destruction of bone around teeth due to bacterial infection
Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care. Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed

GingivitisGingivitis: In this stage bone is still intact although this gum tissue is inflamed.

PeriodontitisPeriodontitis: This stage begins when bone starts to disintegrate around the tooth.

Advanced PeriodontitisAdvanced Periodontitis: At this stage a majority of the bone around the tooth has been lost and the chances of saving this tooth are greatly minimized.

Some factors increase the risk of developing periodontal disease:

  • Tobacco smoking or chewing
  • Systemic diseases such as diabetes
  • Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
  • Genetic susceptibility
  • Hormonal changes
  • Stress
  • Fillings that have become defective
  • Poor oral hygiene

Health concerns linked to periodontal disease:

What is the treatment for periodontal disease?:

Although periodontal disease is treatable, it is not curable. Our goal is to arrest the disease at its current status and maintain oral health so that it does not progress. In order to achieve health we must remove all bacteria and deposits from the teeth and tissues around the teeth. This will require additional appointments and medications that cannot be provided during a routine dental appointment. Depending on your specific situation a treatment plan will be designed specifically for you. Following your initial treatment it is recommended that your cleanings take place on a more frequent schedule, 3 or 4 months in order to maintain health. It is also extremely important the you are taking excellent care of oral hygiene at home- brushing, flossing and using other aides recommended by your dental professional

Premedication:

There are certain medical conditions which require the patient to take a dose of antibiotics prior to their dental appointment. This is done to help prevent any bacteria introduced from the dental procedure, from causing an infection in another part of the body, such as the heart lining, called bacterial endocarditis.

This subject is of great debate, because there is conflicting evidence whether antibiotic premedication is needed at all, and the over prescription of antibiotics can lead to antibiotic resistant strains of bacteria.

American Heart Association Change in Premed Requirements

The American Heart Association previously recommended that patients with certain heart conditions take antibiotics shortly before dental treatment. This was done with the belief that antibiotics would prevent infective endocarditis. As of April 4, 2007 there is no longer need for short term antibiotics as a preventative measure before dental treatment. The changes in guidelines have also been endorsed by the Infectious Diseases Society of America and by the Pediatric Infectious Diseases Society.

The new guidelines are based on a growing body of scientific evidence that shows the risks of taking preventive antibiotics outweigh the benefits for most patients. These risks include adverse reactions to antibiotics, and the concern that inappropriate use of antibiotics can also lead to the development of drug-resistant bacteria. It is stated that infective endocarditits is much more likely to result from frequent exposure to random bacterimias associated with daily activities (brushing and flossing) than from bacterimias caused by a dental procedure.

The guidelines say patients who have taken prophylactic antibiotics routinely in the past but no longer need them include people with the following conditions:

  • mitral valve prolapse
  • rheumatic heart disease
  • bicuspid valve disease
  • calcified aortic stenosis
  • congenital heart conditions- (ventricular septal defect, atrial septal defect, hypertrophy cardiomyopathy)

Preventive antibiotics prior to a dental procedure are still advised for patients with the following conditions:

  • artificial heart valves
  • history of infective endocarditis
  • certain specific serious congenital heart conditions (cardiac transplant)

It is necessary for you to continue to premed prior to dental treatment as you have in the past until we receive documentation from your physician.

Preterm low birth weight babies:

Women with periodontitis are eight times more likely to give birth to premature low-birthweight babies. The inflammatory process associated with gum diseases appears to promote pre-term delivery

Respiratory Disease

Bacteria that reproduce in the mouth can also be carried into the airways of throat and lungs, increasing the risks for respiratory diseases and worsening chronic lung conditions, such as emphysema.

Sealants
Sealants

Sealants are protective coatings that are applied to the biting surface of teeth, typically the 1st and 2nd molars. These teeth tend to have deep grooves that catch food and bacteria. By placing a thin coating on the teeth we are able to "seal" decay, greatly reducing the likelihood that these teeth will need fillings.

Sleep Apnea

What is sleep apnea? Sleep apnea is a serious sleep disorder that occurs when a person's breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times.

There are two types of sleep apnea:

  • Obstructive sleep apnea (OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
  • Central sleep apnea: Unlike OSA, the airway is not blocked but the brain fails to signal the muscles to breathe due to instability in the respiratory control center.

Am I at Risk for Sleep Apnea?

Sleep apnea can affect anyone at any age, even children. However, risk factors for sleep apnea include:

  • Having a large neck size (17 inches or greater in men and 16 inches or greater in women)
  • Certain shapes of the palate and jaw
  • Having larger tonsils
  • Having a large tongue
  • Narrow airway
  • Nasal obstruction
  • Having a family history of sleep apnea
  • Male gender
  • Being overweight
  • Over the age of forty

What are the symptoms of Sleep Apnea?

  • Excessive daytime sleepiness, including falling asleep at inappropriate times
  • Awakening unrefreshed in the morning
  • Depression (possibly)
  • Poor concentration
  • Loud snoring
  • Observed episodes of breathing cessation
  • Awakening with a dry mouth or sore throat
  • Morning headaches
  • Difficulty staying asleep

What are the Effects of Sleep Apnea?

If left untreated, sleep apnea can result in a growing number of health problems including:

  • Hypertension (High Blood Pressure)
  • Stroke
  • Heart failure, irregular heart beats, and heart attacks
  • Impotence

In addition, untreated sleep apnea may be responsible for poor performance in everyday activities, such as at work and school, motor vehicle crashes, as well as academic underachievement in children and adolescents.

Smoking
 
Within...

20 minutes Your blood pressure, pulse rate, and the temperature of your hands and feet will all return to normal.
8 hours Remaining nicotine in your bloodstream will have fallen to 6.25% of normal peak daily levels, a 93.25% reduction.
12 hours Anxieties peak in intensity and within two weeks should return to near pre-cessation levels.
48 hours Damaged nerve endings have started to regrow and your sense of smell and taste are beginning to return to normal. Cessation anger and irritability peaks.
72 hours Your entire body will test 100% nicotine-free and over 90% of all nicotine metabolites (the chemicals it breaks down into) will now have passed from your body via your urine. Symptoms of chemical withdrawal have peaked in intensity, including restlessness. The number of cue induced crave episodes experienced during any quitting day will peak for the “average” ex-user. Lung bronchial tubes leading to air sacs (alveoli) are beginning to relax in recovering smokers. Breathing is becoming easier and the lungs functional abilities are starting to increase.
5 – 8 days The “average” ex-smoker will encounter an “average” of three cue induced crave episodes per day. Although we may not be “average” and although serious cessation time distortion can make minutes feel like hours, it is unlikely that any single episode will last longer than 3 minutes. Keep a clock handy and time them.
10 days The average ex-user is down to encountering less than two crave episodes per day, each less than 3 minutes.
10 days to 2 weeks Recovery has likely progressed to the point where your addiction is no longer doing the talking. Blood circulation in our gums and teeth are now similar to that of a non-user.
2 to 4 weeks Cessation related anger, anxiety, difficulty concentrating, impatience, insomnia, restlessness and depression have ended. If still experiencing any of these symptoms get seen and evaluated by your physician.
21 days Brain acetylcholine receptor counts up-regulated in response to nicotine’s presence have now down-regulated and receptor binding has returned to levels seen in the brains of non-smokers.

TONSILS & ADENOIDS

Where are tonsils and adenoids located?

TonsilsTonsils are located in the back of the mouth on each side. Adenoids are in the back of the nose. Tonsils can be seen by looking in the mouth, but adenoids usually cannot be seen on routine exam. Evaluating the adenoids usually requires passing an endoscope.

What is the function of tonsils and adenoids?

Tonsils and adenoids are lymphoid tissue and part of the immune system, but their role is limited. Removing the tonsils and adenoids does not weaken the immune system. Instead, their removal may actually reduce the frequency of illness in some children.

What problems can enlarged tonsils and adenoids cause?

  • Obstructed breathing during sleep (sleep apnea)
  • Poor disposition and irritable behavior (possibly diagnosed as ADD)
  • Eating problems
  • Constant nasal obstruction and congestion
  • Poor alignment of teeth and abnormal facial development

Signs and Symptoms

  • Allergic shiners- bluish black discolorations under the lower eyelids
  • Snoring
  • Tiredness
  • Open-mouth breathing
  • Dry lips
  • Rolled lower lip
  • Arched V-shaped palate

Dental concerns:

Since constant light forces move teeth, it is clear why the relationship of the tongue influences tooth position.

  • Muscles of the tongue will seek an accommodative position during a swallow by thrusting away from the primary stimulation, for example, enlarged tonsils. This creates force against the teeth that can result in an open bite, cross bite, and/ or protruding teeth.
  • Continuous displacement of the tongue by an object, finger, thumb, tonsils, adenoids will alter the configuration and muscular pattern of the tongue, causing abnormal stresses on the dentition.
  • Bilateral chronic hypertrophy of the tonsils will force the tongue anteriorly and create an open bite in humans
  • Post orthodontic relapse

PATIENT LINKS

http://pdrhealth.com/home/home.aspx - Information on medications

http://www.mayoclinic.org/ - Additional information on specific health topics