The sun is shining and the weather is warming up, which means summer vacation is finally here! Before you hit the road and set off on your adventures, make sure you take your loved ones to their dental checkups. The last thing you need is for your summer vacation to be ruined by a cavity or toothache! Here are five excellent reasons to visit a Rowley family dentist for all your loved ones’ oral health care needs.

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Dentistry is full of old, new, and emerging technology. For example, the different ways to use dental implants over the last 30 years has been a major game changer in the field of dentistry. Likewise, CAD/CAM technology (computer-aided design and manufacturing of dental restorations) has seen steady growth over the same 30 years. Here is a little background on the some of the reasons this technology is here to stay.

Let me start by saying that the best dentistry is NO dentistry. Prevention of decay and other destructive things that happen to teeth is the best line of defense. Having said that, the fact of the matter is, there are many people who need things done to their teeth to preserve them for their lifetime.

Dental amalgam (silver filling) was introduced to dentistry well over 100 years ago. It proved to be one of the major contributors to saving many teeth that were in need of repair. Dental amalgam is a very hard material which can last for many years. However, there are many aspects of dental amalgam that are undesirable. It is ugly, tooth preparation needs to be more aggressive to retain it, the material breaks down over time, and it contains mercury. Dental amalgam is not used in most of Europe and has been dying a slow death in the United States over the last 30 years.

Progressive dentists, who were interested in providing better, longer-lasting dentistry, learned the skill of using gold. Despite the way you feel about gold in your mouth, done well, gold is still one of the best, most biocompatible and longest lasting materials used to protect teeth. Gold has also been dying a slow death mainly due to the fact that patients prefer tooth-colored restorations.

Then composite resin was introduced. It started as a filling material used to fill cavities on front teeth and eventually evolved enough to be used in back teeth. Dental composite, an ultraviolet light-cured resin, is the main direct restorative material used in dentistry today. It has become the amalgam replacement. It is relatively esthetic, chemically bonds to tooth structure, and allows for much more conservative tooth preparation. However, it is much softer than natural tooth structure and therefore has its limitations.

Dental amalgam and composite are what we in dentistry call direct restorative materials. This means that a cavity preparation is made and the material is directly placed in the tooth. This is different than gold or porcelain which are considered indirect materials. These are manufactured and then cemented or bonded to tooth structure.

When a tooth needs a larger filling, specifically one that needs to cover the cusp of a tooth due to fracture, risk of fracture due to cracks, or has undergone extensive destruction due to decay, direct materials like composite are not indicated due to wear factors. Indirect materials are more appropriate and are much longer lasting.

The advantage of CAD/CAM is the ability to provide stronger, esthetic, indirect materials in addition to being more conservative in tooth preparation. Next week I will continue this subject with the specific uses of this technology.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

 

 

The Golden Years are much more golden if your teeth are in good shape. One of the most difficult areas dentists have to address are issues concerning aging patients, specifically those who require assisted or nursing care.

Whether you are the one making decisions for someone else, or you are making your own decisions, regular dental maintenance visits are the key to success with your teeth as you age. Dental health needs to stay at the top of the priority list for many reasons; quality of life and the link between oral health and systemic health are two big ones.

It’s not uncommon for an older patient to say, “I don’t need to fix that. How much longer do I really have to live?” And the response is usually the same every time, “If you told me that you knew you weren’t going to be around next year, I’d say I would agree with you…..but you’ve been saying the same thing for 15 years.” You can’t predict the future. What you can do now is decide how healthy you want your mouth to be now to enjoy. It only involves a choice.

When an elderly patient has a multitude of dental issues the following should be considered:

 *   What is the general health status?
 *   What is the general prognosis medically?
 *   Has the patient ever worn anything removable in their mouth?
 *   What is the minimal amount of dentistry that can be done that will not alter the patient’s quality of life?
 *   What are other treatment options to maintain or improve the patient’s quality of life?

The general health status of the patient can play a role in deciding how to approach a patient’s dental care. People who are medically compromised but are well controlled are usually okay to receive general dental care. If a person is in good physical and mental shape, it’s difficult to use age as a determining factor for dental care.

The most important factor that needs to be considered is quality of life. Studies have shown that loss of teeth results in a loss in quality of life. While some patients with dentures may say they can eat anything, many others would pay anything to have their teeth back. Masticating food properly for digestion and not having plastic in your mouth to disrupt the flavor of food, are two great reasons to keep your teeth. There is no one who could argue that eating with false teeth is as enjoyable as eating with real teeth.

If you have never worn anything removable in your mouth, it tends to get more difficult to adapt to the older you get. Dentures can be difficult to adjust to. There are definitely better techniques and materials than others that can impact fit and function, but it’s still a piece of plastic in your mouth. Poorly fitting dentures can impact a patient’s nutritional intake and can be a serious issue for an older person.

The best way to avoid having to deal with major issues as you get older is to make sure you take care of your teeth along the journey of life. If someone you love ends up in a nursing facility, one of the most important things you could do for them is to make sure they get proper dental care.

 

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com.

One of the most common things dentists deal with is broken and/or sensitive teeth. Teeth can break or be sensitive for many reasons. While catching a popcorn kernel the wrong may cause a tooth problem, more often than not there are other factors at play.

Are you stressed out? It seems that stress levels in people are on the rise. We worry about school, work, finances, illness, children, relationships, and more. Some even worry about how much they worry. Not to add to your stress, but you should be aware that all that worrying could have a negative impact on not only your general health but also your oral health.

According to an article published in the Journal of Periodontology, there is a strong relationship between stress and periodontal disease (gum disease). In addition to stress, other psychological factors, such as anxiety, depression, and loneliness, are linked to an increased likelihood of periodontal disease.

So how does stressing out about your next car payment, for example, lead to gum disease? Researchers believe that the hormone cortisol may be a factor. Cortisol , also known as the “stress hormone,” is secreted by the adrenal glands and involved in many functions, including proper glucose metabolism, blood pressure regulation, insulin release for blood sugar maintenance, immune function, and inflammatory response. An earlier study published in the same journal the year before found that increased levels of cortisol can lead to more destruction of the gums and bone due to periodontal diseases.

Behavioral factors may come into play. People who are under extreme amounts of stress or suffering from depression may be more likely to disregard good oral hygiene. They may even take on new behaviors that could negatively impact their oral health, such as the use of nicotine, alcohol, or drugs, all of which can affect the teeth and gums.

Your gums are not the only oral victims of stress. Another oral side effect is teeth grinding or clenching, which often occurs during sleep. This may lead to headaches, earaches, or toothaches. Facial muscles can become sore and jaw joints tender. Besides causing discomfort, grinding and/or clenching can lead to severe tooth wear, loosening of teeth, and cracked or fractured teeth. Ruling out a sleep breathing disorder should always be done when clenching or grinding is observed as well.

It is important to find healthy things that help relieve stress. A regular exercise routine can do wonders for relieving stress, as well as having a balanced nutritious diet and getting enough sleep. If you find it difficult to manage your stress you should discuss this with your physician.

Cornelius Celsus’s DeMedicina, a Roman author and medical historian, wrote the following about 2000 years ago:

 

Live in rooms full of light.

Avoid Heavy food.

Be moderate in the drinking of wine.

Take massage, baths, exercise and gymnastics.

Fight insomnia with gentle rocking or the sound of running water.

Change surroundings and take long journeys.

Strictly avoid frightening ideas.

Indulge in cheerful conversation and amusements.

Listen to music.

 

Still good advice 2000 years later.

 

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

Here is the scenario: You haven’t been to the dentist in a few years. You decide on a dental office and go for a cleaning, x-rays and examination. The dentist hasn’t told you yet, but you have relatively extensive treatment needs. How do you want to hear the news? Do you want the dentist to tell you everything she finds and present a comprehensive treatment plan to get you back to health? Or, would you rather her tell you the most significant issues that need to be dealt with first, and break the rest of the news to you at a later date?

A patient’s initial visit with a new provider is an important time in the dentist-patient relationship. That first impression plays a pivotal role in how the rest of the relationship unfolds. What happens to that relationship if the dentist presents an extensive treatment plan at the first visit? Is there a “right” way to handle this situation?

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Dental offices are expected to return to more routine care starting this coming Monday, June 8th. The general vibe in the dental community is optimism, as we embark on a revised version of our normal procedures. We are all looking forward to seeing our patients.

Dentists play a key role in screening patients for many disorders relative to overall health, and in providing appropriate referrals into the health care system as needed.  Although the importance of integrating diet and nutrition guidance into dental care has been advocated for decades by educators, it continues to be a challenge for many dental providers to put into practice.

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