J. Peter St. Clair, DMD Blog

The connection between oral health and systemic health is well-established and ever-evolving. One thing we know for certain; we are living longer, but with more chronic diseases and medication than ever before.

The latest statistics are alarming. Forty-seven percent of US adults who are age 30 or older – an estimated 64.7 million Americans – have either mild gum disease (8.7%), moderate gum disease (30%) or severe gum disease (8.5%). As the population ages, the prevalence rises with 70% of individuals over the age of 65 exhibiting some level of gum disease. And, since we are on statistics, by 2030, it is estimated that the number of people over 70 years of age will have doubled from 35 million to 71 million.

So, as we age, our risk of developing disease increases. Interestingly, there is also a direct correlation between the regions of the US with the greatest concentration of gum disease, and those that have a high incidence of cardiovascular disease and diabetes. Although a direct cause-and-effect link is still in the process of being established between gum disease (periodontitis) and other systemic diseases, inflammation is often a common denominator. And it is always important to remember that the mouth is the gateway to the rest of the body. (more…)

If you recently learned that you need a root canal, your first instinct may have been to go online to do some research on the procedure. The Internet can be a great learning tool, but it’s also full of misconceptions about treatments like root canal therapy. To help you separate rumors from reality, here are five common root canal myths in Rowley.

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October is here!!  This means only 3 months left in 2021. It’s crunch time to get everything done that we haven’t gotten done during the rest of the year. For those with remaining dental benefits, it’s also the time of year to consider utilizing those so you don’t lose them.

Unused dental benefits go directly back to the insurance company, which generates hundreds and hundreds of thousands of dollars for the insurance companies each year. Dental insurance companies count on the fact that many people will not claim their $1000 or so in benefits by the end of the calendar year. Those with dental benefits should look for legitimate means to use these benefits before they are lost, especially if you haven’t been to a dentist in a while. (more…)

If you recently learned that you need a root canal, your first instinct may have been to go online to do some research on the procedure. The Internet can be a great learning tool, but it’s also full of misconceptions. To help you separate rumors from reality, here are five common root canal myths in Rowley – debunked!

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Gravity is precise in nature, governed by laws and formulas; it does not respond to individual circumstances or objectives. It’s easy because it always works. Clinical dentistry, on the other hand, is science for sure, but an inexact science at best. Inexact science requires the skill of an artist to create a consistent and predictable result, since it is not a matter of an equation; hence the “Art and Science of Dentistry.” This inexactness is something that dentists struggle with daily.

I am currently treating a patient who presented with a bunch of broken teeth. The patient is frustrated because these teeth have been “fixed” numerous times over the past few years. His previous dentist had tried to bond things here and there to keep the cost down for the patient, but they just kept breaking. The patient, an engineer, said that he even tried giving the dentist suggestions to make things “stronger”. Those suggestions only led to more failure. Predictable dentistry often requires doing things that you would rather not do.

I recently heard an ad on the radio with a famous actor talking about colon cancer screening. He describes that having a colonoscopy after age 50 is huge in finding and treating early changes that lead to colon cancer. Most people don’t want to have a colonoscopy, but also don’t want to get colon cancer, so there is a dilemma. These actions have now become inconsistent with the desired outcome, much like the patient I just described. He doesn’t want to have a complete exam and map out a precise treatment plan that will ensure a more predictable result, but he wants to save his teeth. (more…)

Your dentist may have the best technology, may have gone to a top dental school, and do great clinical work, but none of those are the primary reasons people choose to stay with a dental practice or any service provider. Generally speaking, people stay with their provider because of the relationships they have built with individuals within the office.

When we have a problem, we all like the convenience of calling someone we know and are comfortable with. Whether that problem is a broken filling or needing to change an appointment, it is nice to deal with people who know us and are eager to help with solving our dilemma.

I recently had an appointment with an office that I needed to change. The appointment was a week and a half away. When I called the office to change the appointment, I was less than thrilled with the way I was treated. While I didn’t necessarily expect to know the person on the other end of the phone, I wasn’t expecting to feel like a criminal. The first question I was asked by the grumpy person answering the phone was, “Why do you need to change your appointment?” This was quickly followed by how inconvenient it was for their office that I needed to change my appointment.

I can completely understand how difficult it is for front desk personnel to have to deal with these kinds of issues all day long. In my office, we had over 40 appointment changes last month. That is a lot of conversations about the same thing, and stressful for any staff member who deals with a busy schedule.

We all have busy lives. Things change and sometimes we have to re-manipulate our schedules to accommodate all we have to do. However, there needs to be accountability on both ends. If we have a scheduled appointment with our dentist, our hairdresser, or anyone, it is our obligation to realize that they are relying on us to be there. Giving adequate notice (preferably as far in advance as possible – like 48 hours) of the need to change an appointment is common courtesy.

On the other end, it is important for the provider’s office to realize that people have lives outside of their appointments. While it may be inconvenient for the office to have to reschedule an appointment, the request must be handled with respect and as much accommodation as possible.

An appointment is a commitment and it is important to take our commitments seriously. If you routinely have to change appointments to accommodate your busy schedule, it may make sense to make your appointments differently, such as being “on call” when you are due for an appointment vs. pre-scheduling.

Dental offices typically schedule your next dental hygienist appointment in advance. It may be 3, 4, or 6 months away. One of the reasons this is done is for patients to choose and reserve a time that usually best fits their schedule. Patients are often disappointed if they call to reschedule and the appointment time options are limited.

The need to change appointments happens. As long as it is not a frequently occurring issue, most providers’ offices understand. Mutual respect builds relationships.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. 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

What is your definition of oral health? Is there even a standard definition of oral health? One thing is clear; the definition of oral health is not solely the absence of pain. Pain is also not necessarily an indication of poor oral health.

It wasn’t until the year 2000 that oral health was brought to the forefront of the surgeon general’s report as a critical component to overall health. This was an important event, but unfortunately never amounted to much in terms of being incorporated into most healthcare policies. This has led to continued poor to non-existent cross-over coverage between medical and dental insurance.

In 2005 at the World Congress of Preventive Dentistry, participants from 43 countries made it clear that oral health is an integral part of general health and overall well-being. They even concluded that oral health is a basic human right.

More recently, the United Nations recognized oral disease as an integral part of other non-communicable diseases such as diabetes, cardiovascular disease, stroke, chronic respiratory diseases and cancer. This association with these other diseases was based on common social determinants such as socioeconomic status, diet, tobacco and alcohol use, and not on the basis of transmission. However, there is still no solid definition of what oral health really is. (more…)

We are all hoping for a productive and enjoyable school year for students of all ages. Here’s a quiz to help get those learning juices flowing. Good luck!

Question #1: The risk factors for gum disease are the same as for heart disease (genetics, smoking, weight, lack of exercise, and high cholesterol).

Answer: False. Genetics and smoking tobacco are major risk factors, but stress, medications, lack of proper hygiene, and systemic problems, such as diabetes, are additional risk factors. Just like heart disease, management of gum disease requires strict maintenance visits to monitor and control the disease. Taking care of your body includes taking care of your oral health. (more…)

You may have heard the phrase “the mouth is the gateway to the rest of the body.” The mouth is connected to the rest of the body, and the only healthcare providers who spend time examining this area are your dental team. The days of the dentist being just the “tooth fixer” are gone. The key here is the practitioner thinking “outside the box” and treating each patient’s total-body health.

The average physician spends seven minutes every two years with a patient. There may be a 5 second glance inside the mouth during those visits. If you see a dentist on a regular basis, we (dentists and hygienists) spend an hour twice a year concentrating on a very specific region of the body. There is a lot of information available within that tiny little space.

For example, everyone has heard of gum disease. While many patients and dentists see periodontal (gum) disease as a tooth or oral health problem, the fact is, it is a bacterial disease and bacteria can travel throughout the body. About a dozen of the nearly 7,000 types of oral bacteria can wreak havoc on the body, not just the oral cavity. (more…)

Despite the generalized notion that people should visit a dentist bi-annually, I am more a proponent of individualized frequency recommendations based on a few factors. We are not all the same; therefore, each of us has our own specific needs.

Results from a recent Gallup-Healthways poll of 355,334 Americans indicate that more than one-third of the population, 34% to be exact, did not visit a dentist last year at all. Over 50% of the population said they visited the dentist one time or less last year.

In a study reported in The New York Times and other major media, a report by the Journal of Dental Research indicates “little evidence supports biannual preventive care for all adults.”  Similarly, the headline from HealthDay News read, “Annual Dental Cleaning May be Enough for Some.”

The researchers explored the association between long-term tooth loss and the frequency of preventive dental visits in adults with and without three risk factors for periodontal disease: smoking, diabetes and interleukin-1 genetic variations (regulates immune and inflammatory responses). Subjects were deemed low risk if they had none of these factors.

The data showed that as a group the high-risk patients who had two preventive dental visits lost significantly fewer teeth compared to the high-risk group that had only one preventive dental visit per year. By contrast, there was no difference in tooth loss for the groups at low-risk based on one versus two preventive visits per year. The researchers concluded that individual risk factors should dictate the frequency of cleanings.

The American Dental Association recommends regular dental visits at an interval determined by the patient’s dentist. The patient’s dentist makes an individualized recommendation based on the patient’s health history and current oral health status.

Here are some points that may help you understand the study and the importance of personalized care:

• The key takeaway from this study is that personalized oral care—taking into account your oral and overall health history—is necessary for good dental health.
• The study only looked at tooth extraction and its association with risk factors for gum disease; however, other health conditions can contribute to poor oral health. That’s why personalized dental care is critical to good patient care.
• Personalized treatment plans should be the priority. Recommendations for future dental appointments should be based on what is seen during your examination, your health history, and any concerns you may have about your oral health.
• The American Dental Association’s website at www.mouthhealthy.org has a lot of information on how to take care of your oral health between dental visits.

While there is clearly a segment of the population who can “get away” with visiting a dentist once a year to maintain a healthy mouth, this group is relatively small. 75% of the population has some form of gingivitis or periodontal (gum) disease. Within that group, there are those who should see a dentist/hygienist twice per year, some three times and others four times or more to maintain proper health.

It is up to you and your dentist to have an open conversation about how often you should go. If it has been a while, getting there the first time is step number one.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. 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