What Is Laser Dentistry?

Peggy

 

Peggy Storr RDH

Just as in other areas of medicine, lasers are increasingly becoming more common in dentistry.  Lasers are instruments that produce a very narrow but intense beam of light. The light can remove or shape tissue. While lasers have been used in dentistry since 1985, its estimated that only 6% of dental offices utilize lasers. With improvements in technology and as the cost of lasers decrease, a greater number of dentists and hygienists will feel confident in incorporating lasers into their treatments.

How are lasers used in dentistry?

Hard Tissue (or Tooth) Laser Procedures

  • Cavity detection: Lasers provide readings of by-products produced by tooth decay
  • Tooth preparation for fillings- dental lasers may soon eliminate the need for anesthetic and the dental drill.
  • Tooth Sensitivity-lasers may be used to seal tubules located on the root of the tooth that are responsible for sensitive teeth.
  • Help treat infections in root canals

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Soft Tissue (or Gum) Laser Procedures

  • Reshaping of gum tissue to expose tooth structure if needed to place a filling
  • Reshaping gum tissue to improve the appearance of a gummy smile
  • Remove inflamed gum tissues and aid in the treatment of gum disease
  • Removing muscle attachments causing “tongue-tie”
  • Removing benign tumors from gums, palate, sides of cheeks and lips
  • Reducing pain and minimize healing of cold sores
  • Treat pain and inflammation of temporomandibular joint disorder

 

While lasers do not yet replace the traditional dental drill, or the instruments the dental hygienist uses to scale teeth, improvements in laser technology will soon offer quicker, more effective and more comfortable procedures than in the past. This is good news for all especially those of you are anxious at the thought of visiting the dentist!

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

www.webmd.com/oral-health/guide/laser-use-dentistry

www.rdhmag.com/articles/print/volume-21/dental-lasers

Lesley Ranft, The Future of Dental Lasers, Retrieved from  http://www.Consumer Guide to Dentistry

Lesley Ranft, Laser Dentistry: Enhancing Dental Treatment with Lasers, Retrieved from http://www.Consumer Guide to Dentistry

http://www.Know Your Teeth.com/infobites/abc/article What is Laser Dentistry? http://www.yourdentistryguide.com/laser/

www.dentistrytoday.com300

 

Vitamin D and Dental Health

Karen

Karen Kelley RDH

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I recently read two articles, the first by Dr. Richard Kim, a dentist who practices in New York City, and the second on the website doctorshealthpress.com. They both have information from a Boston study about the correlation of Vitamin D and Dental health. I was interested to learn that so many people have a deficiency of Vitamin D and how it can affect dental health.

This is a portion of Dr. Kim’s article:

“Medical researchers have long known that Vitamin D has many oral and overall health benefits, but there is growing concern that deficiency of this critical nutrient is more common than once thought. Understanding the benefits of Vitamin D, where it comes from and who is at risk for deficiency could make an important difference in your general and oral health.

Somewhere along the way you can probably remember being told to have plenty of calcium in your diet to build strong bones and teeth. Fortunately calcium is everywhere – readily available in many of the foods we all love like milk, cheese, ice cream and even commercially added to orange juice, breads and cereals. Perhaps you didn’t know that without Vitamin D, the body can’t absorb that calcium… no matter how much of it you swallow!

A diet lacking or low in vitamin D will contribute to a phenomena known as “ burning mouth syndrome”, symptoms of which can include dry mouth, a burning sensation of the tongue and oral tissues and a metallic or bitter taste. The condition is most common in older adults who, coincidentally, are frequently found to have a Vitamin D deficiency! Oral Health scientists have found that in addition to many general health benefits, Vitamin D helps to reduce inflammation in the body, which is widely known to have a direct impact on the development and severity of periodontal (gum and bone) disease. As a matter of fact, according to a study published in the Journal of Dentistry (1) among 6700 research participants, those who had the highest blood levels of Vitamin D were about 20% less likely to have gum disease.

Vitamin D is produced naturally by the human body when skin is exposed to sunlight, but more often than not people choose to protect themselves from the harmful effects of ultraviolet rays. Sunscreen and protective clothing may prevent getting enough vitamin D from the sun; and deficiency is common among people who live in northern latitudes or other areas that receive limited sunlight. Up to 50% of older adults have inadequate Vitamin D levels, perhaps partly due to decreased outdoor activity and sun exposure.

Although it is a rule of thumb that the best source of nutrients is a natural one, Vitamin D supplements are readily available over the counter and routinely recommended to individuals at risk for deficiency. Do you have unexplained body or mouth symptoms? Could you be at risk … or have you been recently diagnosed with low Vitamin D levels? Your doctor and dental professional can advise you about the benefits of a supplement, and a recent discovery of Vitamin D deficiency is a good reason to schedule your regular dental checkup.

1. Journal of Dentistry (2005), 33:703–10.”

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From the doctorshealthpress site:

Vitamin D isn’t just for your bones anymore.

This versatile vitamin is now showing promise in the fight against gum disease as well. According to a new study, vitamin D has both anti-inflammatory and immunomodulatory properties. (This means that it can reduce inflammation and boost your body’s ability to fight off infections.) It appears that people who have more vitamin D in their bodies run a lower risk of contracting gum disease.

The Boston-based study looked at 6,700 people who had never smoked before. They examined the gums and teeth of these people and compared their vitamin D status to the health and inflammation of their gums. Adjusting for age, previous dental work, dental hygiene, and other factors, it was found that people who had a higher intake of vitamin D also had overall healthier gums.

In fact, those who had the highest levels of the vitamin in their body reduced their risk of bleeding during oral examination by 20% when compared to patients who had the lowest intake of vitamin D.

So, if you thought this power-packed vitamin was only good for helping your bones, you were wrong. The evidence speaks for itself — vitamin D plays a double role. It acts as an anti-inflammatory and it may just help you walk out of your next dental appointment with less pain and bleeding.

So ensure that you allow your body to produce enough vitamin D. It’s a good reason to get just a few minutes of sun at least three times a week. Make sure you don’t overdo it, unless you are wearing sunscreen. If you can’t get outside, at least try taking a supplement in order to help you get all you need of this wonderful nutrient.

http://www.doctorshealthpress.com/food-and-nutrition-articles/vitamin-d-is-good-for-your-gums-too

After reading these articles, I started doing some of my own ‘research’. I began asking my patients who generally had good overall brushing and flossing habits, not stellar, but good, who’s gums generally looked healthy, but when I was scaling (cleaning) their teeth, they bled more than they should if their gums were truly healthy. (Healthy gums shouldn’t bleed!) Most of the patients that I asked told me they had been diagnosed with low Vitamin D levels! This was very interesting to me. I did some other reading about Vitamin D deficiency and found how common it is. It’s interesting to me that anyone living in the “Valley of the Sun” could be deficient in Vitamin D, but it actually is common.

I also found this article on Web MD entitled:

Keep That Smile! Calcium and Vitamin D Prevent Tooth Loss

“If you’re supplementing your diet with calcium and vitamin D to prevent bone loss, you may be more likely to hang onto your pearly whites, according to a report at this week’s meeting of the American Society for Bone and Mineral Research in Toronto. Even so, older adults need to floss their teeth and see the dentist regularly because with increased age come increased risks for losing teeth.

“Studies have shown that calcium and vitamin D decrease bone loss in the hip and forearm, but we weren’t sure if they had an effect on tooth loss,” says lead author Elizabeth Krall, MPH, PhD, a researcher at Boston University Dental School and Tufts University Nutrition Research Center. “Now we know that supplementation may also improve tooth retention, along with routine dental care and good oral hygiene,” she tells WebMD. To explore the role of supplementation on tooth retention, the researchers followed more than 140 older adults for five years. Participants took either a placebo or 500 mg of calcium plus 700 units of vitamin D daily for three years. Both during and after the trial, their teeth were examined periodically. For those who took supplements, the likelihood of losing one or more teeth was 40% less, even two years later.” ( http://www.webmd.com/oral-health/news/20000927/keep-that-smile-calcium vitamin-d-prevent-tooth-loss)

Anything that gives our patients a 40% less chance of losing a tooth and 20% less gums disease and bleeding during their dental visits is certainly worth looking into further. If a person is low in Vitamin D, it is an easy thing to implement a supplement or sun into a daily routine. The National Institute of Health recommends 10 to 15 minutes of outdoor activity two times a week to get enough Vitamin D. They also suggest for areas where they don’t have as much sun as we do, that vitamin D can be received by consuming milk, eggs, and fish. The Vitamin Council gives further instructions to individuals with periodontal (gum) disease. The Council says for someone with gum disease they may want to consider taking measures to raise their vitamin D blood levels to 40 ng/mL (100 nmol/L). They also suggest moderate UVB exposure (without sunburn) but additionally recommend oral intake of vitamin D and calcium supplements.

If you’re over 50 and have some symptoms of gum disease, ask your MD what your Vitamin D levels are now (they can do a simple blood test) and what you should be doing to raise your Vitamin D to an acceptable level.

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Keep smiling, Karen Kelley R.D.H.

 

 

Sources:

http://www.vitamindcouncil.org/health-conditions/periodontal-disease/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768179/

http://www.easy-immune-health.com/Vitamin-D-and-Teeth.html

http://www.doctorshealthpress.com/food-and-nutrition-articles/vitamin-d-is-good-for-your-gums-too

http://nydentallife.wordpress.com/author/nydentallife/

Photos:

www.hayleyhobsonblog.com

https://www.google.com/search?q=vitamin+d&rlz=1C1CHFX_enUS566US566&espv=2&source=lnms&tbm=isch&sa=X&ei=u8OkU73hM4PfoATSoYKACA&ved=0CAgQ_AUoAw&biw=1366&bih=600#facrc=_&imgdii=_&imgrc=iGoDW3mN-d0KYM%253A%3Bw3KmMBNAyyu8KM%3Bhttp%253A%252F%252Fimages.iherb.com%252Fl%252FNTA-26132-2.jpg%3Bhttp%253A%252F%252Fwww.iherb.com%252FNature-s-Answer-Vitamin-D-3-Drops-4000-IU-15-ml%252F20745%3B1600%3B1600

https://www.google.com/search?q=vitamin+d&rlz=1C1CHFX_enUS566US566&espv=2&source=lnms&tbm=isch&sa=X&ei=u8OkU73hM4PfoATSoYKACA&ved=0CAgQ_AUoAw&biw=1366&bih=600#facrc=_&imgdii=_&imgrc=cPEdvNM6b8bQsM%253A%3B9Er0cRfKFm8AnM%3Bhttp%253A%252F%252Ffibrotv.com%252Fblog%252Fwp-content%252Fuploads%252F2012%252F09%252Fvitamin-d.gif%3Bhttp%253A%252F%252Ffibrotv.com%252F2012%252F09%252Fthe-magnesium-and-vitamin-d-connection-that-most-people-do-not-know%252F%3B348%3B320

https://www.google.com/search?q=vitamin+d&rlz=1C1CHFX_enUS566US566&espv=2&source=lnms&tbm=isch&sa=X&ei=u8OkU73hM4PfoATSoYKACA&ved=0CAgQ_AUoAw&biw=1366&bih=600#facrc=_&imgdii=_&imgrc=cuDcsvoTpITxxM%253A%3BUQF-LZtVo8kWsM%3Bhttp%253A%252F%252Fwww.hayleyhobsonblog.com%252Fwp-content%252Fuploads%252F2013%252F01%252FvitaminD.jpg%3Bhttp%253A%252F%252Fwww.hayleyhobsonblog.com%252Fwhat-do-you-really-know-about-vitamin-d%252F%3B400%3B394

Flossing…Do I have to?

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Wendy Parker RDH
 
Absolutely! In some shape or form, flossing is essential in keeping the mouth and the rest of your body healthy!
As a hygienist, I have heard almost every excuse as to why people don’t floss, and trust me, I understand! From the “I’m too tired at night” to the “I just don’t have time” or the “I just forget to,” my job today is to try and make it a little simpler for you to want to floss and to help you understand why we should floss.
 
As a mother of 4 little ones, I understand that flossing isn’t a priority somedays….getting showered is. But with that, let me just say, flossing really is something that you don’t see the immediate results from, but in 20 years when you have your teeth still and you are smiling at their graduation with all your pearly whites, you will thank me.
 
So, let’s start with answering the basic questions about flossing….WHY should I floss? I brush really well!Brushing is a wonderful thing, and we are encouraged to do it twice a day, for two minutes with a fluoride toothpaste. What most people don’t realize is that brushing only reaches that tops, outside and inside surfaces of the teeth. But how to get inbetween? There really isn’t a substitute for flossing, sorry to be the bearer of bad news. Rinsing with mouthrinse or using an electric toothbrush will definitely help with keeping the mouth cleaner however, it is NOT a substitute for flossing. Plaque and bacteria form on every surface in the mouth, including the tongue and inbetween the teeth, therefore, you have to clean every surface of the teeth, not just the ones you can see. The tongue, saliva, and brushing take care of the plaque on most surfaces of the teeth, but floss truly is the only way to get the sticky plaque off the sides.The idea behind flossing is that as long as you disrupt the bacteria in the mouth once every 24 hours, you prevent it from hardening and becoming tartar. Flossing is MOST effective just before or after brushing at bedtime but really….you can do it any time of the day! Stuck in traffic? Floss. Waiting to pick the kids up? Floss. Going for a walk? Floss. Any time is a great time to floss! When you floss, it prevents Gingivitis (inflammation of the gum tissues), bleeding gums, bad breath, and will make easier dental appointments! The more you floss, the easier it becomes and the less your gums will bleed. It’s kind of like riding a bike. The first time you get one, you’re a little shaky but with practice you’ll be jumping off curbs in no time!
A lot of times people don’t floss because their gums bleed. That is because the gum tissue in that area is unhealthy so the body sends more blood to that area to help it heal. When your gums bleed, and the bacteria from the plaque and tartar are present, that bacteria gets into your bloodstream it is carried throughout the body increasing your chances of heart disease, compromising your immune system, and possibly causing an infection in the lining of your heart, which can be deadly! So, the more you floss, the healthier your gums are and the less they bleed!
 
So now that we know why, let’s focus on HOW to properly floss….

  • Starting with about 18 inches of floss, wind most of the floss around each middle finger, leaving an inch or two of floss to work with
  • Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
  • Gently curve the floss around the base of each tooth, making sure you go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue
  • Use clean sections of floss as you move from tooth to tooth
  • To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth
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The type of floss you choose is up to you. My personal favorites are Glide floss and Oral-B Satin floss. You may need to try a few different types to find the one that’s right for you. But don’t give up! It does get easier. Flossing looks simple, right? But what if you don’t have the perfect and easiest mouth to floss? Or you hate how the floss cuts off your circulation in your fingers every time? When you walk down the dental isle in any store there are so many aides to assist you, so which one is right for you? Hopefully you have already asked your hygienist this question but if not, here are a few things for you to check out the next time you are perusing the dental isle.
 
Several of my patients enjoy using floss picks. These are a great way to start your day. They don’t cut off your circulation and are totally disposable. These are great to keep a pack in your car or purse when you’re out and about.
And you can find all kinds of cute designs for your kids! Kids don’t usually become proficient at flossing until 10 or 11 years old. It’s never too young to start them on flossing. They’ll thank you later!
 

For those with braces, bridges, or large gaps between their teeth you may want to try Oral-B’s superfloss. It is a piece of floss that has one stiff end, a thicker, yarn-like middle section, and regular floss at the end. It’s hand to floss your thread through those brackets, bridges, permanent retainers, and then use the floss width that fits the area. This is a favorite of mine.
Also for places that have a little bit of a space, braces or bridges, is the interproximal brush. Some are disposable, some are reusable, just check them out and decide which one you would like. But these are great for teens who get something stuck in their teeth at school and don’t want to carry a toothbrush with them. Or for men just before business meetings.
 
And of course, there are the rubber tips toothpicks. You can go back to old school and use a regular wooden toothpick if that’s your preference but these are great. They are small, disposable, and awesome for on the go. They have a flexible rubber tip you can get inbetween tight spaces, permanent retainers, and brackets. Check them out, you may like them.
 
I know that there are several other gadgets out there but these are just a few of my personal favorites. If you see one you like, ask us about it and we’ll do the research for you to see if it’s the best one for you! But no matter what you do, just be sure that you do your best and remember what Dory from Finding Nemo says, “Just keep flossing, just keep flossing, flossing, flossing…..” Or was is swimming?

What is Normal?

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Becky Larson RDH

In my short time as a dental hygienist I have had many patient ask me about “weird” things they have noticed inside their mouths. Many patients are worried or scared they might have oral cancer. While oral cancer should be checked regularly, many times the things patients are worried about are completely normal. In general, most mouths have the same or similar anatomy. However, there are variants of normal that one person may experience over another. I have listed a few of these normal variants here:

Tori: A torus or tori (plural) is simply an excessive growth of normal compact bone, either on the floor or roof of the mouth. They develop gradually and are asymptomatic. Tori can grow into many different shapes and sizes and are covered by the normal soft tissues of the mouth. Tori may make taking radiographs very uncomfortable or painful. No treatment is needed unless the patient is having problems speaking or swallowing. Even upon removal tori may grow back.

 

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Fordyce granules: Fordyce granules are simply a cluster of sebaceous glands (glands that secrete oil, similar to a pimple) inside the mouth. Usually they occur on the inside of the cheeks or on the lips. They are yellow in color and more than 80% of adults over the age of 20 experience them. Fordyce granules are also asymptomatic and do not require treatment.

Lingual varicosities: Lingual varicosities are veins under and on the sides of the tongue. They can be red, blue, or purple in color and generally occur in clusters. Everyone has veins in and around the tongue that may vary in size, shape, or color.

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Linea alba: Linea alba is a raised, white line usually along the inside of the cheek. It occurs as a result of clenching or biting the inside of one’s cheek. No treatment is necessary.

Luekoedema: Leukoedema is a generalized opalescent appearance of the inside of the mouth. It most commonly occurs in black adults but can be seen with any ethnicity. When the mucosa is stretched the opalescence is less noticeable. No treatment is necessary.

Amalgam tattoo: Believe it or not, I have seen tattoos inside the mouth! However, an amalgam tattoo is a little different. These “tattoos” result from previous amalgam (silver) fillings where part of the filling material seeps into the tissue. It creates a bluish-gray lesion and they can occur anywhere an amalgam filling has been placed. Amalgam tattoos can look very similar to oral cancer because of their color. A biopsy can determine the difference. Amalgam tattoos generally do not require treatment.

 

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Fissured tongue: Believed to be a result of familial genetic patterns, this variant is seen in about 5% of the population. It involves deep fissures or grooves on the dorsal (backside) of the tongue. Sometimes the tongue can become irritated if food or bacteria remain in the grooves for an extended period of time. No treatment is needed other than brushing the tongue to remove food/bacteria from the surface.

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Geographic tongue: Geographic tongue appears as small, red patches on the dorsal (backside) of the tongue that are surrounded by a yellow or white perimeter. The appearance is similar to that of landmasses on a globe, hence the name “geographic” tongue. The patches may go away and return again in different areas. Stress can be a contributing factor to this condition. No treatment is needed.

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   Make sure to be aware of what is inside your mouth. We recommended oral cancer screenings at least once per year.

As always, please go see your physician if you experience any of the following:

  • Spots, lesions, or discolorations that remain longer than 2 weeks that were not previously present.
  • Any changes is size, shape, or color to pre-existing lesions.
  • Anything that causes you pain or that your dentist recommends getting checked

Happy Oral Cancer Awareness Month!

Want to learn more? Visit us at http://www.alamedadentalaz.com

Information taken from:

Ibsen, O., and Phelan, J. (2009) Oral Pathology for the Dental Hygienist. St. Louis, Missouri: Saunders Elsevier.