Radiographs

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Becky Larson RDH

Why do I need “x-rays” today?

Many patients are concerned about radiograph frequencies, fearing they are receiving too much radiation. While too much radiation is not good, I want to clarify what is too much and share some important facts about the purpose and benefits of radiographs.

Why do we need to take radiographs?

Radiographs can help dental professionals evaluate and diagnose many oral diseases and conditions. Radiographs can be used to evaluate cavities, bone levels, calculus deposits, abscesses, root apices, wisdom teeth, cysts, sinuses, growths, foreign objects, jaw joints, and/or jaw fractures. Much of what goes on in the mouth is not viewable without a radiograph. In most cases, treating patients without radiographs would be performing below the standard of care. Exceptions can be made in certain circumstances regarding pregnancy or patients who have undergone extensive radiation treatment for other reasons.

How often should radiographs be taken?

Radiograph frequencies are recommended by the American Dental Association. A “full set” of radiographs is generally 18-20 images, depending on the office. A full set is usually taken at a patient’s initial visit to the office and then every 3-5 years after. Panoramic radiographs are helpful in assessing when/if wisdom teeth need to be removed and in viewing eruption of permanent teeth in children. In these cases the dentist uses his/her clinical judgment to determine if a panoramic radiograph is necessary. “Check-up” radiographs usually consist of bitewings and anterior peri-apical radiographs. Frequency of these radiographs will vary from patient to patient but can be prescribed anywhere between 6 months and 36 months. Radiograph frequency is prescribed by the dentist based on a patient’s risk of caries or history of caries.

Xray_Dental_Panoramic_7

www.dxis.com

Am I getting too much radiation?

On average, Americans receive a radiation dose of about 0.62 rem (620 millirem) each year. We live in a radioactive world. Radiation is part of the environment and some types can’t be avoided. These include the air around us, cosmic rays, and the Earth itself. About half of our radiation dose comes from these sources. The other half of our yearly dose comes from man-made radiation sources that can include medical, commercial, and industrial sources. Medical radiographic imaging causes more radiation than dental radiographs. One dental intraoral radiograph has a radiation dose of about 0.005 rem. Similarly, a full set of radiographs at a dental office has the same amount of radiation as flying roundtrip from L.A. to New York. In this day and age many dental offices are using digital equipment to process radiographs. Digital imaging emits even less radiation (as much as 80% less) while still producing diagnostic images.

X-ray

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Radiation Safety

As dental professionals we are aware that patient’s are exposed to radiation. We take proper precautions and cover the neck, thyroid, and chest with a lead apron. We also make sure our radiology equipment has regular checks to ensure it is functioning properly. Radiographs are prescribed with the patient’s best interest at heart.

 

We look forward to helping you create that new smile that you have always wanted.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

 

Sources:

http://www.ada.org/~/media/ADA/Member%20Center/FIles/Dental_Radiographic_Examinations_2012.ashx

http://www.dentistry.com/treatments/dental-exam/dental-xrays-and-digital-technology

http://www.webmd.com/oral-health/dental-x-rays

http://www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html

http://www.livescience.com/10266-radiation-exposure-cross-country-flight.html

http://www.radiologyinfo.org/en/safety/?pg=sfty_xray

Oil Pulling

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 Lora Cook RDH

 

WHAT IS OIL PULLING?

Oil pulling is a folk remedy that has recently been growing in popularity, mostly due to social media.  This is an ancient Indian practice, an ancient Ayurvedic ritual.  The origins come from Indian  medicine.  Most recently Dr F. Karach, MD. introduced it to the modern world in 1992.  This practice is promoted as a supplement to regular daily hygiene practice along with brushing and flossing. It involves swishing with a tablespoon of oil.

 

HOW IS OIL PULLING PRACTICED? 

Take a tablespoon of a plant based cold pressed organic oil and swish for twenty minutes, then spit.  Some oils that are recommended are sesame, coconut, sunflower, or olive oil.  The oil will then mix with the saliva and the claims are the oil works to pull out toxins and kill certain types of bacteria.  Depending on which website that you read, oil pulling claims to have a long list of positive results.

 

THE ORAL BENEFITS THAT HAVE BEEN CLAIMED.

Reducing plaque

Reduction in the overall oral bacterial load

Reduces inflammation in the gum tissue

Whitens teeth

Fresher breath

oil-pulling-1

 

OTHER BENEFITS

Migraine headache relief

Correcting hormone imbalances

Reducing inflammation of arthritis

May help with gastroenteritis

Aids in reduction of eczema

May reduce symptoms of bronchitis

Helps support normal kidney function

May help reduce sinus congestion

Reduced hangover after alcohol consumption

Reduces he symptoms of allergies

Helps detoxify the body of harmful metals and organisms

 

The big question is… Do any of these claims have any validity?  There is little formal trial data published about the practice of oil pulling.  The ADA states that insufficient research has been done.  The Canadian Dental Association states, “oil pullling won’t do any harm, however not convinced there are any benefits.”

 

We look forward to helping you create that new smile that you have always wanted.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

 

 

 

Source: 

http://jillee_uploads.s3.amazonaws.com/2013/07/oil-pulling

http://authoritynutrition.com/oil-pulling-coconut-oil/

http://www.sciencebasedmedicine.org/oil-pulling-your-leg/

http://authoritynutrition.com/oil-pulling-coconut-oil/

Invisalign

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Amanda Orvis RDH 

 invisalignlogo

 

Invisalign is a uniquely designed orthodontic treatment developed to correct mild to severe cases of malocclusion, including crowding, protruding or crooked teeth, overbites and/or underbites. Invisalign is an affordable option for correcting most dental malocclusion problems.

 

WHAT MAKES INVISALIGN DIFFERENT?

 

You may be asking yourself, what is the difference between Invisalign and traditional braces? With Invisalign you can achieve very similar if not the same outcomes as traditional braces. The advantages of Invisalign are the comfort, flexibility, and ease of access to properly care for your teeth without having brackets, wires or rubber bands in your mouth.

invisalign-vs-braces

 

Invisalign uses a series of aligners to straighten your teeth over the course of your treatment. Aligners are smooth plastic trays that you wear over your teeth. Each set of aligners is worn for a few weeks before changing to a new set.

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ADVANTAGES

 

The great thing about Invisalign is that there are no personal sacrifices in terms of food! You do not have to give up popcorn, chips, bagels, pizza crust, pretzels, nuts, apples, carrots, or corn on the cob. Fortunately, Invisalign aligners are removable, therefore allowing you to eat and drink as well as brush and floss your teeth as you would normally do. The aligners are worn for 20-22 hours a day while they gradually move your teeth into their correct positions. The aligners should only be removed to eat as well as brush and floss your teeth.

 

HEALTHIER TEETH AND GUMS

 

Often times crowding or malocclusion issues can lead to swollen, red, bleeding gums. These are signs of periodontal disease. By properly aligning the teeth, inflammation is reduced, allowing your gum tissue to fit properly around the teeth. This provides a defense against potential periodontal problems.

Food debris and plaque build-up can lead to tooth decay. In order to maintain strong healthy teeth, simply remove your aligners and brush and floss as you would normally do. Try to avoid eating and/or drinking while your aligners are in your mouth.

 

THE INVISALIGN PROCESS

  1. Talk to your dentist about your interest in Invisalign.
  2. Your dentist will take impressions and photos and send them off to Invisalign. A customized treatment plan will be created just for you.
  3. After your treatment plan is created, you will then go into your dental office for a brief viewing of a virtual presentation of your anticipated final outcomes.
  4. Upon your approval of your anticipated outcomes, Invisalign then fabricates your series of aligners and sends them to your dental office.
  5. Your dental office will then call you to schedule an appointment for you to come in and receive your first set of aligners.
  6. Over the course of your Invisalign treatment you will change out your aligners every few weeks.
  7. After the completion of all of your aligners, retainers are then made to keep your teeth in their new positions to keep that new smile looking great.

We look forward to helping you create that new smile that you have always wanted.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

 Sources:

 

https://www.google.com/search?q=invisalign+logo&source=lnms&tbm=isch&sa=X&ei=McLNU4HYBsyRigKMrYHgBg&sqi=2&ved=0CAYQ_AUoAQ&biw=1455&bih=649&dpr=1.1#facrc=_&imgdii=_&imgrc=ppEm1tcLQDsWdM%253A%3BHoiq8xzkzJxlAM%3Bhttp%253A%252F%252Fwww.sleepdentists.com%252Fimages%252FInvisalign.jpg%3Bhttp%253A%252F%252Fwww.sleepdentists.com%252Finvisalign.html%3B1688%3B677

 

http://www.invisalign.com/how-invisalign-works

 

https://www.google.com/search?q=invisalign+vs+braces&tbm=isch&imgil=XUGHWDXfdD2a-M%253A%253Bhttps%253A%252F%252Fencrypted-tbn3.gstatic.com%252Fimages%253Fq%253Dtbn%253AANd9GcRvBYeXNPP9sv-xb4J-Gtrx9qQymztXqkddcgUFH5qLhUDpEOs-Xw%253B620%253B350%253BKd_nANmUSaFf6M%253Bhttp%25253A%25252F%25252Fwww.masriortho.com%25252Finvisalign-vs-braces&source=iu&usg=__PRQlvmHglFglwqVUOmV6SXSAbUQ%3D&sa=X&ei=8ZysU-6IHImDogSj7ICwAQ&sqi=2&ved=0CFEQ9QEwAg&biw=2133&bih=975&dpr=0.75#facrc=_&imgdii=_&imgrc=XUGHWDXfdD2a-M%253A%3BKd_nANmUSaFf6M%3Bhttp%253A%252F%252Fwww.masriortho.com%252Fwp-content%252Fuploads%252F2013%252F05%252Finvisalign-vs-braces.jpg%3Bhttp%253A%252F%252Fwww.masriortho.com%252Finvisalign-vs-braces%3B620%3B350

 

https://www.google.com/search?q=invisalign+vs+braces&tbm=isch&imgil=XUGHWDXfdD2a-M%253A%253Bhttps%253A%252F%252Fencrypted-tbn3.gstatic.com%252Fimages%253Fq%253Dtbn%253AANd9GcRvBYeXNPP9sv-xb4J-Gtrx9qQymztXqkddcgUFH5qLhUDpEOs-Xw%253B620%253B350%253BKd_nANmUSaFf6M%253Bhttp%25253A%25252F%25252Fwww.masriortho.com%25252Finvisalign-vs-braces&source=iu&usg=__PRQlvmHglFglwqVUOmV6SXSAbUQ%3D&sa=X&ei=8ZysU-6IHImDogSj7ICwAQ&sqi=2&ved=0CFEQ9QEwAg&biw=2133&bih=975&dpr=0.75#facrc=_&imgdii=_&imgrc=JTAejR9TeI5dYM%253A%3BfgICUBiM2Ty84M%3Bhttp%253A%252F%252Fwww.212smiling.com%252Fwp-content%252Fuploads%252F2013%252F02%252Fbody-1.jpg%3Bhttp%253A%252F%252Fwww.212smiling.com%252Fblog%252F2013%252F03%252Finvisalign-vs-braces-which-option-is-better-for-you%252F%3B607%3B171

HELP! I Need A Good Nights Sleep!

Kim McCrady

Kim McCrady RDH BS

     I have been happily married for over 20 years to a wonderful man.  In fact, he is the man of my dreams.  The trouble is I am not doing much dreaming.  You see, my knight in shining armor snores!  He snores so much that I find it difficult to sleep. Each night, I stare at the blades of the ceiling fan.  Almost in rhythm with each exhale and spin of the fan, my sweetie lets out a sound that makes me think Darth Vader lives with me.

darthvadar

Snoring can be more than an annoyance.  It can be a sign of greater and or more serious medical problems.  It is very important to see your medical doctor if you or your partner are complaining about snoring.   Though a medical examination and possibly sleep studies, your medical team can determine if you are a candidate for appliances to help keep you healthy and properly rested.

However, if your medical team determines you are in good health, but just closely related to Darth Vader, your dental team can fabricate a small anti-snoring appliance.  This comfortable appliance is worn completely inside the mouth and carefully repositions the lower jaw to allow for a more open airway during sleep.  If you would like more information about snoring appliances, please contact us for a complimentary consultation.

Let’s all enjoy a Good Nights Sleep!

silent-nite

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com/

http://www.alamedadentalaz.com/

 Sources:

http://distilleryimage5.s3.amazonaws.com.

http://www.glidewelldental.com/dentist/services/removables-silent-nite.aspx

Vitamin D and Dental Health

Karen

Karen Kelley RDH

 images

 

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.

vitamin-d

 

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

How to help with braces cuts or sores?

Kara

 

Kara Johansen BSRDH

If you have ever had braces you know that there are many annoying side effects of working towards a beautiful, healthy, straight smile. Often orthodontic problems that can be taken care of at home before you can make it to your orthodontist office. Here is a list of tips to help the fellow brace face 🙂

Newly tightened braces-

Each time you get your braces tightened it means one step closer to removing them. However, it does make your teeth ache. They can be sore for 3-5 days. One study stated that 91% of adolescents had tooth discomfort during the process of having braces. (1)

  • Before you go into have your teeth adjusted it has been suggested to take an ibuprofen. Remember to only take the medication as directed on the bottle. Take the ibuprofen with milk or food to avoid a stomach ache.
  • After the appointment stick with soft foods like soup or smoothies. Some have said that cool foods feel good on newly tightened teeth.
  • One study stated that chewing sugar free gum after the procedure can cause relief. Aspergum, which is a gum with a little bit of aspirin had a good response in pain reduction. (2)

Sores from braces

A common side effect of braces are cuts in the cheek or canker sores.

  • A warm salt water rinse works wonders. Put a teaspoon of salt into a warm glass of water then swish and spit.
  • Over the counter anesthetic gels have shown to give relief. Orabase or Oragel can help.
  • A tea bag can be placed over the sore to help with sensitivity and inflammation.

Wire pocking lips and gums-

Sometimes when you are eating or brushing a twisted wire can be moved out of place. Remember that lots of times this situation can be avoided with eating the proper foods recommended by your orthodontist. There are a couple of solutions for this predicament.

  • Flexible wires can slip out of the bracket slots on the back teeth. A sterile tweezer can be used to slip the wire into the tube and back into place.
  • You can use the end of a pencil eraser to push the out of place wire behind the arch wire to make it more comfortable. Only do this on softer wires.
  • Dental wax can also be used to be placed around the wire to protect your tissues until you can see your orthodontist to get it fixed.


orthowax

http://us-professional.gumbrand.com/gumr-orthodontic-wax-mint-with-vitamin-e-and-aloe.html

relief-wax-colored

http://www.dental-wax.com/

Loose bracket or band-

If a bracket or band becomes loose you can place wax over the area to hold it into place. If it falls off, save it for when you go back to your orthodontist.

Swollen or puffy gums-

Proper oral hygiene is very important when you have braces. Improper oral hygiene can cause weakening of the enamel (white/dark brown spots), permanent inflamed gums, bleeding gums, halitosis, and cavities.

  • Brush and floss after every meal. Most important is to brush and floss before you go to bed.
  • If you have swollen gums call your general dentist to get a cleaning. It is a good idea to have cleanings every 3 months when you have braces instead of every 6 months. Have your arch wire taken out before your cleanings.
  • Super Floss, floss threaders, interproximal brushes, and Platypus flossers are very helpful.
  • Electronic toothbrushes are a better choice for cleaning your teeth and braces then a manual tooth brush. Water picks are also helpful to remove food debris.

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www.oralb.com www.gumbrand.com www.PlatypusCo.com

 

Sources:

1. Attitudes and perceptions of adults towards orthodontic treatment in an Asian community. Lew KK Community Dent Oral Epidemiol. 1993 Feb; 21(1):31-5. [PubMed] [Ref list]

2. Proffit W R. Contemporary orthodontics. 3rd edn. St Louis: The CV Mosby Company; 2000. [Ref list]

3. http://www.orthocenters.org/emergency.php

What is Normal?

KO6A3321-Edit

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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http://images.radiopaedia.org/images/551480/4e2fd78cc550f4e33c48c0a31a8c64.jpeg

 

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.

lingual_varicosities-142CFA6D1EC5BDDC9F0[1]

 

http://classconnection.s3.amazonaws.com/107/flashcards/2728107/jpg/lingual_varicosities-142CFA6D1EC5BDDC9F0.jpg

 

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.

 

Amalgam_Tattoo_in_the_association_with_an_upper_molar-400x461[1]

http://drjohnart.com/wp-content/uploads/2012/05/Amalgam_Tattoo_in_the_association_with_an_upper_molar-400×461.png

 

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.

Fissured_tongue[1]

 

http://doctorspiller.com/images/OralAnatomy/Fissured_tongue.jpg

 

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.

Geographic-tongue-5[1]

 

http://medicalpicturesinfo.com/wp-content/uploads/2011/08/Geographic-tongue-5.jpg

 

   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.

Oral Cancer Monthly Self Exam

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Amanda Orvis RDH

The prevalence of oral cancer is on the rise; in fact one person dies per hour from oral cancer. In the early stages oral cancer can often times go unnoticed. It can be painless and not obvious to the naked eye. The most common areas for oral cancer are the floor of the mouth & sides of the tongue. That being said, oral cancer can be found in various locations as well as a variety of shapes, colors and sizes. It is important that you perform monthly oral self-exams. If you notice any suspicious areas that do not go away within seven to fourteen days make an appointment with your dentist to have them checked. Remember early detection saves lives.

OCF_wristband-2T

How to perform a monthly self-exam:

Supplies: Flash light and a mirror

Steps:

  • Take a moment to look at the skin on your face and neck in the mirror. Look for any changes in the color of your skin, any changes in moles or beauty marks, any swelling, lumps or sores.
  • Use both hands to gently feel along the outside of your cheeks, your lower jaw bone, your jaw joint, in front of and behind both ears. Checking for any areas that do not feel uniform on both sides, any lumps and/or any areas that are swollen or tender.
  • Gently use both hands to feel down the sides of your neck, follow the path along the neck muscles. Gently place your fingertips around your “Adam’s Apple” and swallow. Try to notice if it moves up and down normally or if there is any deviation.
  • Gently use both hands to feel the tissue above and around your clavicles for any swollen or tender areas, or areas that do not feel uniform on both sides.
  • Remove any removable dentures or appliances from your mouth.
  • Use the flashlight to check the roof of your mouth for changes in color or texture. Use your index finger to lightly sweep the roof of your mouth to feel for any lumps or swellings.
  • Pull out your upper lip and then your lower lip looking for any changes in color, size and/or texture. Gently squeeze each lip and cheek with your thumb and index finger feeling for any lumps or tender areas.
  • Using your fingers gently pull your tongue forward and check the back of your throat. Also check all the surfaces of the tongue and the floor of your mouth looking for any changes in color, size and/or texture in the tissue.
  • Lift your tongue to the roof of your mouth. Using both of your index fingers gently place one index finger on the floor of your mouth and the other index finger under your chin and press your fingers towards each other feeling for any swellings or tenderness along the floor of the mouth.
  • Look at your gums for any change in color and/or texture. Run a finger around all the surfaces of your gums feeling for any swollen or tender areas. \

What to look for specifically:

  • White patches
  • Red patches
  • Sores that fail to heal
  • Lumps, bumps or masses
  • Any areas that are differ from one side to another

 

oral-cancer

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

 

Sources:

http://myoms.org/procedures/head-neck-and-oral-cancer

http://fightoralcancer.org/information/images/

http://www.sixstepscreening.org/wp-content/uploads/SixStepScreening.pdf

http://oralcancerfoundation.org/

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=lh3dem7gJGMA5M&tbnid=lSyDf2Zx6tGb8M:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.ocfstore.org%2Foral_cancer_wristbands_p%2Focf_wristband.htm&ei=73M9U_K4DuO0yAGh6IDABA&bvm=bv.63934634,d.aWc&psig=AFQjCNE7TOClwAu96v2KHsbn1XlrAdQ49w&ust=1396622626125563

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=osKRQqBu-J5qcM&tbnid=o3zZpWEozQnX-M:&ved=0CAUQjRw&url=https%3A%2F%2Fstjamesdentalgroupcudahy.wordpress.com%2Ftag%2Foral-cancer-self-exam%2F&ei=YXQ9U6uJBaKQyAGt9oHQDw&bvm=bv.63934634,d.aWc&psig=AFQjCNFoFpa18hNHhvzAAzKxqgandu3-2Q&ust=1396622812272438

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=JWvDkHxnv4okFM&tbnid=VRZ3RjtVWC5AKM:&ved=0CAUQjRw&url=http%3A%2F%2Flaneendsdental.wordpress.com%2F2013%2F06%2F15%2Fmouth-oral-cancer-in-the-news%2F&ei=zHU9U_XoB6_lygHGu4HQDA&psig=AFQjCNEyDetzw_20EKBCjYSVXCnqHqZW5A&ust=1396623042961165

 

Dental Insurance 101

Kim McCrady

Kim McCrady RDH BS

Dental insurance can be a confusing subject to even the savviest subscriber.  Why?  They make it confusing for a reason. Dental insurance companies are in business to make money for their stockholders and to pay out as little as possible on YOUR dental claims. Did you know, on average an insurance company has a goal to pay out less than 35% of your total maximum annual benefits?  That is roughly $350 per patient per year.  That covers routine exams, x-rays and routine dental cleaning twice in a 12-month period of time.   The good news is we are here to help you navigate the gauntlet and get your moneys worth from your plan.

1-     Know your dental insurance plan.  A common mistake is to assume your medical and your dental insurance are the same company.  Almost always, this is not the case.  Interestingly,  many dental insurance companies do not provide you with an ID card.  The solution is to ask your HR department.  They should be able to provide you with the name and the phone number of your dental insurance carrier. EX:

imgres (2)

www.deltadentalva.com

2-     Providing accurate information to your dental office is the first step to getting your claims paid.  You will need your subscriber ID number and the subscribers’ date of birth and the patients date of birth.  You should know many companies still use your social security number to identify you in their system.  If you are uncomfortable with them using your social security number you can request a unique ID number.

3-     Know your annual deductible.  Almost every dental plan has a deductible they require you to satisfy before they begin to pay out benefits on your dental claims.  This deductible can vary in amount.  There are usually individual and family deductibles.  Family deductibles are often three times the individual deductible. Deductibles can apply to any dental service billed to your insurance company.

4-     Many plans do NOT reset your annual benefits in January.  You should know your benefit year.  This is important so you do not leave unused benefits to the insurance plan.  By knowing your plan year, you can maximize your coverage.

5-     Your plan has a maximum amount of benefits they will pay on each family member each benefit year.  The average maximum benefit is $1500 per year.

6-     Although your plan has a maximum amount of benefits per year that are earmarked for your care, the insurance companies pay out your benefits on a percentage scale, NOT at 100% per claim until you have reached your maximum.   This scale usually has three categories for dental services:

1-Preventative

2-Basic

3-Major

Each insurance company places dental services into a category.  It is important to know how your plan categorizes services so you can better understand you estimated coverage from you dental plan.

7-     When your dental office estimates insurance coverage for the dental services you are receiving from the office, it is only as ESTIMATE.  Any time you or your dental office call your insurance carrier, the insurance company representatives often read a disclaimer to inform you a description of benefits is NOT a guarantee of payment.  It can be very difficult to provide an accurate estimate of insurance coverage.  You should expect a down payment for your care and a balance bill after your carrier has processed your claim.

8-     Once your dental claim has processed and your plan has paid their percentage of the services to your dentist, you receive an explanation of benefits (EOB).  Many people do not even open their EOB’s and read them.   They can be very complex, but very informative.  EOB’s include the fees billed to your plan for services rendered, payments made by the insurance company on your claim and the patient portion for the services.  Often, your plan will include any notes explaining adjustments to payments, including subjecting the claim to frequency limits for services, other exclusions including a feature referred to as down coding.

eob-sample

www.bcbs.com

9-     Down coding is a loophole insurance companies have instituted that allows them to pay their contracted percentage on a lesser service.  The two most common down coded procedures are tooth colored crowns and tooth colored fillings on back (posterior) teeth.   For example, if a tooth colored filling costs $200 and you have 80% coverage on basic services, most plans will not pay the $160.  They will “down code” to minimize their responsibility for the services.   Therefore, the claim will be received at $200, subjected to your deductible, down coded to a fee for a lesser service, such as a silver filling at $140.  Assuming a $50 deductible, the insurance will pay their 80% on $90 instead of $200.  This nets a total insurance payment of $72 on your $200 claim and a $128 patient portion.

10- But what if you have a secondary plan to help with your dental claims? Be careful and DO NOT assume your secondary plan will pick up the patient portion for your primary claim.  You need to be sure you know if your secondary plan has a “non-duplication of benefits clause”.  This means your secondary plan will only pay the difference between what your primary plan covered and what they would have covered if they had been primary.  For example, if a claim is submitted for $1000 for dental services to your primary insurance company and your primary covers the service at 50% (assuming the deductible is satisfied and there is no down coding) the primary should pay $500.  If you have a non-duplication of benefits clause, the secondary will not pay the patient balance of $500 to complete the claim if, they too, would have covered the services at 50%.  But let’s say the secondary plan had 60% coverage for the services rendered and would have paid $600 on the claim.    Then they should make payment of an additional $100 so the total insurance payments received between the two plans is equal to the payment they would have made, had they been the primary plan.  Secondary insurance often is most beneficial when the primary plan has been maxed out and the secondary begins to pay benefits for care.

In plain English, dental insurance is very different than medical.  There are no set co-payments for each office visit.  Each visit is considered by your plan once it is received and processed according to the guidelines and limitations of your plan.  There are thousands of dental plans with thousands of loopholes and limitations.  And it seems the limitations are changing on a daily basis.

Your best bet to successfully utilize your dental insurance coverage is to join forces with your dental office administrators.   They spend hours obtaining breakdowns of benefits, applying this information to your care plan, sending the claim with all supporting documentation, following up on the claim weekly to assure payment on your behalf and will often have to repeat the process for you when the insurance company claims to have not received the information.  Be kind to them.  They are working for you to get you more than the average 35% of your benefits.

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

Essential Oils

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Lora Cook RDH

     Recently several of my patients have asked me some questions about essential oils. To be honest I have a very limited knowledge of the subject. I hate when I don’t have all the answers for my patients. So I thought what better way to learn more about the subject then to write about it.

    However, let me preface this information with a reminder that while these essential oils can provide effective preventive and palliative care, it is not a substitute for dental care. If you have a cavity or a toothache please do not hesitate to give us a call. Periodontal disease and cavities left untreated will only become worse over time.

     As dental professionals we rely on tested clinical research and published research studies wither certain guidelines to substantiate any therapeutic claims and demonstrate effectiveness. However with essential oils there is little published research, because several problems present in trying to conduct research on essential oils. First, essential oils are not standardized. Synthetic Pharmaceuticals are reproduced to be identical, where as essential oils cannot be produced to be identical. Second, while conducting research on essential oils it is difficult to gage for individual differences in how the oils affect people. Also little funding is provided for research on homeopathic remedies. More research studies are done for synthetic therapeutics because these follow the usual scientific research path.

The Essential oils that I would like to talk about are:

  1. Cinnamon oil: bark and leaf
  2. Tea Tree oil
  3. Myrrh
  4. Clove oil
  5. Peppermint oil

1. Cinnamon:

product-rcd-346

risdoninternational.com

  • Leaf oil is primarily useful for palliative care. It may be effective in reducing pain and inflammation.
  •  Cinnamon Bark Oil has antibacterial qualities, it has been shown to effectively destroy 21 different types of bacteria.
  • How to use: You can rinse with diluted cinnamon oil after brushing, or put some on your tooth paste. Cinnamon oil is very strong and should not be ingested. Also some people have been known to have allergic reactions to cinnamon oil, so test in a small area of your mouth first.

2. Tea Tree Oil: This oil is effective for antibacterial, anti-fungal, and antiviral properties.

  • If you have a allergy to celery or thyme, you should not use this oil. Also just like the cinnamon oil, tea tree oil is very strong and should not be ingested.
  • How to use: There are wooded toothpicks that have been impregnated with tea tree oil. These can be found at a health food store, or purchased on-line. You can also mix a small amount with your toothpaste, then brush.

3. Myrrh: This is effective for mouth sores.

hu

doterrablog.com

  • How to use: Mix 1 to 2 drops in eight ounce glass of warm water, swish for thirty seconds then spit.

myrrh_gum_resin

http://www.mountainroseherbs.com

4. Clove Oil: This is effective for toothaches, also known to sooth sore gums.

cloves

libweb5.princeton.edu

  • How to use: Mix one drop with a plant based carrier oil, olive oil wood be a good carrier oil to use. Then apply with a cotton swab. For gum tissue and other oral tissues mix 1 to 2 drops in eight ounce glass of warm water, swish for thirty seconds then spit.

5. Peppermint Oil: This oil is effective in treating bad breath, it also has mild anesthetic properties.

peppermint-oil1-2

www.lalaessentialoils.com

  • How to use: Mix two drops of peppermint oil with two cups of distilled water. Shake we’ll before each use, swish a mouthful for one minute then spit. All essential oils should not be ingested, and always consult your medical physician before starting any type of therapy at home.

There are other essential oils that are effective for oral health that I did not include in this overview: basil, almond and lavender, just to name a few.  I hope that these basic guidelines can shed a bit more light on the subject.  All essential oils should not be ingested, and always consult your medical physician before starting any type of therapy at home.

Sources:

http://www.livestrong.com/article/284574-cinnamon-oil-for-cavities/

http://www.teatree.co.il/en/Files/oral.pdf

http://www.intelligentdental.com/2010/11/30/how-to-use-tea-tree-oil-for-dental-health/

http://birchhillhappenings.com/mouth.htm