The following article was published by the National Institute of Dental and Craniofacial Reasearch in March of this year:

Numerous studies have suggested that the best way to fight chronic periodontitis is with a one-two therapeutic punch. First, a periodontist must scale and plane the roots (SRP) of the affected teeth to clear away noxious bacteria. Second, patients should take an antibiotic pill over several days to control the infection and thus allow the gingival tissues to heal. Still largely undetermined is whether some commonly prescribed antibiotics are more effective than others in returning the gingiva back to good health. In the March issue of the Journal of Clinical Periodontology, NIDCR grantees take a closer look at this issue. They randomly assigned 92 people with chronic periodontitis to receive SRP alone or SPR in combination with one of three antibiotics. The antibiotics, which were chosen because of their different dosage regimes and mechanisms of action, were: azithromycin, metronidazole, or a sub-antimicrobial dose of doxycycline. After one year of followup, they found that patients in all four treatment groups had clinical improvement, particularly in reducing the depth of periodontal pockets and improving tooth attachment. The researchers also found that all three antibiotic and SRP regimens provided a slightly better clinical outcome than SRP alone, particularly when treating periodontal pockets greater than 6 mm at baseline. Although patients randomized to the SRP/metronidazole group had greater improvement on average in attachment loss, no antibiotic was clearly superior. In fact, a number of patients in all treatment groups had attachment loss at the one-year mark. These numbers ranged from 15 to 32 percent in SRP/antibiotic groups to 39 percent in those who received SRP only. As the authors noted, this indicates that more work is needed to learn how to tailor treatment and match it to a patient’s specific needs.

The conclusion, that scaling and root planing in conjunction with an antibiotic therapy afterwards works slightly better than scaling and root planing alone, still needs further study to determine how to properly apply these findings to individual treatment plans.

According to the American Acedemy of Pediatric Dentistry, cheese stimulates the flow of saliva. Salivary flow is the body’s natural defense against cavities by helping to clear the mouth of food debris and protect teeth from decay causing acids. The calcium and phosphorus found in cheese also help to re-mineralize the enamel and keep the saliva from being too acidic.

Often the problem goes away on its own in several weeks to months. If you have recently experienced TMJ pain and/or dysfunction, you may find relief with some or all of the following therapies:

	Moist Heat: Moist heat from a heat pack or a hot water bottle wrapped in a warm, moist towel can improve function and reduce pain. Be careful to avoid burning yourself when using heat.
	Ice: Ice packs can decrease inflammation and also numb pain and promote healing. Do not place an ice pack directly on your skin. Keep the pack wrapped in a clean cloth while you are using it. Do not use an ice pack for more than 10 – 15 minutes.
	Soft Diet: Soft or blended foods allow the jaw to rest temporarily. Remember to avoid hard, crunchy, and chewy foods. Do not stretch your mouth to accommodate corn on the cob or whole fruits.
	Over the-Counter Analgesics: Over-the-counter analgesics are helpful in temporarily reducing pain. Be sure to check with your doctor before taking any kind of medication over any prolonged period of time as indicated on the label.
	Jaw Exercises: Slow, gentle jaw exercises may help increase jaw mobility. Your health care provider or a physical therapist can evaluate your condition and suggest appropriate exercises based on your individual needs.
	Relaxation Techniques: Relaxation and guided imagery can be helpful in dealing with the pain that accompanies TMJ dysfunction. Deep, slow breathing enhances relaxation and modulates pain sensations.

FLUORIDE FACTS

• The benefits of fluoride were discovered in one of nature’s own experiments — the incidence of dental carries proved to be fifty percent less in areas with naturally fluoridated water, while the incidence of major diseases in these areas was the same as in the general population. Studies of large numbers of people over many generations have attested to the value of fluoride as a safe and effective nutritional supplement for the prevention of tooth decay.
• Fluoride has been added to drinkin water for almost fifty years, and follow-up studies have validated the cavity-lowering effects of fluoride supplementation and failed to show any increase in diseases due to this public health measure.
• According to public health officials, fluoride supplementation ranks along with water purification and vaccines as one of the top public health measures of the 20th century.
• The American Academy of Pediatrics, the U.S. Public Health Department, and the American Dental Association have all recommended that from six months to sixteen years growing children with growing teeth should receive fluoride supplements either in their diet or in the water they drink. Continue Reading »

Fluoride supplements put children six and under at significant risk of permanently discolored teeth, according to a review of studies recently posted on the American Dental Association’s (ADA) website in their new section, “evidence-based dentistry,” for dentists and their patients. (1)

Fluoride supplements, in graduating amounts up to 1 mg daily, are often prescribed to children who don’t drink fluoridated water, ostensibly to reduce tooth decay.

“This review confirmed that in non-fluoridated communities the use of fluoride supplements during the first 6 years of life is associated with a significant increase in the risk of developing dental fluorosis, write researchers Ismail & Bandekar and first published in Community Dentistry and Oral Epidemiology, February 1999, (2) but posted to the ADA’s website July 2007.

Fluoride ingestion, once thought to reduce cavities, can lead to dental fluorosis — white spotted, yellow, brown and/or pitted tooth enamel. Modern science indicates fluoride absorbs into tooth enamel topically, primarily.(3)

Studies link dental fluorosis to children’s kidney damage (4) and bone fractures (5).

The ADA and Centers for Disease Control recently advised that fluoridated water should not be mixed into concentrated infant formula, in order to decrease dental fluorosis risk — now a growing U.S. problem. (6)

Never safety-tested by the U.S. Food and Drug Administration) (7), fluoride supplements do more harm than good.(8)

“While fluoride is proclaimed a significant cavity reducer, there is little, if any, science to support that,” says lawyer Paul Beeber, President, New York State Coalition Opposed to Fluoridation.

A National Institutes of Health 2001 news release supports Beeber’s assertion: “… the (NIH) panel was disappointed in the overall quality of the clinical data that it reviewed. According to the panel, far too many studies were small, poorly described, or otherwise methodologically flawed.” (9) Over 560 studies evaluated fluoride among those evaluated by the NIH Consensus Development Program panel for the Diagnosis and Management of Dental Caries.

Recent research shows that fluoridation delivers risks with little, if any, benefit.(10)

“Save money, save our health, save the planet. Stop fluoridation,” says Beeber.

For the References numbered above click link below:

http://www.medicalnewstoday.com/articles/76975.php

I am happy to welcome you to my blog here at Toothhaven.com. It is my sincerest hope to provide meaningful information for people regarding many areas of common interest and concern in dentistry. I will try to keep information posted on newer developments as well as clarifications to questions asked by many patients. Please browse freely through the articles, subscribe to the RSS feeds if you like. If you have comments for me that you do not wish to be public, you may go to the “appointments” menu and click the “contact us” submenu where you can leave private comments I will receive by email. Wherever appropriate, I will be sure to answer. Thank you again for your visit,

Steven J. Brazis DDS

I need to have some cavities filled. Is this safe to do while breastfeeding?

Yes. Since only a small amount of local anesthetic is used, only an insignificant amount could get into your milk, so it is safe to breastfeed following a local anesthetic for dental work. Also, dental x-rays pose no problem to the breastfeeding mother or baby.

Breastfeeding is also usually considered safe following a light anesthesia , which is the type used in dental offices when patients don’t want to be awake and aware during dental work. Since the inhalant (usually nitrous oxide ) is cleared so rapidly from your bloodstream, it is unlikely to enter your milk in significant quantities.

Unless your doctor advises to the contrary, it is safe to breastfeed as soon as you are able. If there is somespecific concern about the anesthetic passing into your milk, breastfeed your baby before the anesthetic is administered, followed by a 3-4 hour wait for the next feeding. Your doctor will be able to advise you on how rapidly the particular medicine would clear your system.

Delta Dental Coverage for Pregnant Women and Implants

Delta Dental of California announced that it has added 2 additional benefits to its standard commercial fee-for-service programs: implant coverage and additional cleaning and exams for pregnant women.

The enhanced benefits are now being offered to all new commercial client groups as well as to client groups renewing their Delta Dental Premier and Delta Dental PPO contracts at no additional charge to the insured.

Implant coverage, which for many years has been available as a rider, will now be included as a standard benefit.¬¨‚Ć benefits for pregnant women included an additional oral exam as well as an additional cleaning or for patients with signs of perio disease, additional perio scaling/root planing of up to all 4 quads.¬¨‚Ć “By offering implant coverage as a standard benefit, we are enabling patients to have more choices to replace lost teeth”,¬¨‚Ć The efficacy of implants is a proven, viable¬¨‚Ć clinical alternative, and the coverage helps make it more affordable.

The additional benefit for pregnant women was added because, while it has not been conclusively proven that perio disease directly results in low-weight, pre-term babies, an extra cleaning and oral exam are both safe and beneficial.

Eventually these benefits will be rolled out to clients in 15 other states, + DC.

For detailed info contact Delta Dental of CA, Jeff Album, 415-972-8418.