Posts for: June, 2020
Like the rest of healthcare, antibiotics have transformed dentistry. Advanced oral infections that once eluded successful treatment are routinely stopped with the use of these “wonder drugs.” But their overuse over the years has given rise to dangerous “superbugs” resistant to many antibiotics.
Antibiotics are one of the 20th Century's most significant healthcare achievements. Drugs like penicillin played a major role ending the global threat of tuberculosis, cholera and bacterial meningitis. Over the last few decades, more antibiotics have been developed to defend against an even wider array of bacterial dangers.
But along the way doctors and dentists began prescribing antibiotics for all manner of illnesses including viral infections like colds or flu for which they're less effective. They've also been increasingly used as a preventive measure, including inclusion in animal feed to fight disease.
But our tiny biological nemeses are adaptable. As bacterial strains come in contact with greater amounts of antibiotics, individual bacterium that survive transmit their resistance to subsequent generations. This can produce new strains like Staphylococcus aureus (MRSA) that are resistant to methicillin and other common antibiotics that once contained them.
There's deep concern that these new resistant strains, often recent incarnations of old diseases once thought defeated, will lead to higher rates of sickness and death. Increasing resistance could also make common procedures like those performed by dentists and oral surgeons, much riskier to undertake.
To combat this, pharmaceutical companies are racing to create new drugs to compensate. Recently, they've received an encouraging sign of hope in this battle from an unlikely source: viruses. Researchers in Tel Aviv, Israel have discovered an antagonistic protein to bacteria among a group of viruses called bacteriophages. The protein, injected into a bacterium, commandeers the cell's DNA function to aid virus reproduction, which kills the host.
In the words of one researcher, this makes these particular “enemy of our enemy” viruses our “friend.” Although the discovery is still a long way from practical use in antibiotics, harnessing it in future drug versions could help pack a greater punch against resistant bacteria.
In the meantime, providers and patients alike must practice and advocate for stricter protocols regarding the use of antibiotics. The viability of tomorrow's healthcare is on the line.
As we get older, we become more susceptible to chronic health conditions like diabetes, heart disease or arthritis. We can also begin to see more problems with our teeth and gums.
Whether it's ourselves or an older loved one, oral health deserves a heightened focus as we age on prevention and prompt treatment. Here's what you can do to protect you or a family member's teeth and gums during the aging process.
Make accommodations for oral hygiene. Keeping your mouth clean of disease-causing plaque is important at any age. But it may become harder for someone getting older: Manual dexterity can falter due to conditions like arthritis or Parkinson's Disease. Older adults with decreased physical ability may benefit from larger gripped toothbrushes or those modified with a bicycle handle. Electric power brushes are another option, as are water irrigators that can do as effective a job of flossing as threaded floss.
Watch out for “dry mouth.” Older adults often develop chronic dry mouth due to saliva-reducing medications they might be taking. It's not just an unpleasant feeling: Inadequate saliva deprives the mouth of acid neutralization. As a result, someone with chronic dry mouth has a higher risk for tooth decay. You can reduce dry mouth by talking with your doctor about prescriptions for you or a family member, drinking more water or using saliva boosting products.
Maintain regular dental visits. Regular trips to the dentist are especially important for older adults. Besides professional cleanings, dentists also check for problems that increase with aging, such as oral cancer. An older adult wearing dentures or other oral appliances also needs to have them checked periodically for any adverse changes to fit or wear.
Monitor self-care. As long as they're able, older adults should be encouraged to care daily for their own teeth. But they should also be monitored in these areas, especially if they begin to show signs of decreased mental or physical abilities. So, evaluate how they're doing with brushing and flossing, and look for signs of tooth decay or gum disease.
Aging brings its own set of challenges for maintaining optimum dental health. But taking proactive steps and acting quickly when problems arise will help meet those challenges as they come.
If you would like more information on dental care for older adults, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Aging & Dental Health.”
“My tooth hurts…or maybe more than one. Or, it might be my gums.”
If you're having trouble describing the pain in your mouth, don't feel bad. Although our body's pain mechanism is great for alerting us to a problem, it can't always tell us the true cause and location of that problem.
That's especially true of tooth pain. It could be a sign, for instance, of decay within a tooth's inner pulp. When under attack, the nerves in the pulp often send out pain signals that could be sharp, dull, continuous, intermittent, seeming to come from one tooth or several.
If this is the case, depending on how deep the decay is, you could need a filling to resolve the problem or, if it's more extensive, possibly a root canal treatment to save the affected tooth. If you need a root canal, after removing the pulp's diseased tissue, the procedure calls for filling the empty pulp chamber and root canals to prevent future infection.
Another possibility for the pain is gum disease that has also infected the tooth. Gum disease usually begins with the bacteria in dental plaque, a thin biofilm that builds up on tooth surfaces, which infect the gums. If not treated promptly, the infection can advance below the gum line to the tooth roots and supporting bone. From there, it could invade the tooth and travel through the root canals to the interior pulp.
In this scenario, we'll need to treat the gum disease by removing plaque and tartar (hardened plaque) deposits from all tooth and gum surfaces. This is usually done manually with hand instruments or ultrasonic equipment, but it may also require surgical access to infected areas around the roots. If the tooth's nerve has become involved, we may also need to perform a root canal treatment as described above.
There are three key points to take from these two tooth pain scenarios. First, the only way to determine the true cause of your pain (and what treatment you'll need) is with a dental exam. Second, the sooner your pain is diagnosed and you begin treatment, the better your outcome—so see your dentist at the first sign of pain or other symptoms like swollen or bleeding gums.
And finally, you may be able to prevent these and other dental problems by removing disease-causing plaque through daily brushing and flossing and professional teeth cleaning every six months. Prevention through effective oral hygiene may help you avoid a future bout of mysterious tooth pain.
If you would like more information on treating tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”