Jul 30, 2019
Antibiotic prophy….say what?! For most of our patients, antibiotic prophylaxis is something they’ve never heard of and don’t need to worry about. However, for some of our patients, particularly with heart conditions, it can be an important part of their oral health care. In short, antibiotic prophylaxis is the use of antibiotics before a dental procedure to prevent a bacterial infection elsewhere in the body. It is a treatment that may be recommended for you after talking with your physician and Dr. Brunacini or Dr. Karagiorgos. There are side-effects and risks to taking antibiotics, so antibiotic prophylaxis is only used when the benefit outweighs the risk for you. To learn more, we talked with Dr. Karagiorgos.
1. What is Antibiotic Prophylaxis?
Dr. Karagiorgos: Antibiotics usually treat bacterial infections, but sometimes physicians or dentists recommend antibiotics prior to a treatment, such as a teeth cleaning or root canal, to reduce the risk of infection. This is because during some dental treatments, bacteria from the mouth can enter the bloodstream and cause infection elsewhere in the body. We only recommend this for certain patients, which is why it’s important to have a conversation with us and your physician.
2. Who Could Benefit from Antibiotic Prophylaxis?
Dr. Karagiorgos: With a few exceptions, most patients who require antibiotic prophylaxis before a dental visit will need it for one of two major reasons:
- Risk of infection to replacement (artificial) joints–commonly the hip, knee, or shoulder.
- Risk of infection in the heart.
The American Heart Association recommends antibiotics before dental procedures only for individuals with the highest risk of infection. This includes patients who have:
- A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.
- A history of endocarditis (heart infection).
- A heart transplant with abnormal heart valve function.
- Certain congenital heart defects, including:
- Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), which has not been fully repaired, including in children who have had surgical shunts and conduits.
- A congenital heart defect that has been completely repaired with prosthetic material or a device (for the first six months after the repair procedures).
- Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at, or adjacent to, a prosthetic patch or prosthetic device.
If you’re not sure what these guidelines mean for you and your particular heart condition, make sure to ask your cardiologist; “Do I need to take antibiotics for dental work?”
3. What if I’ve had Hip Surgery or a Joint Replacement?
Dr. Karagiorgos: For many years, people that had undergone surgery for replacement of a joint (most commonly hip or knee joints) had to take antibiotics before any dental procedures. While this is generally still required for patients with two or more replacement joints, the American Dental Association no longer recommends routine antibiotics prior to dental procedures to prevent prosthetic joint infection.
Many orthopedic surgeons have their own criteria for deciding which of their patients might be at risk of joint infection with dental procedures (even cleanings). That is why in most cases I defer to a patient’s orthopedic surgeon to decide and prescribe prophylactic antibiotics for dental visits.
If you have any questions about your particular situation, make sure to discuss them with me or Dr. Brunacini, as well as your orthopedic surgeon or physician. This is especially important if you have a significant immunodeficiency or previously suffered an infected prosthetic joint. We are part of your health care team and will work together to determine if you have a need for antibiotic prophylaxis.
4. What Else Should I Know?
Dr. Karagiorgos: Good oral health and good general health go hand in hand. So, keep up with your regular oral care routine of brushing twice a day, flossing at least once a day, and seeing your dental team with us for regular cleanings.
At Falmouth Dental Arts you will notice that we ask you about any changes to your health history at every visit. This includes medications that you are taking and any allergies you may have. It is important for us to know what medications that you take, and in what dosages and frequency. If you take many medications and it becomes difficult for you to remember them, then you can ask your physician to give you a current list that you can carry with you. This information is important for us to know when determining the best course of treatment and care for you.
Also, I find it fascinating that the turnover of new tissue in the oral cavity is one of the fastest in the body! Ever notice how a pizza burn in your mouth heals in a matter of days? The mouth is a great window into the body, often reflecting systemic disease before it can be determined by other means. This is why we thoroughly examine all of the mouth, not just the teeth. We want to help you be healthy in your mouth and your whole body!
Thank you, Dr. Karagiorgos!
If you have questions about antibiotic prophylaxis or about how your health issues may impact your dental care, please give us a call today at 207.781.5900. We are here to be your healthcare partner and provide you with the best oral care possible!
*Image courtesy of www.medlineplus.gov
May 28, 2019
Oral health is important no matter your age. It’s not just a part of maintaining a beautiful smile, but also a crucial element in overall wellness and quality of life. The health of your body and the health of your mouth are connected, and both require ongoing care. This is especially true for our older patients. Aging certainly doesn’t mean you have to resign yourself to dentures…with proper care, your teeth can last a lifetime. However, there are additional concerns that come up for patients over 60. To learn more, here are 5 tips from Dr. Brunacini and Dr. Karagiorgos.
1. Watch Out For Cavities As You Age
As we age, we become more prone to cavities. Dry mouth, also called xerostomia, is often the cause and is a side effect of many medications. Saliva is one of your mouth’s best defenses against tooth decay. Be sure to tell Dr. Brunacini or Dr. Karagiorgos about any medications you are taking or if you are experiencing dry mouth. They will have recommendations for how to restore moisture and work with you to help keep your mouth healthy.
2. Share Your Medical History with Dr. Brunacini and Dr. Karagiorgos
We are a part of your health care team. Beyond sharing what medications you are taking, it is important to share any medical conditions such as heart conditions. In such cases, Dr. Brunacini and Dr. Karagiorgos may recommend antibiotic prophylaxis, which is taking antibiotics prior to a dental procedure. We all have bacteria in our mouths, but for people with certain conditions when that bacteria enters the bloodstream it can cause infection elsewhere in the body. Talk to Dr. Brunacini or Dr. Karagiorgos if you have any questions or concerns about the interactions between your medical conditions and oral care.
3. Cosmetic Procedures Are For Patients of Every Age!
If you are self-conscious about your smile or wish you could improve the look of your teeth, let us know! There are several cosmetic options for patients of any age that can dramatically improve your smile. Examples include:
- Veneers: These can be done on aging teeth can help patients have more confidence in their smiles.
- Teeth Whitening: This works on natural teeth and can make teeth look more youthful. Please note that whitening does not work on crowns.
- Orthodontics: There are options that exist as long as teeth have good bone support. Our teeth become more crowded as we age which can result in some teeth becoming crooked over time.
4. Let Us Know if Your Dentures Are Loose
There have been many advances in recent years to help people with loose dentures. If you have discomfort or concerns about the fit of your dentures, talk to Dr. Brunacini or Dr. Karagiorgos. They can discuss possible choices for you such as implants which help dentures have a tighter fit, or implant-support bridges. The point is, there are options and we are here to help!
5. Don’t Forget Your Oral Health Care Basics
It’s important for all our patients, especially those over 60 to follow our recommended oral health care regimen: brush twice daily, floss daily, and schedule regular appointments with FDA. We hear from some patients with arthritis that brushing can be a literal pain. We recommend an electric toothbrush to help get to all parts of your teeth while limiting your arm movement. We also like to remind our patients to include healthy diet as part of their oral health care. For example older patients need to make sure they are getting enough calcium–not just from supplements, but from dairy products and leafy greens to support teeth health.
Thank you Dr. Brunacini and Dr. Karagiorgos! If you have more questions about your oral health or need to schedule an appointment, please give us a call at 207.781.5900. Our entire staff is dedicated to providing you with the most caring and comfortable environment possible while also providing top quality dental care for all ages.
*Image courtesy of www.cdc.gov
Mar 19, 2019
National Dentist Day was March 6 and was established as a way to show appreciation and thanks for dentists. We have two of the best dentists to thank: Dr. Brunacini and Dr. Karagiorgos! As a way to honor these two, we thought we’d ask them some questions about their path to dentistry and what they love about the work they do. Let’s learn more about FDA’s Dynamic Duo!
1. Why did you go in to dentistry?
Dr. Brian Brunacini: I enjoy the variety and problem-solving in dentistry. There are always new things to learn and I’ve enjoyed keeping up with the advancements in digital dentistry to improve the accuracy of diagnoses and quality of care.
Dr. Karagiorgos: After graduating with a degree in civil/structural engineering, I worked in the field but I disliked my job. I was 27 and I knew I didn’t want to do that as a lifelong career. Around that time, I went through a health scare that made me decide to pursue a career that would be meaningful and satisfying to me. I thought more about what a cousin had once suggested: dentistry. So I went back to school to take all the prerequisites to go to dental school, and meanwhile I worked for the Tufts’ Oral Surgery department as a Dental Assistant, where I assisted in surgical procedures such as extraction, implant placement, and even cosmetic surgery. This experience solidified my desire to pursue dentistry. I really enjoyed the surgical aspect of dentistry and considered specializing but the great thing about general dentistry is that you’re able to do a little bit of everything.
2. What is rewarding about your work?
Dr. Brian Brunacini: I love getting to know our patients and working together by sharing what I see and can potentially do for them. I really enjoy empowering patients to be more involved in their healthcare decisions so that they can improve their health.
Dr. Karagiorgos: Every day is about finding the best dental solution for each individual patient while keeping each patient’s special circumstances and aesthetic vision in mind, as well as the financial aspects involved to create the best possible treatment plan for every individual. There’s also an aspect of artistic expression to what we do: it’s making a filling look like a tooth. In a way, dentistry is a very satisfying form of artistic expression on a small scale.
3. What is unique about working at FDA?
Dr. Brian Brunacini: We practice progressive dentistry that allows us to provide excellent holistic care for the whole patient while using crest-of-the-wave technology. We also have a laid-back atmosphere at the office which creates a comfortable, inviting place for patients. That coupled with an amazing team–from receptionist to hygienist to assistant to dentist–who all work together to help patients makes this an ideal practice where we build lasting relationships with our patients.
Dr. Karagiorgos: The patients and staff here make my job feel like it’s not even work. It’s a great feeling to be a part of a team like this. And we meet patients from all walks of life, so it’s great to talk to everyone and get to know them.
4. What is your favorite dental care tip?
Dr. Brian Brunacini: Mine comes down to diet. Everyone knows how important it is to eat well for their overall health, but it also is important for healthy teeth and gums. There is strong correlation between a decrease in sugar/carbohydrate consumption and a decline in tooth decay rates. It’s not just about limiting overall sugar consumption–it’s also important to pay attention to how often during the day you eat or drink sugar. For example, sipping on an iced coffee with sugar all day is worse than drinking it in one sitting.
Dr. Karagiorgos: Floss, floss, floss!!! Flossing can remove plaque and food debris particles in places where toothbrush bristles cannot easily reach, like under the gum line and especially between your teeth. Plaque buildup can lead to tooth decay and gum disease, which daily flossing can help prevent!
Thank you Dr. Brunacini and Dr. Karagiorgos! We appreciate the thoughtful care you both bring to the practice everyday.
Whether you’ve been coming to FDA for years or are a new patient, we hope you learned something about our wonderful dentists. If you have a question for them or need to schedule a visit, give us a call today at 207.781.5900. We are here to give you the best oral health care possible!
Jan 24, 2019
There are going to be lots of happy, healthy smiles in Falmouth because two premier dental practices, Falmouth Dental Arts and A Perfect Smile, are merging! The practices will continue to offer superb dental care under the name Falmouth Dental Arts led by Dr. Brian Brunacini and Dr. Antonios Karagiorgos.
Since Dr. Glen Knock founded the practice in 1974, Falmouth Dental Arts has been on the cutting edge of dentistry and the cutting edge of how to treat people. From oral sedation to Integrative Dentistry to incorporating the latest digital advancements, Falmouth Dental Arts is committed to providing the best oral health care possible. Continuing on the tradition of Dr. Knock, Dr. Brunacini and Dr. Karagiorgos see beyond patient’s smiles; they see and treat the whole person. A Perfect Smile and the late Dr. Robert Nelson were also aligned with this approach, and both practices have always prioritized patient comfort and holistic oral health care. By merging these two excellent practices, they unite under a 40-year-old brand and have an opportunity to help even more people in this community and spread a broader message of good oral health.
With excellent patient care having always been at the core of both practices, patients can relax while they receive the best oral care possible from a team of knowledgeable and experienced dental professionals. Dr. Brunacini and Dr. Karagiorgos and the expanded Falmouth Dental Arts team are here to serve you and your families. They are now available for smile consultations, exams, and dental emergencies and are happy to answer any questions. Their goal is to develop a partnership with each patient—a partnership that not only provides the highest quality dental care, but also a connection to compassionate and knowledgeable healthcare professionals.
Falmouth Dental Arts will be closed January 28-February 1 to make the move to their new location at 168 US Route 1, in the home of A Perfect Smile. They will re-open on February 4 in A Perfect Smile’s offices at 168 US Route 1. For any patient questions or to schedule an appointment, please call Falmouth Dental Arts at 207.781.5900.
Mar 19, 2018
We can tell a lot just by taking a look around your mouth while you are sitting in our chair. But sometimes, we need to take a closer look at your teeth to get to the root of a problem you may be experiencing. X-rays are most commonly used to help us to find issues that can’t be seen with a visual exam. While these images do provide valuable information, they don’t show everything that’s going on in your mouth. Plus, they aren’t always the easiest images to help explain what might be causing an issue. That’s why you might see Dr. Brunacini or Dr. Karagiorgos using an intraoral camera.
What is an Intraoral Camera?
An intraoral cameral is a tiny digital camera that takes pictures of hard-to-reach areas in your mouth. Our intraoral cameras look similar to a pen and are equipped with a tiny lens on the end. During an examination, the camera is moved throughout the inside of the mouth, allowing us to see detailed images of the surfaces of your teeth, gum conditions, and other tiny details about tissues, cavities, etc. The camera also captures clear video and images of corroded or tarnished fillings, hairline fractures, bleeding gums, plaque, and other problems. To our patients’ delight, the camera is painless and can be used while you are sitting comfortably in the dental chair.
How do Intraoral Cameras work?
The first intraoral cameras were introduced back in the late 1980s and required a lot of bulky technology. Images were saved to a floppy disc and videos were saved to film and had to be viewed in a VHS player. Over the years, the design changed drastically allowing for improved function with significantly smaller equipment. Today’s intraoral cameras are connected directly to a computer and the images it can immediately be viewed by both the dentist and the patient in real time. These images can then be examined in-depth for a better diagnosis and stored for future reference.
Why do we use Intraoral Cameras?
Intraoral cameras offer numerous benefits to the patient. Dr. Karagiorgos explains it like this: “Showing our patients photographs of what we are looking at in their mouths is a great way to communicate ideas about conditions or possible treatments. Photography becomes a great tool in our toolbox to engage patients so that they feel more included in the decision-making process. It lets the patient see with their own eyes and helps make what might sound complicated much easier to understand.”
With the video and images captured by the camera, we are able to give you a better look at a particular diagnosis and to help you understand a treatment plan more completely. Instead of just explaining to you what might be happening in your mouth, we are able to show you exactly what is going on. In many cases, an issue might not present with tangible symptoms. For example, you might not have any pain in a back molar, but the intraoral camera might discover a fractured tooth. The cameras are also useful in the tooth restoration process, allowing you to see the before and after pictures of your treatment.
No matter the issue, the intraoral camera helps you make treatment decisions with confidence. Want to learn more? Let us show you what the camera looks like at your next visit! Call us at (207) 781-5900 to schedule your appointment today.
Aug 21, 2017
This month we would like to take some time to feature the most recent addition to our team here at Falmouth Dental Arts: Dr. Antonios Karagiorgos (pronounced “kara-george-us“) or simply “Dr. K.” Dr. Karagiorgos also goes by Adonis, so please feel free to call him by that name as well. We think he’s a really interesting fellow and we can’t wait for everyone to get to know him as he settles in with us.
- Welcome to the Falmouth Dental Arts team. How has it been so far?
It has been a lovely experience; I have really enjoyed meeting the patients and getting to know the staff. Since Glen retired officially, I am now coming in full-time four days a week from Monday to Thursday. I thank both the patients and the staff for making this a smooth transition – it has been a great experience.
- How did you decide you wanted to study dentistry?
It’s kind of a long story. I have a cousin from Greece who lived with my family in Massachusetts when I was 18 years old. She was doing an international program to become a pediatric dentist. At one point I remember her telling me: this would be a perfect career for you, since you’re artistic, kind, outgoing, and you love talking to people. At the time I told her that I couldn’t imagine myself working in peoples mouths for a living, so I just dismissed the idea completely.
After graduating with a degree in civil/structural engineering, I worked in the field but I disliked my job. At that point, I was counting the hours to when I would be able to leave work for the day. I was 27 and I knew I didn’t want to do that as a lifelong career. I did many different things; I worked as a project manager for the Olympic games in Athens, Greece, and after that I started the process of joining the Air Force as a pilot but disqualified myself by getting laser eye surgery to correct my vision. Around that time, I went through a health scare that made me decide to pursue a career that would be meaningful and satisfying to me. I thought more about what my cousin had suggested: dentistry. So I went back to school to take all the prerequisites to go to dental school, and meanwhile I worked for the Tufts’ Oral Surgery department as a Dental Assistant, where I assisted in surgical procedures such as extraction, implant placement, and even cosmetic surgery. This experience solidified my desire to pursue dentistry. I really enjoyed the surgical aspect of dentistry and considered specializing but the great thing about general dentistry is that you’re able to do a little bit of everything.
- What do you want to bring to Falmouth Dental Arts?
Right now I bring extractions and surgical extractions, but in the future I hope to also bring implant placement and IV sedation to Falmouth Dental Arts.
With my past experience assisting in surgery, I hope to make a bigger contribution to the surgical aspect as far as extractions, and hopefully doing implants in the future. I am trained in intravenous or IV sedation, which is a treatment option that would help patients who are nervous or anxious at dental appointments. Right now we offer oral sedation, where patients take a pill and wait for it to take effect, but hopefully within the next year we can begin to offer IV sedation as an option. IV sedation is more predictable with the added benefit of a faster onset. The goal is to provide moderate conscious sedation, where patients are conscious, still breathing on their own, still able to follow instructions, but relieved of any anxiety to keep patients completely at ease with their dental care.
- Where did you practice before coming to Falmouth Dental Arts?
Well, while I was training for IV sedation, my wife and I lived up in Bar Harbor for ten months, basically on the doorstep of Acadia National Park. During my training, I also worked full-time in public health dentistry in Ellsworth, where we provided clinical access to those who don’t have the financial means to obtain dental care. After completion of my training we moved to Portland, where I continued to work for public health dentistry in Augusta while working part-time at Falmouth Dental Arts. Although I am now full-time at FDA, I continue to work a few days a month working for public health dentistry as a way to give back.
- What do you love about working at Falmouth Dental Arts?
It’s the people. The patients and staff here make my job feel like it’s not even work. It’s a great feeling to be a part of a team like this. And we meet patients from all walks of life, so it’s great to talk to everyone and get to know them.
- What do you think the future of dentistry looks like?
This is a very interesting time in dentistry because technology is changing at such a rapid pace and the amount of research going on is unprecedented. We’re on the precipice where we can’t even imagine the changes that will be coming to the field. Dentistry is going to be unrecognizable in 20 years. I look forward to a time when we can help the body repair itself, including the dentin beneath the enamel of patients’ teeth. Whereas now, if a tooth is decaying or breaking down, we intervene with a filling to stop the process of decay, so if we can induce the body to heal itself that would be a great advancement in the field. I’m not sure when it will happen, but regenerative dentistry would be a huge leap forward in dentistry.
Is there any particular piece of technology that you’re really interested in?
I am very interested in 3D imaging. This technology gives us an accurate three-dimensional image of the oral and facial structure, which then functions as a guide in simulated surgery and precision implant placement, which makes surgery less invasive. This will lead to shorter surgery time and faster recovery for the patient. 3D imaging can also make taking impressions for dental work a lot easier and less messy for the patients.
- What is an interesting dental fact that most people may not know?
Tooth enamel is the hardest substance in the human body– even harder than bone.
- When you’re not taking care of patients’ teeth, what do you like to do? What are some of your hobbies?
I definitely love cooking – that’s a hobby of mine. I also like fly-fishing, snowboarding, and biking, and those are some of the great things that brought us to Maine. My wife and I enjoy being near the water to take advantage of water-related activities.
In high school, I started flying small planes as well; someday I hope to pick that back up again.
- What is your favorite part of dental practice?
The patients. I have the opportunity to meet all different kinds of people – which I was missing when I was in front of a computer screen all day as an engineer and didn’t get to interact with others. On top of that, each individual presents different challenges that constantly keep me on my toes. Every day is about finding the best dental solution for each individual while keeping each patient’s special circumstances and aesthetic vision in mind, as well as the financial aspects involved to create the best possible treatment plan for every individual.
There’s also an aspect of artistic expression to what we do: it’s making a filling look like a tooth. In a way, dentistry is a very satisfying form of artistic expression on a small scale.
- Your biography on the website reads that you’re licensed to practice dentistry in Maine and Alaska. How did that come to be?
The original plan was to move to Alaska with my wife after training in Bar Harbor but family and our love of the area kept us here. I would like to renew my Alaska license – it recently expired – because in the future I would like to do mission trips, either to underserved communities within the United States, South America, or the Philippines, where my wife is from, and donate my services to people in need.
- Do you have any pets?
We have our dog, who has been with us seven months now. He is an Aussie doodle, which is an Australian shepherd-poodle mix. His name is Roux. He is a beloved member of our family.
- Favorite dental tip?
Floss, floss, floss!!! Flossing can remove plaque and food debris particles in places where toothbrush bristles cannot easily reach, like under the gum line and especially between your teeth. Plaque buildup can lead to tooth decay and gum disease, which daily flossing can help prevent!
For more about Dr. Karagiorgos, make sure to check out his biography and schedule your next appointment with him today!
