Oct 15, 2019
Fluoride and flavors and flip-caps oh my! If you’re staring down the selection of toothpastes and wishing there was a Yellow Brick Road leading to the perfect one, you’re not alone. Luckily, your friends at Falmouth Dental Arts are here to help!
First and foremost, as you’re examining the tube of toothpaste, keep your eye out for two key details: the ADA seal of approval and fluoride content. The American Dental Association tests the safety and effectiveness of toothpastes on the market, and gives its seal to those pastes which pass the test with flying colors. Varieties without the ADA seal either have not been tested, or have not passed the ADA tests. Either way, choosing a product without the seal is a gamble for your teeth. Take the safe bet, and look for the ADA seal.
Most toothpastes contain fluoride, a chemical compound with a variety of uses. In the dental realm, fluoride protects your teeth from decay by reinforcing your enamel. Fluoride has been used as an active ingredient in toothpaste for over a century, and has been introduced into a majority of city water supplies to improve oral health in the community. In recent years, fluoride has become a bit of a hot topic because it is toxic when ingested in large doses. Additionally, high levels of fluoride can lead to fluorosis: a discoloring of the teeth. However, because over-the-counter pastes contain such trace amounts of fluoride that fluorosis and toxicity are not of concern, Falmouth Dental Arts recommends fluoridated toothpastes.
Dr. Karagiorgos states that “adding fluoride to our water supply has been statistically significant to help to improve oral health in at-risk communities. However, at Falmouth Dental Arts, we believe in a patient’s freedom to choose what goes into their bodies, and whether fluoride is right for them as an individual.”
“Proper oral health maintenance including brushing with any sort of paste, is the best method of reducing the risk of dental decay. Fluoride is not a nutrient, and our bodies have no need for it metabolically. It is very good at doing is killing the bacteria that cause tooth decay. Using it appropriately, in small topical doses such as those found in ADA approved toothpastes and mouthwashes can help to prevent decay, and also to reverse small amounts of acid damage. Acid damage can occur from cavity causing bacteria, acid erosion from reflux or consuming acidic foods.”
Beyond the ADA seal and fluoride content, your selection of toothpaste is entirely up to you! As you narrow down your choice, here are a few additional factors to consider:
1. Sensitivity: most toothpaste brands have a line specifically designed to address tooth and gum sensitivity. Some brands are entirely devoted to helping soothe sensitive teeth. Either way, most over-the-counter sensitivity pastes deliver on their promises to pacify any pain. If your sensitive teeth aren’t responding to an OTC sensitive-specific paste, talk to Dr. Brunacini or Dr. Karagiorgos about prescription strength options.
2. Whitening: Who doesn’t want a brighter, whiter smile? Many toothpastes claiming to possess whitening powers typically do address basic surface stains. However, the different ingredients in whitening toothpastes can cause dental sensitivity over time. Additionally, any sort of abrasive ingredient advertised to whiten your teeth (such as activated charcoal, natural exfoliants, or microbeads) can erode your tooth enamel. Avoid abrasive materials in your toothpaste, and always keep smart brushing techniques in mind. If you’re looking for more intensive whitening, talk to Dr. Brunacini about in-office and at-home options at your next appointment!
3. Options for Kids: For brand new brushers, look for a training toothpaste which does not contain fluoride. When your child understands that toothpaste should be spit out and not swallowed, you can make the switch to a fluoride paste. Fun toothpaste flavors can be helpful if you’re trying to make brushing fun–which goes for children and adults alike!
At the end of the day, the most important thing you can do for your teeth is to brush them properly twice a day! What you use to brush helps or hurts your effectiveness as a brusher, so you do want to choose your tools and pastes with care. Look for a toothpaste stamped with the American Dental Association’s seal of approval. Feel free to choose a toothpaste with a fun flavor and ingredients to address sensitivity or whitening concerns–just avoid any ingredients that might erode your tooth enamel.
If you have questions about proper brushing techniques, or want to have Dr. Brunacini and Dr. Karagiorgos put their stamp of approval on your toothpaste–just ask them at your next dental exam and cleaning! If you have any questions, or to schedule your appointment, please call our office at 207.781.5900
Aug 12, 2019
Not all bacteria are bad! Our bodies also host a range of good bacteria that help keep us healthy. They are part of your body’s microbiome, which is defined as a community of micro-organisms (such as bacteria, fungi, and viruses) living on or in the human body. There is an emerging field of medical research on our microbiomes and how the bacteria that live on and in our bodies affect our health. Perhaps you’ve heard of the microbiome in your gut and how it can impact your health ranging from mental well-being to digestion, but did you know there is also a microbiome in your mouth? Fascinating, right!? We’ve discussed how our oral health impacts our overall health before, now let’s zoom in to the microscopic level and learn about the microbiome in our mouths.
Your Oral Microbiome
You swallow about 1 trillion bacteria each day (!!!) and have a unique community of bacteria that live in your mouth known as your oral microbiome. Your oral cavity has different habitats, from your tongue to your teeth to your tonsils where some 700 different bacteria exist and help perform vital functions such as transporting ionic minerals and carrying molecular oxygen. There is a symbiotic relationship between us and the microbes that live within us…they help us stay healthy and thrive! You’re probably familiar with one of the most famous symbiotic relationships: E.T. (everyone’s favorite cinematic extra-terrestrial) and the little boy Elliot. In the movie when E.T. was healthy, so was Elliot. When E.T. got sick, so did Elliot. Don’t be afraid to make friends with your microbiome!
As we’ve noted before, 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 do a thorough examination of your whole mouth when you come in for a routine cleaning. When your oral microbiome is healthy and balanced we see that reflected in your mouth. For example, when the plaque (or oral biofilm) in your mouth is healthy, it forms a clear, odorless, protective film. Your teeth feel clean and your gums look healthy and pink. When imbalanced, the plaque becomes sticky, white, has an odor, and over time contributes to tooth decay and gum disease. You may notice symptoms such as bad breath and bleeding gums with an imbalanced microbiome. What’s interesting to note is that a number of bacteria associated with tooth decay and gum disease still exist in mouths with a healthy microbiome, but do not have the same adverse effects. Keeping the environment in your mouth healthy through routine oral health care is what’s important for maintaining a healthy oral microbiome. So keep on brushing and flossing!
The Mouth-Body Connection
Your oral microbiome’s impact extends beyond your teeth and gums. Research has shown that oral microbiomes have a link with gastrointestinal diseases such as inflammatory bowel disease, nervous system diseases such as Alzheimer’s, and endocrine system diseases such as diabetes. We’ve discussed some of these correlations, such as your oral health and diabetes, on the blog before, and cannot stress enough how important dental care is to your overall health. Here are some examples of the link between these health conditions and your oral microbiome:
- Gastrointestinal Diseases: People with gastrointestinal diseases, such as inflammatory bowel disease (IBD), often have correlating oral symptoms like dry mouth and mouth ulcers. People with IBD routinely have an imbalance of oral bacteria in the gut. It has also been found that people with advanced gum disease and tooth loss have an increased risk for gastrointestinal, pancreatic, and liver cancer.
- Nervous System Diseases: Researchers have been studying the gut-brain axis and its connection to disease and have found that a healthy gut biome is integral to decreasing the development of diseases such as Alzheimer’s, depression, and anxiety. Given the close connection between the oral microbiome and the gut, oral health plays a role here as well. In fact there was a ground-breaking study from 2019 that showed bacteria responsible for gum disease also appeared in Alzheimer’s patients’ brains.
- Endocrine System Diseases: We know that diabetes increases your risk of dental diseases and oral symptoms such as dry mouth and gum disease. However, it has also been found that people with periodontitis, or gum disease, have an increased risk of developing diabetes. It’s unclear which exactly happens first, the development of the disease or an imbalanced oral microbiome, but researchers continue to study the correlation and relationship between the two areas.
We find it compelling to learn more and more about how our oral health is linked with our overall health. We always like to say that we are part of your healthcare team: our goal is to keep you informed and to help you make the best choices for your health. If you ever have any questions about how we can help you, please don’t hesitate to ask any of our team members!
Oral Care with Your Oral Microbiome in Mind
So, what can you do to keep your oral microbiome and your whole body healthy? We can never say it too much: maintain your oral health care routine of twice daily brushing, daily flossing, and regular visits to our office for check-ups. As part of this, we also recommend avoiding oral-care products that have harsh detergents or mouthwash with alcohol as part of their ingredients. These products may destroy the microbiome–the good bacteria along with the bad. Look for alcohol-free mouthwash and toothpaste without sodium laurel sulfate (SLS) or triclosan.
Diet is also a big part of maintaining a healthy oral microbiome. We often talk about the importance of a healthy diet for the health of your mouth, and this is just another reason to stress the importance of approaching your oral health holistically. Keep your diet rich in vegetables, high-calcium dairy products, protein, and omega-3s, and avoid excess sugar and complex carbohydrates. There are lots of ways to do this…loading up on dark leafy greens, yogurt, strawberries, eggs, and sardines, for example. Your mouth and your whole body will thank you!
Your mouth is an extraordinary place and we love helping you take care of it! We are here to provide you with the best care possible…from the tiny micro-organisms in your mouth to your whole body. Please let us know if you have any questions about your oral health care or if you need to schedule your next appointment by calling our office at 207.781.5900.
*Image courtesy of www.askthedentist.com
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
Jun 20, 2019
Did you know that your routine dental check-up could save your life? Dentists are on the front lines of a growing health concern: oral cancer. Oral cancer is the uncontrollable growth of cells that invade the oral cavity (mouth) and the oropharynx (part of the throat at the back of the mouth). According to the Oral Cancer Foundation, approximately 53,000 people will be newly diagnosed with oral cancer in 2019; that means 145 people each day. Prevention and early detection is one of the most effective strategies for treating oral cancer, as when it is caught early there is an 80-90% survival rate. Oral cancer screenings are an important part of our regular dental exams and something we want to help create more awareness about for our patients. To learn more about this critical health topic and the resources we have at FDA, we talked with Dr. Brunacini.
1. Why is oral cancer screening an important part of care at FDA?
Dr. Brunacini: As dentists, we are part of your health care team. A lot of what is seen in the mouth can be an indicator of overall health and a lot of patients see their dentist more frequently than their physician. That makes an oral cancer screening at the dentist extremely important for early detection of any changes in the mouth which can be the key to easier treatment options for oral cancer, as well as a rapid recovery, and a prolonged life.
2. What happens during an oral cancer screening?
Dr. Brunacini: A lot of the oral cancer screening is simply examining the soft tissues with our eyes. We examine the gum tissue, lips, cheeks, and tongue. We also palpate areas of the face and neck to check for any nodules or lumps. If there is an area of concern, we also offer to do a VELscope screening. VELscope is a non-invasive oral cancer screening device that emits a safe blue light that provides earlier detection of abnormal cell growth that could be cancerous or precancerous.
3. What are some risk factors for oral cancer?
Dr. Brunacini: The most common risk factors include tobacco, alcohol, and sun exposure. Cigarettes and other forms of tobacco account for most cases of oral cancer and lip cancer is often caused by excessive sun exposure.
Also, another risk factor, although less known, is HPV (Human Papillomavirus). It is a very common virus that most of us get exposed to throughout our childhood. There is now a vaccine that can be given, which could help decrease the risk for oral cancer.
Please let us know if you have any questions or concerns about these risk factors and your health.
4. Are there any warning signs or symptoms for oral cancer?
Dr. Brunacini: Yes, patients should be aware of any white patches or areas that bleed more easily, as these can sometimes be a sign of oral cancer. If there is a noticeable and recent change in your mouth, such as tenderness or a change in the way your teeth fit together, it is always a good idea to let us know. We will assess and address the issue and make sure that you are equipped with the information you need to make the best decisions for your well-being.
5. If you find something during a screening, what are the next steps?
Dr. Brunacini: Generally, if there is an area of concern, the next step will be a referral to an oral surgeon. The oral surgeon will perform a biopsy of the area to determine the diagnosis. A lot of times, the biopsy determines that the area is not of concern. However, when the biopsy is positive for cancerous cells, then further treatment may be indicated. Throughout this process, we are here to support our patients with the follow up care they need.
Thank you, Dr. Brunacini!
We strive to be your dental care partner for a healthy life and always want to make sure you have information about how we can help you achieve that. If you have any questions or concerns about your oral health or would like to schedule an appointment with an oral cancer screening, please call us at 207.781.5900.
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
