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
Jan 22, 2019
January is a great time to think about your health…and why not take an integrative approach and think about your oral health as well. Poor dental care has been linked to cardiovascular disease and complications in diabetes. Your dentist can be a part of your health care team and help you set up an oral health plan that takes your whole body’s well-being into account. This methodology is called Integrative Dentistry. We offer an Integrative Dentistry approach for our patients and are committed to learning our patient’s health history, needs, and questions as we put together a treatment plan with them. However, for some of our patients, Integrative Dentistry is still an unknown term. We talked with Dr. Brunacini to learn more about Integrative Dentistry and how this approach can impact you and your oral health.
1. What is Integrative Dentistry?
Dr. Brunacini: Integrative Dentistry is an approach that simply views the oral cavity– or the mouth, teeth, and gums–as another system within the human body. By approaching dentistry with the whole body in mind, we can better educate and communicate with the patients. Building a partnership with our patients is paramount for us in giving them the best oral health care possible.
2. Why is a holistic approach important in dentistry?
Dr. Brunacini: For so long, dentistry has always been separate from the rest of the medical field. There is more and more awareness of oral health and its connection to overall health. By taking this integrated approach with patients, they can better understand how their oral health can affect the rest of their body’s systems. In this way, a holistic approach helps patients improve the health of their smile while also improving their overall health. It’s a win-win!
3. What are some integrative oriented procedures at FDA?
Dr. Brunacini: We use water treated with ozone at FDA to sterilize our water and water lines. Also, we can use ozone gas to sterilize teeth prior to cementing crowns or placing fillings or as part of our periodontal program. This is an effective and nice alternative to using disinfectants and antibiotics with patients.
4. What does the future of Integrative Dentistry look like?
Dr. Brunacini: I see more integration with physicians to provide custom treatments for patients, such as finding the best materials to use in fillings and root canals for an individual person. This means better care for patients, which is something we are always striving for.
Thank you, Dr. Brunacini!
If you would like to learn more about our integrative approach to dentistry, give us a call at 207.781.5900. We look forward to helping you have the best health care possible for your whole self.
Image courtesy of www.seattlemag.com
Dec 21, 2018
‘Tis the season…to give! One of our favorite parts of the holiday season is the opportunity to give back to those in need. We believe that everyone deserves a healthy smile and access to oral health care. That’s why we’ve partnered with Dental Lifeline Network and their Donated Dental Services (DDS) to help people in our community receive the dental care they need. This is a program we support at Falmouth Dental Arts and have also contributed to through Dr. Knock’s always amazing Dancing with the Dentists. In the spirit of the Season of Giving, we wanted to share more about this incredible organization with you this month.
Donated Dental Services provides free, comprehensive dental treatment to the country’s most vulnerable people with disabilities, and to those who are elderly or medically fragile. These are people who cannot afford necessary treatment and cannot get public aid. The program operates through a volunteer network of more than 15,000 dentists and 3,700 dental labs across the United States. Since its inception in 1985, the DDS program has surpassed $330 million in donated dental therapies, transforming the lives of 117,000 people.
In Maine, the program has had an amazing impact. Some numbers for you:
- 177 volunteer dentists
- 36 volunteer laboratories
- $3.5 million in donated treatments
- 1,161 dental patients treated since 1999
If you’d like to contribute to Donated Dental Services, they are always in need dental professionals to volunteer their time, and rely on financial contributions to make more treatments possible. To make a donation, you can visit their website. Your donation will help provide comprehensive care to those who need it most.
Thank you for being a part of the FDA family and for helping us celebrate the Season of Giving! We hope you have a wonderful holiday season with your family and friends!
*Image courtesy of www.shutterstock.com
