In 2008, the American Heart Association updated its recommendations for the use of preventive antibiotics before certain dental procedures, including teeth cleaning and extractions, for people with specific heart problems.

The use of preventive antibiotics prior to certain dental procedures is recommended for patients with:

• artificial heart valves
• a history of infective endocarditis (an infection of the lining inside the heart or the heart valves)
• a cardiac (heart) transplant that develops a heart valve problem
• suffer from a congenital (present from birth) heart condition:
  • unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits;
  • a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure;
  • any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device.

Check with your cardiologist if you’re not sure whether you fall into one of these categories.

People who may have taken prophylactic antibiotics before the new recommendations were issued, but no longer need them include those with:

• mitral valve prolapse (may have been identified as a heart murmur)
• rheumatic heart disease
• bicuspid valve disease
• calcified aortic stenosis
• congenital (present from birth) heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy

Talk to Dr.Shlafer about how these recommendations might apply to you.

**Source–American Dental Association

Excess stress may give you a headache, a stomachache, or just a feeling of being on edge. But too much stress could also be doing a number on your mouth, teeth, gums, and overall health. The potential fallout from stress and anxiety that can affect your oral health includes:

Mouth Sores, including canker sores and cold sores

Clenching of teeth and teeth grinding

Poor oral hygiene and unhealthy eating routines

Periodontal (gum) disease

Mouth Sores

Canker sores—small ulcers with a white or grayish base and bordered in red–appear inside the mouth, sometimes in clusters. Experts are not sure what causes them–it could be immune system problems, bacteria, or viruses–they do think stress, as well as fatigue and allergies can increase the risk of getting them. Canker sores are not contagious.

Most canker sore disappear in a week to 10 days. For relief from irritation, try over the counter topical anesthetics. To reduce irritation , do not eat spicy foods, hot foods or foods with a high acid content, such as tomatoes or citrus fruits.

Cold sores, also called fever blisters, are caused by the herpes simplex virus and are contagious. Cold sores are fluid-filled blisters that often appear around the lips. Emotional upset can trigger  an outbreak. So can fever, a sunburn, or a skin abrasion. Like canker sores, fever blisters often heal on their own in a week or so. Treatment is available, including over-the-counter remedies and prescription antiviral drugs.

Teeth Grinding

Stress may make you clench and grind your teeth–during the day or night, and often subconsciously. Teeth grinding is also known as bruxism. If you already clench and grind your teeth, stress could make that habit worse. And grinding your teeth can lead to problems with the TMJ (tempromandibular joint) located in front of the ear where the skull and lower jaw meet. Dr.Shlafer can evaluate you and may recommend a night guard, or different appliance to help stop or minimize the action.

Poor Oral Hygiene

Being under extreme stress may affect your mood and cause people to skip oral hygiene habits such as brushing and flossing. If you already have gum disease, skipping daily hygiene can worsen the problem. When under stress, you may also develop unhealthy eating habits, such as snacking on large amounts of sugary foods or drinks. These habits increase the risk for tooth decay and other problems. Increasing  or resuming your exercise routine can help relieve stress and help you feel energized, as well as boost your immune system.

Gum Disease

Stress can cause an increase in dental plaque, even when high levels of stress are short-term. Long-term stress can put you at risk for bleeding gums, or gingivitis which can progress to serious gum disease.

Eating a balanced diet, seeing Dr.Shlafer regularly, and good oral hygiene helps reduce your risk of periodontal disease.

Q: What is a Turbyfill Denture?

A: Turbyfill dentures are prosthodontic dentures specially created to balance a patient’s occlusion (bite) and esthetics as well as accommodating the loss of bone and gum tissue.

Q: Are the Turbyfill Dentures just like regular dentures?

A: No. For denture wearers who have experienced bone and/or tissue degeneration with other types of dentures. Turbyfill is the answer. Many of the problems associated with common denture (loose or ill-fitting dentures) are well controlled with the Turbyfill Denture technique.

Q: Are Turbyfill Dentures comfortable?

A: The Turbyfill Denture technique captures a copy of your mouth while eating, chewing, and speaking with great accuracy. This makes them amazingly comfortable while enhancing the patent’s facial appearance.

Q: Will the Turbyfill Dentures change color over time?

A: No. The Turbyfill Denture is made with all-porcelain teeth, along with custom coloring for the denture base. (gums)

Q: Does a Turbyfill Denture require adhesive?

A: No. With a Turbyfill Denture, your days of adhesives are over. Turbyfill custom dentures do not require any adhesive, because the Turbyfill denture  captures a copy of your mouth with such accuracy, the adhesives many patients have come to depend on is not needed to keep them in place.

One  zing to the nerve of a tooth after a sip or a bite of food is enough to send shivers up your spine. Sensitive teeth can seriously limit the enjoyment of your favorite foods. So if ice cream meeting your tooth has you seeing stars, the layer beneath the surface of your tooth (called dentin) has become exposed.

What’s at the root of sensitive teeth? How does this happen? A number of  factors are to blame. Gum recession– when the gums pull away from the tooth and expose the root surface, is common with periodontal disease, which happens when plaque accumulates along the gum line. As plaque build, the bacteria releases toxins that cause gums to get infected and then recede.

Grinding causes teeth to flex and crack, creating a notch that exposes dentin at the gum line, called an ab-fraction. If you grind, you may need a mouth-guard to protect your teeth.

Brushing with to much force , with a stiff toothbrush, or even an old toothbrush can cause ab-fractions as well. Be sure to brush gently with a soft bristled brush that you replace every few months whether it looks worn or not.

Teeth whiteners are notorious for creating tooth sensitivity. It is usually transient, but it can last for several days or a week.

How sensitive is too sensitive? If the pain last for only a few days it’s not really an issue. If your teeth are sensitive to hot foods and beverages, or the pain lasts more than a minute, or is spontaneous, you’ve earned a trip to see Dr.Shlafer.

What are the dangers of gum disease?

Gum disease is the leading cause of tooth loss among adults. More importantly, the infection releases toxins into the bloodstream leading to serious health risks:

• Stroke—- A study of over 800 stroke victims indicates that advanced gum disease can increase the risk of stroke by over 50% in adults aged 25-54
• Diabetes—- It’s a two way street. Type II diabetics are 3 times more likely to develop gum disease–20 times more likely if they smoke. Recent studies confirm that gum disease disrupts glycemic control, so for Type II diabetics not only are they at risk for gum disease, but gum disease also aggravates their diabetes.
• Heart Disease—–Many studies show a link between gum disease and heart disease. One study indicates that the risk of fatal heart disease is twice as high for individuals with severe gum disease.
• Spontaneous Preterm Births—-The latest evidence indicates that pregnant women with severe gum disease are 7 times more likely to have a premature baby. Scientists believe that the infection releases toxins that reach the placenta and disrupt fetal development. The oral infection also leads to accelerated production of hormones that trigger premature delivery.

Is There A Cure?

Gum treatments, such as root planing and scaling or LANAP ( a laser gum surgery technique that takes the place of the traditionally gum surgery–without the post-op discomfort) can effectively be used to treat and control gum disease. Prevention and early detection are your best defenses against gum disease. It is critical to catch and treat gum disease early before destruction of the bone and tissue has compromised your oral health.

How Can I Prevent Gum Disease?

The best “brushers”  in the world will naturally build up tartar on their teeth. Even patients with healthy gums should maintain regularly scheduled visits to remove the build-up of tartar and check for the formation of new cavities. Patients with gum disease are recommended to have their hygiene visits more frequently to help control the amount of bacteria in the mouth. At your visits Dr.Shlafer and the hygienists will be evaluating the condition of your gums, which will include a thorough exam, x-rays when needed, a visual inspection, and an analysis of hard and soft tissue. If you have any specific questions about gum disease, let us know, we’ll be happy to help.

What is Gum Disease?

According to the American Dental Association, at least 60% of adults in the United States have moderate to severe gum disease! No doubt you have heard some of the terms:  Plaque, Tartar, Calculus, Gingivitis, Periodontitis,Pyorrhea, Periodontal Disease, Gum Disease. But what does it all mean?

Quite simply, gum disease starts when plaque and tartar are allowed to accumulate at the base of your teeth. The bacteria in plaque leads to an infection in the gums called gingivitis. Left untreated, the infection spreads to the tissue and bone that holds your teeth in place, a condition called periodontitis. Because of the bacterial infection associated with periodontitis, tooth abscesses are also common.

What are the Signs of Gum Disease?

Gum disease is rarely painful,  especially in the early stages. Although there may be no visible signs, some of the common indications of gum disease are:

• Gums that bleed when you brush or floss (healthy gums do not bleed)
• Gums that are red, swollen, or tender
• Gums that have pulled away from the teeth (receded)
• Infection between the gums and teeth
• Loose permanent teeth or separating (drifting) teeth
• Changes in the way your teeth fit together when chewing
• Persistent bad breath

If you have one or several of these symptoms, it’s time to have your gums evaluated and stop the progression of the gum disease.

Snoring may seem comical on T.V., but obstructive sleep apnea is no joke. It can increase your risk of high blood pressure and diabetes. These seven health problems are linked to obstructive sleep apnea:

1. High Blood Pressure—the frequent nighttime awakenings that plague people with sleep apnea cause your system to go into overdrive, resulting in elevated blood pressure levels at night.
2. Heart Disease—People with obstructive sleep apnea are more likely to suffer heart attacks in the middle of the night. The causes may be low oxygen or the stress of waking up often during sleep.
3. Type 2 Diabetes—Sleep apnea is very common among people with type 2 diabetes—up to 80% of diabetics have some obstructive sleep apnea.
4. Weight Gain—Adding weight raises your risk of sleep apnea and up to 2/3rds of people with sleep apnea are severely overweight.
5. Adult Asthma—Although the link has not been proven, people who are treated for sleep apnea may find they have fewer asthma attacks.
6. GERD—there is no proof that sleep apnea causes acid reflux, but many people with sleep apnea complain of it.
7. Car Accidents—Daytime grogginess can put people with sleep apnea at increased risk of falling asleep behind the wheel.

If you have any of these concerns, it’s time to be evaluated by your medical doctor; who will let you know if a sleep apnea device would be the appropriate treatment for you. This is an appliance Dr. Shlafer can make to help patients control their sleep apnea symptoms.

Loose Fit

Dentures rest on a ridge of bone and gum tissue. Over time, that ridge will shrink causing the dentures to no longer fit properly. If there are tooth roots that have been retained to hold the denture (called an Over-denture) or if implants have been placed to hold the denture or if you have a partial denture, the ridge will not shrink as rapidly. The shrinkage causes the denture to become loose. Sometimes a partial or denture can be relined to restore the fit however, if the denture is worn or brittle, or if there is significant changes to the ridge, a new denture may need to be fabricated in order to obtain a proper fit.

Sore Spots

As gums change over time, a sore spot will occasionally develop due to changes in how the denture or partial rests on the gums. If a sore spot develops, contact Dr. Shlafer for an adjustment or relining of your denture.

Discolored Dentures

Dentures get bacteria build-up on them, just like natural teeth. Soak dentures and /or partials daily in a cleaning solution and brush daily as well. If all the stain and bacteria cannot be removed, bring your dentures to the office to be professionally cleaned.

Bad Odor

Dentures can absorb bacteria and fluids that cause offensive odors to develop. If your dentures appear to be clean but have an odor, contact us for some simple remedies for removing these odors.

Broken or Chipped Denture

Chips or fractures in your dentures or partials can sometimes be easily repaired. Be sure to call and bring them in for an evaluation.

Dental x-rays help Dr.Shlafer visualize diseases of the teeth and the surrounding tissue that cannot be seen during an exam. In addition, x-rays help find any problems early on which may save you from unnecessary discomfort by avoiding an emergency situation when least expected.

What Problems Can Dental X-rays Detect?

In adults, dental x-rays can be used to :

• Show areas of decay that may not be visible with an oral exam, especially small areas of decay between the teeth.
• Identify decay occurring beneath an existing filling.
• Reveal bone loss that accompanies gum disease.
• Assist in the preparation of tooth implants, braces, dentures and other dental procedures.
• Reveal changes in the bone or in a root canal resulting from infection.
• Reveal an abscess–which is an infection at the root of a tooth or between the gum and a tooth.
• Reveal other abnormalities, such as cysts and some types of tumors.

In children, dental x-rays are used to:

• Watch for decay
• Determine if there is enough space in the mouth to fit all the incoming permanent teeth.
• Determine if primary teeth are being lost quickly enough to allow permanent teeth to come in properly.
• Check for the development of wisdom teeth and identify if the teeth are impacted.

How Often Should Teeth Be X-rayed?

The frequency of getting x-rays of your teeth often depends on your medical and dental history in addition to your current condition. Some patients need x-rays more frequently, while as a general rule of thumb, full mouth x-rays are taken every five years and bitewing x-rays (check-up films) are taken every 12-24 months.

People who fall into the high risk category who made need x-rays taken more frequently include:

• Children. Children generally need more x-rays than adults because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay.
• Adults with extensive restorative work, such as fillings,—- to look for decay beneath existing fillings or in new locations.
• People who drink a lot of sugary beverages, —–to look for tooth decay–since the sugary environment creates a perfect situation for cavities to develop.
• People with periodontal (gum) disease, —-to monitor bone loss.
• People who have dry mouth—called xerostomia—whether due to medications (such as antidepressants, anti-anxiety drugs, antihistamines and others) or disease states (such as Sjogrens syndrome, damaged salivary glands, radiation treatment of the head and neck.) Dry mouth conditions can lead to development of cavities.
• Smokers, to monitor bone loss resulting from periodontal disease–smokers are at increased risk.

How Safe Are Dental X-rays?

Exposure to all sources of radiation–including the sun, appliances in your home, and dental x-rays—can damage the body’s tissues and cells which could lead to cancer in some instances. Fortunately the dose of radiation you are exposed to during the taking of dental x-rays is extremely small, especially since we have had the newer technology of digital x-rays for many years.

If you are concerned about radiation exposure due to x-rays, talk to Dr.Shlafer about how often x-rays are necessary for you.

Dental visits aren’t just for cavities and teeth cleaning anymore. During a check-up, Dr. Shlafer along with your hygienist will assess the overall health of your mouth and gums. A dental check-up is an essential part of preventive care. Here are some ways to get more out of your next visit.

1. Make a Checklist of Questions or Concerns  —————Be prepared with questions you would like to ask. Be sure to mention any of the following problems:

                Bleeding when you brush–this is a common symptom of gum disease.

               Pain or sensitivity—tooth pain or unusual sensitivity when biting  down  or eating hot or cold foods can be a sign of a cracked tooth, broken filling, or cavity.

               Sores inside your mouth that don’t heal normally–this could be a sign of oral cancer, of course early detection is crucial.

                Problems with flossing or brushing–a jagged tooth or broken filling can make it difficult to floss. Arthritis or other medical conditions may make it hard to brush too. The dental team here can help you find the source of the problem and offer solutions to help.

              Clenching your jaw or grinding your teeth—many people do this especially at night. Over time this will wear your teeth down, damaging enamel and making teeth more susceptible to decay.

2. Update Your Medical History———-Make sure we are aware of your complete medical history. Common problems like diabetes can affect  the health of your gums and teeth. Some medical problems can lead to dry mouth, which increases your risk for cavities.

3. List All Medicines, Vitamins, and Supplements You Take——–Certain prescription drugs for allergies, high blood pressure or depression can cause dry mouth. Some medications and dietary supplements can thin your blood, increasing the risk of bleeding during dental work. It is very important for Dr. Shlafer to know all the pills you are taking, including supplements, even if you don’t consider them serious.

4. If  Money is a Concern, Ask About Alternate Treatment Options—-When  household budgets are strained, some people put off dental visits.  That can lead to problems that are far more expensive than preventive care. Talk to Dr. Shlafer and ask if alternate treatment might be an option for you.

5. Find Out What You Can Do Better———- The field of dentistry is constantly changing. New products continue to come along to make oral hygiene easier and more effective. New research provides insights into the best ways to keep gums healthy. Ask Dr. Shlafer about anything that you could be doing to improve your oral health!

Remember, we’re here to help, so get the most our of your next visit and ask whatever questions or concerns are on your mind.