Antibiotic Prophylaxis: Prosthetic Joints and Orthopedic Implants

If you have had a joint replacement and taken antibiotics before dental work in the past, you may not need to make a trip to the pharmacy before your next procedure. The American Dental Association has found it is no longer necessary for most dental patients with orthopedic implants to have antibiotic prophylaxis to prevent infection.

What Is Antibiotic Prophylaxis?

Antibiotic prophylaxis (or premedication) is simply the taking of antibiotics before some dental procedures such as teeth cleaning, tooth extractions, root canals, and deep cleaning between the tooth root and gums to prevent infection. We all have bacteria in our mouths, and a number of dental treatments—and even daily routines like chewing, brushing or flossing—can allow bacteria to enter the bloodstream (bacteremia). For most of us, this isn’t a problem. A healthy immune system prevents these bacteria from causing any harm. There is concern, however, that bacteria in the bloodstream could cause infection elsewhere in the body.

Prior to 2012, premedication prior to dental procedures was common for joint replacement patients, even though there was little evidence to support the practice and experts recommended against its practice for most dental patients. In 2012, the American Dental Association and American Association of Orthopedic Surgeons published updated guidelines, stating that dentists “might consider discontinuing the practice of routinely prescribing prophylactic antibiotics”. In January 2015, the ADA’s Council on Scientific Affairs issued another guideline, which continued to discourage prophylactic antibiotic use for most patients with prosthetic joint implants. Guidelines are re-evaluated every few years to make sure that they are based on the best scientific evidence.

Why Don’t I Need Antibiotic Prophylaxis? 

Based on careful review of the scientific literature, the ADA found that dental procedures are not associated with prosthetic joint implant infections, and that antibiotics given before dental procedures do not prevent such infections.

In fact, for most people, the known risks of taking antibiotics may outweigh the uncertain benefits. Risks related to antibiotic use include nausea, upset stomach and allergic reactions, including anaphylactic shock (a severe allergic reaction that can be life threatening). Other risks include developing antibiotic resistance in bacteria, which can complicate treatment of infections such as strep throat, pink eye and meningitis; as well as increasing the risk of C. difficile infection, which causes diarrhea and other intestinal problems. Patients over 70 years old are also at increased risk of experiencing adverse  reactions to some antibiotics. 

Who Can Antibiotic Prophylaxis Help?

Depending on your personal medical history, you may still be a candidate for premedication. For example, antibiotic prophylaxis might be useful for patients undergoing dental procedures who also have compromised immune systems (due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk of orthopedic implant infection. It may also benefit others with heart conditions. Always talk with your dentist or physician about whether antibiotic prophylaxis before dental treatment is right for you.

The above article is from mouthhealthy.org

Coloman E. Kondorossy, DMD, FAGD, DICOI   
Stephen K. Kondorossy, DMD, MBS  
General Dentists  
1445 Hamilton Street  
Somerset, NJ 08873   
(732) 249-0055   
SomersetImplantDental.com

Ketosis Breath: When Your Diet Affects Your Oral Health

The ketogenic diet has created buzz in the health community and for good reason. Many have found success in restricting their carb intake so that the body burns fat instead of glucose to lose weight. If you're following a keto diet, you might notice some unpleasant side effects that accompany the positive changes on the scale. For example, so-called ketosis breath is a common complaint. Understanding keto breath is the first step to ensuring your diet doesn't impair your oral health.

Ketosis and Your Breath

If a lower-carb lifestyle is supposedly healthy, then why does it result in foul-smelling breath? The answer is in how your body breaks down fats. After swapping a typical carb-heavy diet for one that promotes fats and protein, your body goes into ketosis. As the University of California, San Francisco explains, ketosis is a process wherein your body begins to burn fat for energy, since glucose stores (your body's preferred source of energy) aren't readily available. While in ketosis, your body converts fat cells into three types of ketones, which are fat byproducts. One of these ketones, called acetone, is essentially unusable for your body's energy stores. 

Therefore, your body releases it via your urine and lungs, notes Medscape. It's acetone that gives your breath that distinctive "ketosis" smell, which, according to Medline Plus, can be compared to an overly sweet, fruity scent.

Keto Diet and Oral Health

When swapping carbs for healthy fats and proteins, your body undergoes several changes. While ketosis breath is often associated with a low-carb lifestyle, the diet may also have a positive effect on your oral health. After all, in avoiding carbs, you're also avoiding processed sugars, which the American Dental Association counts among the worst foods for oral health. Because oral bacteria thrive on sugar, reducing your sugar intake may reduce cavities.

A low-carb diet may also help reduce inflammation. A study in BMC Oral Health found that a diet low in carbohydrates and high in omega-3 fatty acids resulted in lower rates of gingivitis and inflammation in patients. So while going low-carb may make your breath smell, it may actually help improve your overall oral health.

Freshening Up

If you've noticed that you have keto breath and you still want to continue your keto diet, consider some of these methods to deal with the smell:

• Chew sugar-free gum to help stimulate saliva and freshen your breath.
• Adjust your intake of complex carbohydrates, such as leafy green vegetables and whole grains, while continuing to avoid refined carbs.
• Fill a water bottle and sip throughout the day.
• Continue good oral health habits. A keto lifestyle, while beneficial for oral health, is not a substitute for daily brushing and flossing.
• Add fresh herbs to water and tea. Herbs such as clove, cinnamon, mint and fennel are natural breath fresheners.

Starting and continuing a ketogenic lifestyle should only ever be done with the supervision and approval of a qualified health care professional. While it's true that a keto diet may offer benefits for oral health, it has a few drawbacks as well. By addressing some of the roadblocks, you can make sure that your keto diet is as healthy as it is successful. To keep you on track, lessen the smelly side effects by brushing with Colgate Total Fresh Mint Stripe Gel toothpaste. It has a minty blend of gel and paste that leaves your mouth clean and fresh. 

The above article is from colgate.com

Coloman E. Kondorossy, DMD, FAGD, DICOI   
Stephen K. Kondorossy, DMD, MBS  
General Dentists  
1445 Hamilton Street  
Somerset, NJ 08873   
(732) 249-0055   
SomersetImplantDental.com

Travel: Is Dental Care Abroad Safe ?

If you are planning a trip out of the country it may be helpful to schedule a dental checkup before you leave, especially if you'll be traveling in developing countries or remote areas without access to good dental care. If you’re considering a vacation outside the United States for dental treatment in an attempt to save money, often referred to as "dental tourism," there are some things you should first consider.

Question: Is dental care abroad safe? 
Answer: The procedures, equipment and drugs used by dentists in the U.S. are held to high standards. The U.S. Centers for Disease Control and Prevention has comprehensive guidelines on infection control procedures for dental health-care settings. They exist to prevent the spread of infections, including blood borne illnesses such as hepatitis and AIDS. U.S. dentists must abide by regulations for radiation safety (X-ray equipment and its use) and for proper disposal of biomedical waste. Also, the drugs and dental instruments and materials used by dentists in the U.S. are regulated by the U.S. Food and Drug Administration to ensure that they are safe. These standards are in place for your safety.

Q: What recovery time and follow-up care will I need? 
A: Many dental procedures are surgical in nature and may require months of healing. This should be factored in to your travel plans. Significant dental procedures require follow-up care to make sure everything is healing and functioning properly. Post treatment risks after dental surgical procedures include bleeding, pain, swelling and infection. Continuity of care is important and should be a consideration when making treatment decisions. Establishing a "dental home" provides you with comprehensive oral health care so conditions such as gum disease and tooth decay can be diagnosed at an early stage when treatment is simpler and more affordable. A dentist who knows your case history can provide you with guidance on good oral health habits, preventive oral health services and diagnosis and treatment of dental disease based on your individual needs.

Q: What qualifications are required of dental professionals? 
A: Dentists trained in the U.S. graduate from a dental school accredited by the American Dental Association Commission on Dental Accreditation. In addition, dentists must pass national examinations and meet state requirements before they earn a license to practice. Similar levels of training may exist in the country to which you are travelling, but this may be difficult to determine if that country does not have similar dental regulations.

Q: Will my insurance cover dental procedures in other countries? 
A: If you have insurance for dental care performed outside of the U.S., you should confirm with your insurer and/or employer that follow-up treatment is covered upon your return to the U.S. You should consider arranging follow-up care with a U.S. dentist prior to travel to ensure continuity of care upon your return. If you do not have a dentist in the U.S., you can find an ADA member dentist in your area at ADA Find-a-Dentist. You should confirm with your U.S. dentist and the dental care provider in the other country that the transfer of patient records to-and-from facilities outside of the U.S. is consistent with current U.S. privacy and security guidelines.

Q: What about travel advisories?
A: The U.S. Department of State issues travel alerts to disseminate information about short-term conditions, generally within a particular country, that pose imminent risks to the security of U.S. citizens. In the spring of 2009, for example, the Department of State issued a travel alert cautioning people to avoid non-essential travel to Mexico because of an outbreak of H1N1 influenza in that country that resulted in a number of deaths. In addition, the alert recommended that travelers check the department's Web site for new travel advisories as well as the Web site of the U.S. Centers for Disease Control and Prevention for any additional information or recommendations.

Bottom line: If you’re considering travelling for dental care, remember, saving money overseas may lead to greater expense to your health and your wallet when you arrive back home. 

The above article is from mouthhealthy.org

Coloman E. Kondorossy, DMD, FAGD, DICOI   
Stephen K. Kondorossy, DMD, MBS  
General Dentists  
1445 Hamilton Street  
Somerset, NJ 08873   
(732) 249-0055   
SomersetImplantDental.com

Wine Tasters, Beware

Wine tasters may be at high risk for enamel stain and erosion.

Why? Sipping wine many times a day -- and swishing it in the mouth -- increases the enamel's exposure to damaging acids.

That is why it's better to drink a glass of wine, soda, or sweet tea with a meal instead of sipping it over several hours.

Above article from: Webmd.com/oral-health

Coloman E. Kondorossy, DMD, FAGD, DICOI   
Stephen K. Kondorossy, DMD, MBS  
General Dentists  
1445 Hamilton Street  
Somerset, NJ 08873   
(732) 249-0055   
SomersetImplantDental.com

What Are Wisdom Teeth?

Wisdom teeth are the last molars on each side of the jaws. They are also the last teeth to emerge, or erupt, usually when a person is between 16 and 20.

Since wisdom teeth are the last permanent teeth to come in, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to wisdom teeth that are impacted, teeth that are trapped beneath the gum tissue by other teeth or bone. If teeth are impacted, swelling and tenderness may occur.

Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding and disease. Since teeth removed before age 20 have less developed roots and fewer complications, the American Dental Association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.

How are Wisdom Teeth Removed?

A tooth extraction is a relatively routine procedure. Your dentist or a dental specialist, called an oral surgeon, will recommend either "going to sleep" using general anesthesia, or numbing this area in your mouth with a local anesthesia such as Novocain®.

After the tooth (or teeth) is removed, you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit any bleeding that may occur. Some pain and swelling may occur but it will normally go away after a few days; however, you should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.

Removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future.

Horizontal Impaction	Angular Impaction	Vertical Impaction

To read the entire article visit crest.com

Coloman E. Kondorossy, DMD, FAGD, DICOI   
Stephen K. Kondorossy, DMD, MBS  
General Dentists  
1445 Hamilton Street  
Somerset, NJ 08873   
(732) 249-0055   
SomersetImplantDental.com

Braces

Braces and orthodontic treatment are used to correct “bad bites,” or malocclusion (teeth that are crowded or crooked). In some cases your teeth may be straight, but your upper and lower jaws may not meet properly. These jaw or tooth alignment problems may be inherited or could result from injury, early or late tooth loss, or thumbsucking.

If you have an abnormal bite your dentist may recommend braces or another orthodontic treatment to straighten out your smile. Correcting the problem can create a nice-looking smile, but more importantly, orthodontic treatment results in a healthier mouth. Not correcting an abnormal bite could result in further oral health problems, including:

• tooth decay
• gum disease
• tooth loss
• affected speech and/or chewing
• abnormal wear to tooth enamel
• jaw problems

Straightening your teeth can be accomplished in different ways. The kind of orthodontic treatment you have will depend on your preference and the options provided by your dentist or orthodontist. Traditional braces realign teeth by applying pressure. They usually consist of small brackets cemented to your teeth, connected by a wire, which is periodically tightened by your dentist or orthodontist to gradually shift your teeth and jaw. The brackets may be metal or tooth colored. Sometimes they are placed behind your teeth. Under the direct supervision of a dentist or orthodontist, removable aligners are another option for treating orthodontic problems.

Orthodontic treatment may be provided by your dentist or an orthodontist, a dentist who specializes in the diagnosis, prevention and treatment of dental and facial irregularities. It will depend on the orthodontic experience of your dentist and the severity of your case.

Since abnormal bites usually become noticeable between the ages of 6 and 12, orthodontic treatment often begins between ages 8 and 14. Treatment that begins while a child is growing helps produce optimal results. That doesn’t mean that adults can’t have braces; healthy teeth can be orthodontically treated at any age.

Treatment plans will vary based on your situation, but most people are in treatment from one to three years. This is followed by a period of wearing a retainer that holds teeth in their new positions. Today’s braces are more comfortable than ever before. Newer materials apply a constant, gentle force to move teeth and usually require fewer adjustments.

While you have braces it’s important to maintain a balanced diet for the health of your teeth. Of course, a healthy diet is always important, but eating too many sugary foods with braces can lead to plaque build-up around your brackets that could permanently stain or damage your teeth. Avoiding foods like popcorn, corn on the cob, chewing gum, whole apples, and other sticky foods is also a good idea. Ask your dentist about foods to avoid while you are in treatment. Not all of us are born with beautiful smiles, but with a good oral hygiene routine, and a little help from orthodontics, you can have a beautiful and healthy smile.

You can read more about orthodontists and orthodontic treatment from the American Association of Orthodontists.

To read the entire article visit mouthhealthy.org

Coloman E. Kondorossy, DMD, FAGD, DICOI   
Stephen K. Kondorossy, DMD, MBS  
General Dentists  
1445 Hamilton Street  
Somerset, NJ 08873   
(732) 249-0055   
SomersetImplantDental.com