A Must-Read If You Take Supplements For Osteoporosis

Many people are often surprised by the wide range of medications that affect their oral health. Some of these can cause complications during oral surgeries like extractions or dental implant placement. For example, people who take Coumadin, a commonly prescribed blood thinner, may experience more bleeding during these procedures. pillbottle

Certain drugs, however, create a much greater risk. The complication with bisphosphonates, often prescribed to treat osteoporosis, is a risk for jaw osteonecrosis. In simple terms, this is death of the jaw bone.

Jaw osteonecrosis occurs when the bone fails to heal after a surgery, even a minor procedure such as a tooth extraction. It results from obstruction of blood supply from the drug’s potential interference with the bone’s ability to repair itself.

Most who acquire osteonecrosis experience pain, swelling or infection of the gums and jaw, gums that don’t heal, and loose teeth. However, its onset can occur without obvious symptoms.

Bisphosphonates include trade names such as Fosamax, Actonel, Boniva, Reclast, Binosto, Prolia, Zometa and Xgeva. The most prescribed is Fosomax and ranks as one of the top 25 most prescribed drugs on the market. Fosamax was approved by the FDA in 1995 and reports began surfacing in 2003 that linked bisphosphonates with jaw osteonecrosis.

In addition to treating osteoporosis, bisphosphonates are also used to treat cancer that has spread to the bone. In these cases, bisphosphonates are given intravenously and in higher doses. This creates a much greater risk of osteonecrosis of the jaw than for individuals on the medication for osteoporosis.

Jaw osteonecrosis risk seems to increase with the amount of time biphosphonates are taken. However, researchers have determined that bisphosphonates can create a risk for necrosis with even short-term use of the oral medications for osteoporosis.

In a study of 208 participants who took Fosamax for varying durations, 4 percent acquired osteonecrosis. This finding was in contrast to the drug makers’ claims that bisphosphonate use only posed a noticeable risk for those who took the medication intravenously, such as cancer patients.

Not only did the study show that short-term usage can place the patient at risk, the drug can maintain a 10-year half-life in bone tissue. The risk for jaw necrosis is highest with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery.

Many physicians who prescribe bisphosphonates have relied on the drug makers’ stance of low risk typically prescribed for osteoporosis. This has left patients often unaware of the risks when they are scheduled for dental procedures.

This is why it is important to make us aware of all the drugs you take, including over-the-counter supplements. The goal is to provide a successful outcome for each procedure. Being familiar with your overall health enhances the potential for positive results.

If you have questions regarding the medications you are taking in regard to oral risks, call our office or ask at your next visit. Very importantly, keep us updated on your medications at every visit.

Protect Your Dental Implants For A Lifetime Of Benefits!

Today, Dental Implants have become so fine-tuned that they hold one of the highest success rates of all in-bone implant types – nearly 97%.

One of the reasons that modern Dental Implants are such a wise investment is that they are designed to last for a lifetime. However, as with any procedure that involves an implant in human bone, there is an element of risk.

Although not a frequent occurrence, removing an implant means the patient has lost their investment and must endure additional procedures and expenses for repair and replacement. But, it is the patient who plays an important role in helping to minimize this risk.

One of the most important factors in any successful medical or dental procedure begins with the doctor who coordinates your care. Your doctor should never be selected based on the lowest fee. The doctor chosen should have training and experience in the diagnosis and placement of all implant types in order to select the system most appropriate for your individual needs.

In selecting your doctor, you should also look for a good track record in the placement of implants. Successful placement relies on the ability to assess for adequate bone mass to support an implant without interfering with adjacent structures.

Obviously, a qualified doctor can enhance your potential for a successful outcome. While the doctor involved in your treatment is important, much of the risk falls into the patient’s hands after the placement process.

Patients can improve their potential to have a successful outcome almost immediately. When the implants are placed, the patient should closely follow their post-op instructions. For most patients, we recommend they eat cool, soft foods for the first few days. This helps to keep swelling and bleeding to a minimum and enables the gum tissues to heal faster around the incision sites, which helps to lower infection risk.

Once home, other factors can also put your implants at risk. For smokers, their risk for implant failure is high because of the chemicals in cigarette smoke. These are drying to oral tissues and delay the healing process. The longer the sites take to heal, the greater the risk for infection to set in.

A surprising but destructive force to Dental Implant success is grinding or clenching your teeth. Also known as bruxing, teeth clinching and grinding is a common symptom of bite misalignment. As a matter of fact, the force of clenching can be so intense it can be similar to that used to crack a walnut. Signs of clenching or grinding are worn, chipped or broken teeth. If you suspect you grind or clench, mention this prior to treatment so corrective measures can resolve the problem.

Most important of all is the patient’s commitment to maintaining good oral hygiene. Even though Dental Implants do not experience decay, the gum tissues and bone supporting the implants are as susceptible to oral bacteria as before. When oral bacteria infection is able to move its way down the implant sites, the only option for ridding the infection may involve removal of the implant.

Having Dental Implants will require you to be more committed than ever to your at-home oral hygiene regimen. We may also schedule your dental cleanings to occur every four months rather than twice a year. These visits allow our hygienist to remove accumulated bacteria in your mouth and around implant sites.

In our office, we are very proud of the success rate our implant patients enjoy. When adults are able to regain the ability to bite, chew and laugh with confidence, we are as thrilled as they are! We want every patient to have a confident smile for a lifetime!

If you’ve considered Dental Implants, let’s discuss the types that may be best for you. Call toll free 1-866-9-Smiles to arrange a consultation. We’ll discuss the various options available in today’s implant dentistry as well as anticipated costs and payment options.

What To Do If A Crown Comes Off

surprised-cartoonIt’s Murphy’s Law — the worst things seem to happen at the worst times. While there is never a good time to lose a crown (also referred to as a ‘cap’), disasters tend to happen at the worst times, like the morning you’re leaving on vacation or the night before an important job interview. And, they always seem to happen on a weekend when waiting for a Monday dental visit seems an eternity.

A crown is a custom-designed ceramic shell made to cover a natural tooth. They are typically placed to protect the health of a tooth. A crown is often recommended when a tooth has developed cracks or has too much filling material for the tooth structure. Crowns are also placed for esthetic reasons or to correct bite alignment.

Porcelain crowns are ‘cemented’ in place with a special adhesive. This adhesive is designed to secure the crown for most normal functions, such as eating, biting and flossing. However, things like eating ice, an injury to the mouth, or night-time grinding may disrupt the adhesive and dislodge the crown.

If you lose a crown, don’t panic. There are simple measures you can take to protect the tooth structure and temporarily replace the crown until you are seen in our office.

As soon as the crown comes off, rinse it while holding carefully. Place the crown in a hard container (such as one that holds a retainer or mouth guard or even a clean pill bottle). Rinse the mouth gently with lukewarm water. Call our office immediately to schedule a time to have the crown re-cemented. If your crown comes off after our normal business hours, the recording will give you instructions on how to reach me.

Fortunately, you can temporarily secure the crown until it is re-cemented. Most drugs stores sell a putty-like dental cement made to temporarily hold crowns in place. Denture adhesives can also provide temporary grip. Follow the directions carefully and then avoid chewing in the area of the crown. Floss only in a downward motion to avoid dislodging the crown again.

If you cannot get to a drug store, apply petroleum jelly to the inside of the crown. This will provide some help in holding it in place, although for a brief time.

NEVER use household glue to reattach your crown! Most of these products contain highly-toxic ingredients which can leak into your mouth and get into your system. And, because glues like Super Glue and Gorilla Glue are ‘permanent’ glues, removing this material can be very difficult and even damage the tooth structure during attempts to remove it. Too, the crown can be damaged in the process of removing this type of glue.

If you’ve lost the crown, your remaining tooth structure may be sensitive to hot or cold until a new crown can be created and attached. If this occurs, the area should be covered until you can be seen in our office. For this, use a layer of the drug store dental cement on the tooth to fill it in and cover sensitive nerves. Again, avoid chewing in that area and floss downward only.

Regardless of what caused your crown to come off, our goal is to get you smiling comfortly and confidently again – and as soon as possible! Call us at 586-739-2155. We always welcome emergency patients who have experienced mishaps that result in a crown coming off or tooth loosening (or loss).

Special Bond With Shelby Township Community

When I hear “It takes a village,” I think of Shelby Township. Many hands and much energy goes into coordinating all the terrific activities, events and offerings that bring us together in a unified way.

In a couple of months, our dental office will celebrate 20 years in the Shelby Township community. It’s hard to believe it’s been nearly two decades since I chose this location as my dental ‘home.’ Yet, it’s connected me to a terrific staff and hundreds of dear patients who make up our extended family of beloved smiles!

It has been our pleasure to support the area in a number of ways, with Shelby Township Parks & Recreation holding a special place in our hearts. For many years, we have sponsored activities from Breakfast With Santa to Summer concerts to art fairs to little league baseball – and everything in-between!

Dr. Barbat being presented Certificate of recognition
Dr. Barbat being presented Certificate of recognition

I was pleasantly surprised on December 1st at the Shelby Township Tree Lighting ceremony where I was presented a Certificate by the talented and dedicated staff of Shelby Township Parks & Recreation for our support and in honor of our 20 years in the community.

Christal, Dr. Barbat, Sarah, Anna, Nan, Doreen and Michelle
Christal, Dr. Barbat, Sarah, Anna, Nan, Doreen and Michelle

We have also proudly supported Turning Point Macomb, an organization for victims of domestic and sexual abuse as well as award an annual scholarship to a high school senior entering college to pursue a health-related career.

On behalf of myself and our entire team, thank YOU for helping to make the past 20 years so fulfilling. I can’t imagine my days being spent in a better community of people who bring their warm smiles to our care! Thank you!