Glick & Woods Dentistry

Glick & Woods Dentistry

Muting the dentist’s drill eases the patient’s fear

Much like noise-canceling or noise-reduction headphones in airliners, a new dental technology can block out the shrill sound from the dentist’s instruments, which has been the prime cause of patient phobia and anxiety.

The device, containing a microphone and a chip, shuts out sound from the dental drill through soundwaves that produce interference. The prototype device, invented by clinicians from King’s College London, uses an electronic filtering system that locks onto soundwaves and removes them.

Patients would only have to plug the device into their MP3 player or mobile phone and then plug its headphones into the device. They could listen to their own music while canceling out unwanted noise, although they would still be able to hear the dental team conversing or speaking to them.

The technology was initially authored by Professor Brian Millar at King’s College London Dental Institute who worked with research engineers at Brunel University and London South Bank University for over a decade before designing the prototype. The professor was inspired by carmaker Lotus’ efforts at developing a system that removed unpleasant road noise while still allowing drivers to hear emergency sirens.

The drilling sound of the dentist’s handpieces has been a deterrent for most patients, postponing their trips to the dentist and critical oral care.

“Many people put off going to the dentist because of anxiety associated with the noise of the dentist’s drill. But this device has the potential to make fear of the drill a thing of the past,” says its creator, Professor Millar. “The beauty of this gadget is that it would be fairly cost-effective for dentists to buy, and any patient with an MP3 player would be able to benefit from it, at no extra cost. What we need now is an investor to develop the product further, to enable us to bring this device to as many dental surgeries as possible, and help people whose fear of visiting the dentist stops them from seeking the oral healthcare they need.”

Low-fluoride toothpaste is no better than nonfluoride toothpaste in preventing tooth decay among children

Toothpastes containing less than 1,000 parts per million of fluoride concentrations are as ineffective at preventing tooth decay as toothpastes with no fluoride at all. This finding, published in the Cochrane Database of research group Cochrane Collaboration, is taken from 79 clinical studies involving 73,000 children worldwide.

Children’s toothpastes are in the range of 100 ppm to 1,400 ppm fluoride concentration. “Toothpastes with lower fluoride levels, in the 440 to 550 range, give results that are no better than the results seen with toothpaste that does not contain fluoride,” said co-authors Helen Worthington and Anne-Marie Glenny of the Cochrane Oral Health Group, School of Dentistry, University of Manchester.

The researchers sought to establish the link between the use of topical fluorides (toothpastes) and the risk of dental fluorosis in young children. Dental fluorosis refers to changes in the appearance of tooth enamel caused by long-term ingestion of fluoride while the teeth are forming. It can range from mild white patches on the teeth to severe mottling with brown staining.

The results suggest that brushing a child’s teeth with a fluoride toothpaste before the age of 12 months can increase the risk of the child developing mild fluorosis. And although 1,000 parts per million of fluoride is effective in fighting tooth decay, there is strong evidence that such levels may still cause fluorosis in children up to 6 years of age whose permanent teeth are still developing.

The authors, however, pointed out that for some children considered to be at a high risk of tooth decay by their dentist, the benefit to health of preventing decay may outweigh the risk of fluorosis. In such cases, careful brushing of children’s teeth with a small amount of toothpaste containing higher levels of fluoride would be beneficial.

“The risk of tooth decay and its consequences, such as pain and extractions, is greater than the small risk of fluorosis. Children would have to swallow a lot of toothpaste over a long period of time to get the severe brown mottling on the teeth,” Dr. Glenny added. Parents are advised to speak to their family dentist if in doubt.

Regular intake of green tea prevents and cures gum disease, study finds

Green tea has become an increasingly popular beverage being touted in numerous studies as having therapeutic benefits for heart disease, rheumatoid arthritis, genital warts and obesity. Green tea’s antioxidant properties are believed to produce anti-inflammatory and wound-healing effects.

In a recent study published in the Journal of Periodontology, the researchers discovered that green tea also promotes healthy teeth and gums. An antioxidant known as catechin was identified as responsible for resolving symptoms of periodontal (gum) disease. It works by preventing the growth and sticking of disease-causing bacteria or virus to teeth and gums. Antioxidants are substances that protect our cells against the effects of free radicals. Free radicals are molecules produced when our body breaks down food or by environmental exposures like tobacco smoke and radiation. Free radicals can damage cells and may play a role in heart disease, cancer and other diseases.

In the study, the researchers examined 940 men aged 49 through 59 on the three indicators of gum disease by measuring the pocket depth between the gums and tooth, loss of the bone attachment of the tooth and probing bleeding gums. They found that the men who had regular intake of green tea had healthier gums and teeth than those who drank less green tea. They noted that a cup a day increase in consumption resulted in the shrinking of the above indicators or symptoms.
Periodontal or gum disease, a chronic (persistent) infection of the gums and bone supporting the teeth, has been known to work its way to become a precursor of cardiovascular disease, lung disorders and diabetes.

Acupuncture before treatment eases anxiety of dental patients

Patient anxiety or fear of going to the dentist has been one of the predicaments dental practitioners face when providing dental care. One in 20 patients or 5% of patients in the US and Europe have odontophobia, or extreme dental fear, while up to one-third experience some degree of anxiety.

A new study, tested on 20 patients (16 women and 4 men) who have moderate to severe anxiety, found that acupuncture can calm down anxious patients when performed prior to dental treatment.

Using the Back Anxiety Inventory questionnaire, the average BAI score of the patients fell from 26.5 to 11.5. The BAI score was assessed before and after acupuncture treatment using acupuncture points located on top of the head. Acupuncture was administered five minutes before dental treatment.

All 20 patients were able to receive dental treatment after acupuncture was given. Prior to this, dental treatments were only possible in six and only after much effort from the dentist and patient.

The acupuncture was performed by the dentists themselves, who are members of the British Dental Acupuncture Society. The patients were from eight different dental practices.

There have been various techniques to calm down anxious patients before they receive dental treatment, including relaxation techniques, biofeedback, behavioral therapy, hypnosis and sedatives. However, these are time-consuming and need considerable psychotherapeutic skills to be effective. The authors suggest that, although acupuncture still needs to be tested in a larger study, it could offer a simple and inexpensive method of treating dental anxiety.

Oral bacteria in pregnant mother can infect the unborn fetus

Periodontal disease (gum infection) can spread through the bloodstream and infect the uterus (womb). This could cause low birth weight, premature delivery and infection of the unborn child. A case report published in the Green Journal of the American College of Obstetricians and Gynecologists reported fetal death due to infection of oral bacteria, Fusobacterium nucleatum, found in gum disease.

The mother had gingivitis and pregnancy-associated gum bleeding. Normally, our body’s antibodies fight bacteria in the blood before it reaches the placenta, but the mother experienced respiratory tract infection just before birth, which weakened her immune system. This gave way to bacteremia (infection of the bloodstream) that penetrated into her placenta (the baby’s source of nutrition).

A study at the Case Western Reserve University School of Dental Medicine and the Case School of Medicine found injection of Fusobacterium nucleatum in mouse placenta triggered an inflammatory reaction, similar to the infection of uterus in humans. The inflammatory response brought death to fetal mice.

In the stillbirth case, the cause of death was found to be septic infection and inflammation caused by bacteria. The placenta and the fetus’ lung and stomach were tested positive for the bacteria that were present in the mother’s oral plaque.

This is the first published case of full-term stillbirth due to transmission of mouth bacteria.

The importance of oral hygiene to overall health has been emphasized in numerous studies. Dental evaluation has now become an essential part of patient management.

Oral bacterial infection has also been linked to heart disease, diabetes and arthritis.

Getting to the bottom of sensitive teeth

Dentine hypersensitivity is a sudden, sharp shooting pain in the teeth triggered by hot, cold or acidic foodstuff. Pain is also felt with touch, such as from chewing or tooth-brushing, and with air pressure, such as when one is breathing through the mouth.

Cracked teeth, cavities, worn tooth enamel (outer layer of the tooth), worn tooth fillings and exposed tooth roots can cause hypersensitivity. When the tooth’s outer covering breaks down, dentin is exposed (inner tooth bone layer), allowing heat and cold or food particles to pass through its hollow tubules; this irritates the nerve fibers in the tooth pulp. The sensory nerve endings are responsible for our sensation.

The dentin may also be exposed when gums recede due to infection (periodontal disease). In advanced periodontitis, the tooth attachment and its supporting structures are destroyed, leaving the root exposed. This leads to hypersensitivity in the gumline. Brushing the teeth too aggressively can also injure the gums and expose the tooth roots.

Treatments of sensitive teeth range from desensitizing toothpastes that contains potassium nitrate (inactivates the nerve) to fluoride gel that strengthen tooth enamel, sealants and bonding agents that seal the sensitive teeth and root canal therapy. Endodontic, or root canal, treatment (removal of the pulp tissue) will be recommended by the dentist in severe or chronic cases.

Proper oral hygiene, including proper brushing technique and flossing, and healthy diet will prevent tooth decay, gum disease and tooth mineral loss. Enamel loss has been attributed to an acidic diet, which produces demineralization

Frequent Toothbrushing Can Lower Heart Disease Risk

You will never look at toothbrushing again as a routine hygiene to take lightly or you can do without. A recent study found that people who brush their teeth less frequently have a 70% increased risk of heart disease compared with those who brushed their teeth twice a day. When people don’t brush their teeth regularly, they are prone to periodontitis, a chronic gum infection. This will manifest at first as gingivitis, or inflammation of the gums, which not only causes bad breath but also sets off a chain of events in our bloodstream.

One of our body’s responses to inflammation is blood coagulation, or clotting. Protein substances in our blood that cause blood to get sticky rise when there is inflammation. When this condition becomes chronic or persistent, it will cause accumulation of plaque that blocks normal blood flow to the blood vessels, a condition called atherosclerosis. Plaque that has already formed in the arteries may also be swollen by bacteria and cause further narrowing of these blood vessels. This heart disease leads to stroke and heart attack.

People who reported poor oral hygiene tested positive for these clotting protein substances, which are inflammatory markers in blood tests. With the strong link between periodontal disease and risk of cardiovascular disease, people are advised not to take chances and observe oral hygiene. Prevention is still the best cure. Being diligent with the simple acts of toothbrushing and flossing can prevent the risk of a fatal cardiac event.

Painful and Unsightly Mouth Sores

Mouth sores are any open blisters found in the oral cavity. They are commonly seen on the lips, the tongue, the gums, the palate and the inside of the cheeks. Examples include canker sores, cold sores and fever blisters.

There are myriad reasons for mouth sores. Many are caused by infectious organisms, bacterial, viral or fungal. Cold sores or fever blisters, for example, are caused by a virus, herpes simplex. Others may be due to trauma from the teeth or from some other physical or chemical injury. Others may be entirely due to an existing medical problem, for example cancer or an autoimmune disease. Finally, they can also be caused by an allergic reaction or to a dietary deficiency.

Generally, treatment depends upon the underlying cause for the mouth sore. However, common personal care strategies include gargling with cold water, avoiding hot, spicy, salty and acidic foods, maintaining good oral hygiene and taking pain medications.

Although over-the-counter medications are commonly available for mouth sores, you will need to see a doctor when the mouth sores lasts longer than two weeks, if you have an immune deficiency such as HIV or you are a cancer patient on treatment, if there are lesions or rashes on the other parts of the body or if you experience unintended weight loss.

Impact of an Impacted Tooth

An impacted wisdom tooth can trap food particles and debris. Bacteria feed on these food particles, which may cause infection of the surrounding tissue. This is called pericoronitis.

Pericoronitis may include any of the following symptoms: pain, swollen gum tissue in the area of the affected tooth, difficulty in biting or opening of the mouth, swelling of the cervical (neck) lymph nodes, foul smell or taste in the mouth, pus from the gum tissue near the tooth or swelling on the affected side of the face.

Patients with pericoronitis are given antibiotics to combat the infection. Additionally, warm saltwater rinses will help with healing. If treated, the infection should resolve within one week. Your dentist may advise you to have the impacted tooth removed. However, the offending tooth can only be removed once the infection is under control.

Taking Care of Your Gums Takes Care of Your Teeth, Too.

Periodontal disease is an infection of the gums, thus aptly called gum disease. Bacteria are the primary culprit in periodontal disease. A bacterium produces sticky, colorless plaque on the teeth. Brushing and flossing will help eliminate plaque. However, plaque that is not removed will form tartar, a harder substance to clean. Tartar harbors bacteria that make it easier to invade your gums, causing gum disease.

Initially, bacteria from tartar will cause inflammation of the gums, or gingivitis. Gingivitis is seen as swelling and reddening of the gums. Gums bleed easily even during brushing the teeth. Gingivitis is easily treated with improving dental hygiene and regular cleaning by a dentist. If left untreated, gingivitis will develop into periodontitis, a more serious type of infection. Gums pull back from the teeth and form shallow pockets of infection.

To protect yourself from gum disease it is important to practice good oral hygiene. This includes brushing your teeth diligently twice daily, avoiding cigarettes and tobacco products, eating a balanced diet and making regular visits to your dentist.