Orthodontics and Periodontal Disease

Does having periodontal disease mean I can’t or shouldn’t have braces to straighten my teeth? Periodontal disease, when active, results in bone loss around teeth. Orthodontics involves moving teeth through bone to relocate them in better places for both appearance and function. The process of moving teeth activates bone cells to remove bone in front of the moving tooth and lay new bone down behind it. All of this occurs due to the light forces being applied by either wires or appliances patients must wear over the months necessary to accomplish the task. What is not helpful, as active orthodontics is taking place, is to have a bacterial infection and inflammatory response going on at the same time. This does not mean, however, that people who have had periodontal disease treated and controlled cannot undergo orthodontic procedures. In fact, sometimes this is desirable because it moves teeth to positions that are more easily cleaned. So let’s discuss how someone might proceed through orthodontics who has or has had periodontal disease. Make sure the periodontal disease is under control. Do not start orthodontics until released by the dentist involved with treating this condition. Understand the risk to each tooth before starting orthodontics as well. If a tooth has a poor or questionable prognosis (outlook for future retention and stability), it may be best to remove the tooth before starting treatment. Commit to on-going periodontal supportive care at a tighter interval to assure that periodontal disease does not recur. Usually following active periodontal therapy involving surgical procedures it is wise to be on a three-month supportive care interval for the first...

Rest Versus Laziness

What’s the difference between rest and laziness? And what does this have to do with my teeth and gums? Let me answer the last question first. There is an indirect association between laziness and flossing. It doesn’t take a lot of work to perform daily but the time just seems to slip away and we forget. To make it a habit takes intentional effort for at least 21 days some studies indicate. So if you aren’t already in the habit of flossing, consider this your gentle reminder today. Now to the first, and to me the more interesting question. Rest is a necessary part of health and laziness depletes energy. Rest refreshes the mind and laziness dulls thinking. Rest is purposeful and sometimes it requires great discipline to cut off an enjoyable activity and go to bed. Laziness is undisciplined. When I “relax” my mind and go passive time flies by. When I come out of it, it is usually with regrets, “Man, I wish I had done ____ instead!” Rest is connected to performance. In fact it is in the rest phase that muscles repair after exercise and nerve patterns in the brain and extremities build new pathways that enable people to learn to play instruments or swing golf clubs. Without rest, the practice efforts fail miserably. Laziness is the failure first to exert the effort to practice and so there is nothing really to rest from. Enjoy your day!...

Our Two Jobs in Oral Health

When it comes to oral health we, as patients, have two jobs. The first job is effective plaque control on a daily basis. Note: I also lump in everything else we do that keeps our mouths and bodies healthy into this. So why don’t I call it something like, “Daily health measures?” Because I don’t want anyone missing the need for effective plaque control! My point is we can’t substitute flossing by taking supplemental vitamins, for example, and still expect good results when it comes to controlling for tooth decay and periodontal disease. The second job is effective appointment management. We have to know when and where to take our teeth and gums, and then follow through in a timely manner. And as a periodontist, what are my two jobs on behalf of patients? My first job is to check plaque control. That is, I have to make sure that your systems are working adequately enough so that my care will make a difference. And as part of this responsibility, I’m trying this little experiment of daily messages with the hope they are encouraging gentle reminders to hang in there and do the little things which are so important for each of us in the long run. And my second job is to do all the things I was trained for years to do to help you. We can talk more about this down the road. Have a great day!...

Activating Facebook to Talk with Patients and Friends

What keeps people well? I know we go to physicians, dentists and other healthcare providers when we are sick, but is this all there is? Certainly a walk through the supermarket checkout line mixed in with all the celebrity news magazines are articles on how to be healthier and the rest, yet as a country, we seem to be going the other way. It seems to me that we often attempt to figure all of this out by ourselves and sometimes what we need to see is (1) others around us have the same problems and questions and (2) that there are reasonable solutions to many of our problems. Of course my primary area of expertise is in dentistry so I am a pretty good resource to questions in this area, but all of us are in need, not only of good information, but encouragement to do what we can to live with as much health as we can possibly have. Which brings me to another observation. Sometimes I become too focused on myself and my health when there is something even better for me than this. We can’t always be in tip top health, but we can be in community with others in a way that is encouraging to all. This is why I have decided to dedicate this, until now, dormant FaceBook Page to topics on wellness and health. This, in fact, is consistent with my instructions to patients on their roles and responsibilities in achieving a better level of health when they have, or have had, periodontal disease. And by activation, I mean to consistently post...

Questions about Water Fluoridation

Both sides of water fluoridation are passionate. One side believes it to be one of the ten most important public health advances of the 20th century. http://1.usa.gov/xM8jsl This group includes organized dentistry, politicians, and public officials. On the other side are a few concerned scientists who somehow have the courage or the protection from political fall-out to take a minority position in a public health matter. In addition to these scientists there is also a large group of people who tend to not trust authority of any kind. They, in fact, make it more difficult for people on the opposing side to want to ever change, because they don’t want to be identified with these anti-everything groups. For a good summary of the argument opposing public water fluoridation I recommend you read “50 Reasons to Oppose Fluoride.” http://bit.ly/yquYHE The sections I quote below are from this article. As I was attempting to determine if putting something in the water is a good idea or not, I thought it best to start by creating a logical series of questions. And I started with what I think is the most important question followed by the next most important and so on. This, to me, is the best way to cut through political fog and most efficiently arrive at a comfortable decision as to which side to support. Question #1: Which side has the burden of proof? Does the health benefit reducing tooth decay equal the risk of placing a substance that is a known poison at higher concentrations into public water systems? Most rational minds consider safety more important than possible...

How Can Patients Promote Dental Health?

In this age of social media, people have the opportunity of helping others live better lives. On the other hand, much “promotion” is simply a form of nagging. How can we encourage our families and friends in ways that are most effective? What You Might Do 1. Lead by example. Tell your friends when you are doing something good for your own health. Here are some ideas to stimulate your thinking. • “I just figured out a better way to floss. It’s not that hard after all.” • “Just had my 6 month dental cleaning and learned that too much toothpaste can wear away the enamel.” 2. Promote dentists you like. Sincere and specific comments about experiences in dental offices are more than appreciated. They are influential and motivational. If you have had a great experience somewhere and you “tweet” it out or share it on Facebook, other’s will reflect on their own circumstances and may move to act. • “I sure love Dr. Shmedlap’s office. She is such a caring dentist.” • “I know people say that ______ procedure is painful. It wasn’t for me. Dr. Shmedlap is my hero.” 3. Pass on or re-tweet health messages you read to those who follow you. What to Avoid Don’t overdo it. Be selective in order to give your words more weight. People stop listening when people don’t give it a rest once in a while. Avoid telling people what they ought to do. Adults hate this because it reminds them of all the times their parents lectured them. It’s an automatic turn-off. Don’t promote negative stereotypes. I love dentist...