Bisphosphonates and dental care

If your doctor has prescribed you bisphosphonates, especially if they must be injected intravenously, it is important to tell your dentist because, in this case, it is contra-indicated to proceed with any surgical treatment in the mouth, including extractions and dental implants.

Bisphosphonates are drugs that prevent the loss of bone mass in certain medical conditions. Doctors prescribe it in tablets for women in menopause or pre-menopause. Bisphosphonate tablets are also indicated for people with Paget’s disease (misshaped bones).

These drugs can also be injected intravenously during therapy of bone metastases of breast cancer. In this case, some patients may develop in their mouths a condition called osteonecrosis. This condition is described by bone death following a blood circulation problem.

The link between osteonecrosis and bisphosphonates is not yet well understood. It is important then to inform your dentist if you take these drugs especially if intravenously. Your dentist can then check for any signs of osteonecrosis in the mouth and treat if needed. Furthermore, it’s strongly believed that keeping a good oral hygiene can reduce the risk of getting osteonecrosis of the jaw.

Links

• Bisphosphonates and oral health care
• Photo: The Beehive Blog

Dental Christmas

During the Christmas season, don’t forget to brush and floss your teeth after that delicious meal and dessert you will have with your loved ones!

But also, remember those less fortunate than you who either can’t afford a Christmas meal, or those who don’t have anyone to spend Christmas with.

Dental history

The true precursor to the modern dental chair was constructed by James Beall Morrison in 1867. The base of the chair was made of iron, and the chair itself boasted both a headrest and a footrest. Coupled with a foot-powered dental drill, this chair allowed dentistry to become less of an art and more of a science.

Floss and then smile

Are you still not convinced that flossing is important?

Smile

Smiling reduces stress.

It takes less muscles to smile than to frown!

A smile also confuses an approaching frown.

A healthy smile is important for confidence and self-esteem.

The world always looks brighter from behind a smile.

A smile is an inexpensive way to change your looks.

Life is like a mirror, we get the best results when we smile at it.

Everyone smiles in the same language.

Caricature, dental hygiene

If a root canal fails, does the tooth need to be extracted?

Not at all. The success rate of a root canal is about 85%, which means in most cases a root canal last for a lifetime. There are circumstances where a tooth with a root canal becomes infected again which might cause pain to the patient. In that situation the root canal can be retreated.

What is a retreatment? It’s a procedure of redoing the root canal by re-cleaning the inside of the roots, disinfecting and obturating each canal. Some teeth may require an apectomy instead, which is a microsurgery used to remove the infected tip of the root. Modern techniques of restatements and apectomy work well.

In rare cases where a tooth is fractured all the way to the root, extraction is the only thing that can be done. A dental implant, a bridge or a partial can later replace the tooth.

Links

• 10 myths and facts about root canals
• Si un traitement de canal échoue, est-ce que la dent doit être extraite?

Do root canals require long and frequent appointments?

Not anymore. Years before a root canal was done by hand with small instruments that the dentist had to carefully manipulate. Sometimes the technique was so long that the dental assistant fell asleep!

Nowadays, with mechanically rotary instruments, root canal treatment may take between one and two hours in one single appointment. The length of an appointment depends on the condition of the tooth and the number of canals it has. Nevertheless if there are complications, additional appointments might be needed.

In cases where we have severe infection, your dentist or endodontist might chose to place a drug inside your tooth to help disinfect the interior of the roots, and then finish the root canal treatment a few days later. But if there is no infection or no complications, the procedure can be completed in one single appointment.

Links

• 10 myths and facts about root canals
• Est-ce qu’un traitement de canal nécessite des rendez-vous longs et fréquents?

What is periodontal disease?

Periodontitis, or periodontal disease, is the inflammation and infection of the tissues that surround teeth. Those tissues are mainly the gums, the supporting bone, the periodontal ligament and the cementum, which together are called the periodontium.

If the inflammation has only affected the gums, it is called gingivitis and it can normally be treated with good oral hygiene. But when inflammation reaches deeper tissues like the bone, the disease is then called periodontitis. This condition is diagnosed by the detecting with a probe the presence of pockets around teeth (spaces between gums and teeth) and by the loss of bone level seen on dental x-rays.

Periodontitis is more difficult to treat than gingivitis. Improved oral hygiene at home is not enough. Curettage and root planning by the dentist or by the periodontist (gum specialist) is needed, and sometimes-even surgery depending on how aggressive the disease is. If periodontitis is not treated, teeth eventually become loose and fall out.

It’s important to note that gingivitis is the first stage of periodontal disease, and if not taken care of with proper oral care, it can quickly lead to periodontitis.

Links

• Periodontitis, Studio Dentaire
• Qu’est-ce que c’est la maladie parodontale?

 

Fact: saliva

Saliva has many functions, including the one that helps digestion, and has also a role in disinfection. Saliva is a liquid that moistens foods when ingested by the mouth, making them softer to swallow. Moreover saliva is a natural cleanser of the mouth that removes food debris and disinfects teeth and gums. It does not of course replace brushing and flossing.

Related articles

• Fact: saliva
• Fact: chewing force
• Fact: neonatal teeth
• Fact: dentition
• Fact: lost baby tooth

Links

• Beaglehole R, Benzian H, Crail J, Mackay J, The Oral Health Atlas, 2009
• Saliva, Studio Dentaire
• Fait: salive, Conseils dentaires

Does a tooth with a root canal need a crown?

Some people might say that a root canal is very costly, and to have a crown on top is even more expensive! But in order to make sure a tooth treated with a root canal to sustain chewing forces and to last a long time without fracturing, it is important put a crown on it.

A dental crown serves to make a tooth more solid and maintain its integrity after it has suffered destruction, either from tooth decay or from a trauma. A tooth that must get a root canal probably already had a very large cavity that had reached the pulp chamber where the nerve is located. After the dentist had properly cleaned the tooth from all decay and that the root canal treatment is completed, there usually doesn’t remain sufficient healthy tooth material to restore the tooth with a filling. It is then necessary to complete the treatment by a post and a crown to ensure that the tooth will not break eventually.

There are however certain situations where a tooth’s nerve is irritated after a trauma and not because of a destructive dental cavity. If the tooth that had the trauma is not broken or cracked, and if it did not already have a big filling, then some dentists believe that it’s possible to do a root canal without a crown. In this case, a filling (with or without a post) is enough to restore such a tooth.

Links

• 10 myths and facts about root canals
• Est-ce qu’une dent qui a un traitement de canal a besoin d’une couronne?

Fact: chewing force

Can you imagine 200 kg per square centimetre? That’s like the weight of three adults on a very small surface! That’s how strong the human jaw is, and this should also convince people to stay away from lions.

Not only the jaw is strong but also the enamel (outer layer of teeth) is the strongest substance in the human body, even strong than bone! I would still not recommend to chew anything with your teeth as some metallic objects can fracture the enamel.