Posts for: July, 2012

By Arnold Cutler, D.D.S.
July 26, 2012
Category: Oral Health
Tags: medication   aspirin  
AspirinNotJustaHarmlessOTCMedication

We tend to think of aspirin as a harmless medication. It is dispensed over the counter and is the most widely used OTC medication in the U.S. We take it without thinking we may be exposing ourselves to risks. But in certain situations aspirin can cause dangerous side effects.

What is aspirin, and how does it work?
The chemical name for aspirin is acetylsalicylic acid. It is used to reduce mild pain, inflammation and fever. When you take an aspirin, it blocks the formation of prostaglandins, substances your body creates that are associated with inflammation. Prostaglandins cause inflamed tissues to become red and swollen, but they also serve protective purposes, such as forming a barrier that protects the stomach from the acid it produces to digest your food. That's why long-term aspirin use can sometimes cause stomach bleeding and ulceration or other health problems.

Why do cardiac patients take aspirin?
Another effect of aspirin is to prevent blood platelets from clumping together. Blood platelets are structures in the blood, smaller than white or red blood cells, that aid clotting by sticking together at the site of an injury. This effect of aspirin can cause prolonged bleeding, but it may be beneficial to people who have cardiovascular (from cardio, meaning heart; and vascular, meaning vessel) disease with narrowed blood vessels.

Aspirin can keep blood flowing in the obstructed vessels and thus prevent heart attacks and strokes; but it can also increase the risk for strokes that are caused by bleeding in the brain. Most physicians attempt to lower such risks by asking their patients to keep their daily aspirin consumption to a low dose 81 mg “baby” aspirin.

How does aspirin affect your teeth and gums?
Be sure to let your medical and dental professionals know you are taking aspirin, and how much you take. Also tell us about other OTC medications you take, including herbal medications and supplements, because they may interact with aspirin to cause side effects.

If you have been told to take aspirin because of a cardiac condition or procedure, be sure to follow your recommended treatment. Do not suddenly discontinue aspirin therapy; doing so can increase your risk for heart attack and stroke. Ask us if you should stop taking aspirin before a major dental or oral surgery, but do not stop taking it on your own. We will consult with your physician about your medical condition and let you know our recommendation. In most cases you can continue your aspirin therapy without causing excessive bleeding during the dental procedure.

Contact us today to schedule an appointment. You can also learn more by reading the Dear Doctor magazine article “Aspirin: Friend or Foe?


By Arnold Cutler, D.D.S.
July 18, 2012
Category: Dental Procedures
BelieveItorNotYourBodyCanRegrowLostBone

Of all the of amazing procedures in today's dentistry, surgery that causes new bone to grow — in places where it had previously been lost — is high on the list of the most extraordinary. (When bone is lost or resorbed, it is broken down into its mineral components, which are dissolved into the bloodstream. Resorption of tooth-supporting bone often takes place after teeth are lost.) Dental techniques that cause new bone growth are important because a certain amount of bone is needed to replace lost teeth with dental implants.

Today's dental implants themselves are an amazing innovation. Implants consist of a replacement for the tooth's root, usually made of a metal called titanium. A replacement for the crown, the part of the tooth that is visible above the gums, is attached to the titanium root. Titanium has the remarkable quality of being able to fuse with the bone in which it is anchored. This process, first discovered in the 1950s, is called osseointegration.

In the case of missing upper back teeth, many people who wanted dental implants in the past were told that they did not have enough bone to anchor the implants and that they had to get removable dentures instead.

But now a new surgery called maxillary sinus augmentation can cause your body to regenerate bone where it was lost and is needed to anchor dental implants.

Bone in the upper jaw or maxilla usually supports your upper back teeth. Inside the maxilla, on either side of your upper jaw, are air spaces in the bone, which are lined with a membrane. These spaces, called the maxillary sinuses, are generally shaped like pyramids; but their shape and size is different in each person. The new surgical procedures involve lifting up the sinus membrane in the area where bone is needed and filling the space thus created with a bone grafting material. Your body then creates new bone to fill the space. This usually takes about six months. If you have almost enough bone to stabilize the implants, they can be placed simultaneously with the graft, thus saving time and avoiding a second surgical procedure.

All grafting materials used today are approved by the Food and Drug Administration (FDA) and must be prepared according to their guidelines. They are specially treated to render them completely safe for human use.

After the surgery there is usually no more than mild to moderate swelling and some discomfort, about the same as having a tooth removed.

If you are missing upper back teeth, contact us to schedule an appointment to evaluate your upper jaw. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery.”


StraightFactsAboutStraighteningTeethmdashTheScienceBehindOrthodontics

What is orthodontics?

Orthodontics is a sub-specialty of dentistry devoted to the study of growth and development of the teeth and jaws and treatment of improper bites (malocclusions).

What causes improper bites?

Malocclusions result from irregularities in the positioning of teeth, disproportionate jaw relationships, or both.

Why have orthodontic treatment?

Orthodontic treatment is carried out primarily to improve the alignment and function of your teeth and bite. It also results in improved oral health, easier maintenance, a better smile, and enhanced self-confidence and esteem.

What is the first step?

Schedule an appointment with our office for an orthodontic evaluation of your teeth and jaws and learn what options are best for you.

What do we need in order to plan your orthodontic treatment?

  • Molds (impressions) of your teeth to study your bite (study models).
  • “Articulated models” placing your study models in a machine that replicates jaw movement.
  • Specialized x-rays showing your teeth and how your jaws align.
  • Photographs of your smile and position of your teeth.
  • Computer imaging.

What are braces?

Orthodontic appliances, commonly known as braces, are small brackets that are placed on teeth, through which thin flexible wires are threaded. They are the parts that move the teeth.

How do they work?

The wires tend to straighten out to their undistorted forms moving the teeth with them. Since the tissues that attach the bone to the teeth are living, they are constantly changing and remodeling themselves. Harnessing these natural forces allows the movement of teeth. Light controlled forces acting through the wires cause new bone to be formed as the teeth move into new improved positions.

What are current options for orthodontic appliances?

  • Fixed appliances, traditionally known as braces, include brackets bonded to the teeth. These may be either metal or clear brackets, which are less visible but more susceptible to breakage.
  • Removable appliances, or clear aligners. These consist of a series of computer-generated clear plastic custom fitted trays that progressively move the teeth into better alignment.

Orthodontic treatment is an ingenious scientific discovery that has allowed the dental profession to precisely move teeth for better appearance as well as improved function. It harnesses the body's natural processes by which tissues normally remodel themselves to maintain a steady state, allowing your dental team to move your teeth into improved position for a lifetime of dental health and a great smile.

Contact us today to schedule an appointment or to discuss your questions about orthodontics. You can learn more by reading the Dear Doctor magazine article “The Magic of Orthodontics.”


By Arnold Cutler, D.D.S.
July 02, 2012
Category: Oral Health
SleepApnea-aHiddenDanger

Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.

If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.

Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.

What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.

At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.

Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.

Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”




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