Antibiotic Prophylaxis or Premedication

February 22nd, 2023

In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. Barker suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

  • A history of infective endocarditis
  • Certain congenital heart conditions (heart conditions present since birth)
  • An artificial heart valve
  • A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our Millburn office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

The Root of the Matter

February 15th, 2023

A strong, healthy smile is built on a strong, healthy foundation. Let’s take a moment to explore just what creates that foundation—your roots.

The Root of the Matter

The visible part of your tooth is called the crown. And while we spent the great majority of our time thinking about what goes on above the gum line—brushing, flossing, whitening, sealing, preventing cavities—the roots, the parts of the teeth below the surface, are also essential to our dental health.

  • What’s inside the root?

The inside of each tooth holds pulp, which is living tissue made of nerves, blood vessels, and connective tissue. The nerves in the pulp allow us to feel pain when a tooth is damaged, decayed, or infected. Tiny blood vessels provide oxygen and nutrients to the cells.

The inside of each root also contains pulp, located in one or more root canals. These canals are small tunnels that travel from the pulp chamber to the tip of each root. Nerves and blood vessels connect pulp tissue to the nervous and circulatory systems in the body, entering and exiting the tooth from very small openings in the root tip.

  • What’s outside the root?

On the outside, while roots look like crowns, they’re covered with a different protective surface. Roots are covered by cementum rather than enamel. This is a hard tissue, but not as hard as enamel. But cementum has another advantage—it not only helps protect our teeth, it helps them stay anchored in our jaws. (More on this below.)

  • How many roots are we talking about?

The number varies, not just depending on the tooth, but depending on the individual. Most adults have 32 adult teeth: eight incisors, four canines, eight premolars, eight molars, and four wisdom teeth, or third molars. Because the number of wisdom teeth can range from four to zero, though, that total can be smaller.

Rooted to the Spot

The reason that you can rely on your teeth for a lifetime of chewing, biting, and grinding food is the fact that they’re so securely anchored in the jaw.

  • Alveolar bone in the jaw contains a socket for each tooth.
  • A thin layer of connective tissue called the periodontal ligament lines the socket and surrounds each root. It’s filled with fibers that attach to the root’s cementum covering and to the alveolar bone, holding the tooth securely in place.
  • The periodontal ligament not only anchors the tooth, it cushions it from the daily pressure of biting and chewing.
  • Finally, the gums surround the teeth and bone, protecting them from bacteria and plaque.

Even though this design is very secure, there are situations where the root becomes vulnerable. In that case, you should see Dr. Barker at our Millburn office right away. Our goal is for you to keep your teeth healthy and strong, and for a lifetime!

Choose Chocolate on Valentine's Day

February 8th, 2023

From a student handing out sweets for her classmates to an older married couple exchanging boxes of candy, Valentine’s Day is the time of year when people like to show affection by gifting sugary treats to their loved ones. Whether you’re on the giving or receiving end of Valentine’s Day candy, you can celebrate the holiday in a healthier way by making dark chocolate your confection of choice.

Contribute to Your Health

According to the Cleveland Clinic, studies have shown that the cocoa beans used to make chocolate contain flavonoids, which can help protect the body against damage from various toxins. Flavonoids may also help lower blood pressure and improve blood flow to the heart and the brain. Dark chocolates typically contain a higher amount of flavonoids than other types, making them a great choice for chocolate lovers. However, you should keep in mind that many companies produce chocolate that is so heavily processed that the flavonoids are largely eliminated. Your best bet is to look for high-quality dark chocolates and cocoa powders that have undergone minimal processing.

Protect Against Cavities

If you think there’s no way candy could ever be beneficial for your teeth, think again. The Texas A&M Health Science Center has reported that the tannins present in cocoa beans may actually help prevent cavities by interfering with bacteria’s harmful interaction with teeth. Just like with flavonoids, tannins have been found to be present more often in dark chocolates, rather than milk chocolates, giving you another great reason to choose the richer, sweet varieties.

Avoid a Sticky Situation

One more benefit of choosing chocolate over other candies is that it is less likely to get stuck in the crevices and spaces between teeth. Gooey sweets like taffy can stay lodged in the mouth for longer periods of time, putting you at a greater risk for developing cavities. When you choose your chocolate, be sure to avoid types that also contain sticky ingredients like caramel or marshmallow, and instead opt for the plain varieties.

Remember that the health benefits you can receive from dark chocolate are largely based on eating the candy in moderation. With that being said, it’s easy to make this delicious and health conscious switch when you’re out shopping for your sweetheart, friends, loved ones, and yourself. Have fun satisfying your sweet tooth this year and Happy Valentine’s Day from all of us at Short Hills Smiles!

February is Heart Month

February 1st, 2023

The American Academy of Periodontology stresses the importance of good oral health since gum disease may be linked to heart disease and stroke. Thus far, no cause-and-effect relationship has been established, but there are multiple theories to explain the link between heart disease and periodontal disease. One theory suggests that oral bacteria may affect heart health when it enters the blood and attaches to the fatty plaque in the heart's blood vessels. This can cause the formation of blood clots. Another theory suggests the possibility that inflammation could be a contributing link between periodontal disease and heart disease. Gum disease increases plaque buildup, and inflamed gums may also contribute to the development of swollen or inflamed coronary arteries.

What is coronary artery disease?

Coronary artery disease is caused in part by the buildup of fatty proteins on the walls of the coronary arteries. Blood clots cut off blood flow, preventing oxygen and nutrients from getting to the heart. Both blood clots and the buildup of fatty proteins (also called plaque) on the walls of the coronary arteries may lead to a heart attack. Moreover, periodontal disease nearly doubles the likelihood that someone will suffer from coronary artery disease. Periodontal disease can also worsen existing heart conditions, so many patients who suffer from heart disease need to take antibiotics before any dental procedures. This is especially true of patients who are at greatest risk for contracting infective endocarditis (inflammation of the inner layer of the heart). The fact that more than 2,400 people die from heart disease each day makes it a major public health issue. It is also the leading killer of both men and women in the United States today.

What is periodontal disease?

Periodontal disease is a chronic inflammatory disease that destroys the bone and gum tissues around the teeth, reducing or potentially eradicating the system that supports your teeth. It affects roughly 75 percent of Americans, and is the leading cause of adult tooth loss. People who suffer from periodontal disease may notice that their gums swell and/or bleed when they brush their teeth.

Although there is no definitive proof to support the theory that oral bacteria affects the heart, it is widely acknowledged better oral health contributes to overall better health. When people take good care of their teeth, get thorough exams, and a professional cleaning twice a year, the buildup of plaque on the teeth is lessened. A healthy, well-balanced diet will also contribute to better oral and heart health. There is a lot of truth to the saying "you are what you eat." If you have any questions about you periodontal disease and your overall health, give our Millburn office a call!