O.K. So let’s say you’re tackling that stack of bills sitting on your desk. Maybe it’s Tuesday night, maybe it’s Saturday morning.
Writing checks and sending them in the mail is a drag. Plus, you have to allow time for the check to get there. Calling with a credit card is awesome, except you know that whoever you’re paying isn’t open. I love that feeling when I see the line that says, “pay your bill online!”
And now…you can pay Mead Family Dental online, too!
Take a look at this quick tutorial video and you’ll be all set!
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Joint replacement surgery changes lives. For some people having a knee or hip replaced can end years of pain and struggle. The procedure has become quite common and many dental patients in our office have had it done.
Orthopedic surgeons and dentists have been telling themselves and their patients a story about artificial joints and the risks involved with dental treatment after having one. The story goes kind of like this:
Dental treatment causes oral bacteria to get into the bloodstream. These bacteria find their way to artificial joints and if they do, they can get horribly infected. Sometimes the infection can cause the artificial joint to become so bad that it fails and needs to be replaced. This is a serious and expensive side effect. The solution to this problem is premedicating with an antibiotic before you have any dental work done. That will make it so any oral bacteria that make it into the bloodstream are killed off before they can get to the artificial joint.
At first glance, this story makes sense. You definitely don’t want an artificial joint to become infected. Since we know that dental work can cause oral bacteria to get into the bloodstream, having dental work is clearly the problem. Right?
Well…not really. The story might not be true. In fact, there is no scientific evidence that artificial joints are more susceptible to infection after dental work. The story seems plausible but just doesn’t line up with our available evidence.
Some would say, “the complication of an infected joint is so severe that taking a dose of antibiotics is a small price to pay to keep us safe.” It turns out that there is also no scientific evidence that taking any particular antibiotic can keep an artificial joint from becoming infected. Furthermore, it’s worth mentioning that taking antibiotics isn’t a risk-free event, either. Allergic reactions can happen even in people who have had no reactions taking the same medication in the past. On top of that, every time you take an antibiotic it affects the natural balance of all the good bugs that inhabit your body as well. If you’ve ever gotten a yeast infection after taking an antibiotic, you know exactly what I’m talking about! Furthermore, the overuse of antibiotics promotes bacteria that become resistant to the antibiotics which is bad for everyone!
So this is what we’ve been battling with in dentistry. The standard for joint premedication has been take 2000mg (2g) amoxicillin an hour prior to your dental appointment. However, it is somewhat typical for a patient who is supposed to take their premedication to forget to take it. In fact, it happens often. At least weekly in my experience. So then you try and decide whether you should send them home and reschedule their appointment, give them the premedication at the office or just skip it. We sure could use a little bit of guidance from professional organizations, right?
In 2012 the American Dental Association (ADA) and the American Association of Orthopaedic Surgeons (AAOS) published some guidelines. Some vague guidelines. Frustratingly. Vague. Guidelines. You can read about these guidelines in a blog post I wrote back in 2012. Essentially the guidelines stated that although there isn’t any scientific evidence to support the use of antibiotics prior to dental treatment in joint replacement patients, each case should be considered separately. The opinion of the surgeon, patient and dentist were essentially equally valid. There was not a strong “you should do this” or “you shouldn’t do this” attached to the 2012 guidelines.
I have been trying to explain to joint replacement patients that the evidence goes against the need for premedication. However, these patients have been taking antibiotics for their artificial joints for years and years. They have been told by surgeons, dentists, hygienists and all sorts of other health care providers that they are truly at risk if they don’t. Many patients wanted to continue the antibiotics for dental treatment “just to be sure.” And who could blame them? Many dentists weren’t willing to take the (essentially nonexistent) risk either. Our policy had been that the patient just needed to get a letter from their orthopedic surgeon stating that the surgeon felt premedication was necessary and we’d write the prescription. This was a compromise that I was willing to make so long as we were stuck with these wishy washy guidelines.
In early January 2015, the American Dental Association finally weighed in strongly on the controversy:
“In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection. The practitioner and patient should consider possible clinical circumstances that may suggest the presence of a significant medical risk in providing dental care without antibiotic prophylaxis, as well as the known risks of frequent or widespread antibiotic use. As part of the evidence-based approach to care, this clinical recommendation should be integrated with the practitioner’s professional judgment and the patient’s needs and preferences.”
Not perfect, but pretty good in my estimation. The factors that may require premedication now are people who have previously had complications with infected artificial joints as well as patients with immune system compromise.
There should be rejoicing in the streets! Think of how much less often patients will have to take antibiotics! But alas, I’ve already run into patients with concerns. I completely understand this because it’s tough to change what we’ve been doing for so long. For now, we’re going to talk to patients and explain that they really don’t need antibiotics. But we’ll keep in touch with their orthopedic doctors, too. Change happens slowly, but I think the new guidelines are a big step in the right direction!
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We’ve got teeth for chewing, that’s for sure. And chewing means you’re getting more nutrition out of the food you consume. So that makes sense.
We also need teeth for speaking. If you’ve ever talked to a 7 year old who was missing some front teeth while waiting for their new ones to come in, you may have noticed that some of their “sss” sounds and “fff” sounds were a little off.
But what about smiling? Do we smile only as a side effect for having thisawesome chewing and speaking apparatus?
The first question you might ask might be, “do any other animals smile?” The answer to that question is “kind of.”
Since people can communicate with the spoken or written word, we rely less on “nonverbal” communication than other animals. But any husband who’s ever asked their noticeably angry wife “what’s wrong?” and gotten the answer “nothing” knows…words don’t always communicate the complete meaning.
Animals communicate in a wide variety of ways. From the song of the humpback whale to the intricate dance of one bee explaining to its hive where the best flowers are, animals are amazing communicators. Often, parts of their body have become specialized to communicate. Take a beaver’s flat tail. When alarmed, one beaver can tell many other beavers of danger just by smacking that flat tail on the water. If you’ve ever heard that noise, you can see how effective it is!
Dogs and other canines are amazing nonverbal communicators. They have a body that’s perfectly designed to communicate with members of their pack and even the humans that come into their social circles. They’ve got tails that can wag, expressive ears, hair that can stand up or lay flat and they’ve also got long, noticeable teeth that can easily be displayed! However, if you’re seeing a dog’s teeth, you probably understand that they’re smile doesn’t mean the same thing as your grandmother’s!
Clearly, in humans smiling is built into our DNA. Teeth aren’t just for chewing and speaking. Teeth are for SMILING! If you aren’t happy and confident about your smile, I want to help! The team at Mead Family Dental can help you achieve the smile you’ve always wanted. We offer interest free payment plans that can fit most any budget. Give us a call at (989) 799-9133 or email me at firstname.lastname@example.org and we’ll get you smiling again!
Did this post make you smile? Did it make the hair on the back of your neck stand up? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
The New Year brings renewal. Every year we think to ourselves…what am I going to do differently this year? And every year we make unrealistic resolutions about running 5 miles per day, losing 50 lbs and never eating fast food again.
This year should be different! If you’re going to make resolutions, why not make them the easy kind? I mean “falling off a log” easy. The kind where you almost can’t help but succeed. In the spirit of easy resolutions for the new year I give you three easy things you can do for healthier teeth this year.
Drink less sugar: It’s pretty trendy to be anti-sugar. I’m not someone who believes that all sugar is point, but I think that moderation is a good idea. As a dentist, I tend to see sugar differently than dietitians. When you take sugar in, the bacteria (aka: bugs) in your mouth’s natural flora (aka: plaque) take that sugar in, too. The bugs turn this sugar into acid, and this acid starts to dissolve your teeth. So before the sugar ever makes into your bloodstream, we dentists are concerned about the acid that it’s creating in your mouth. Furthermore, the sugar found in drinks like soda and fruit juice is concentrated and easily absorbed by the bugs. Plus, people often sip these sugary beverages over a period of time, which creates an acid attack that lasts much longer. If you’re careful about the sugar in your beverages, you can make a big difference in the amount of acid those bugs can create! So instead of that 20oz. Coke or tall can of Red Bull, why not reach for something sugar free? Water is probably the best, but I won’t fault you for sugar free options like diet sodas and “Crystal Light-like” beverages as well. Carbonated beverages like diet sodas can cause a problem if you drink a lot of it, to be sure. But we’re interested in reducing your risk for cavities, not sainthood!
Put floss in the shower: The second easy thing you can do to make your teeth healthier this year is putting floss in your shower. That’s all. Just put it in your shower. I’m not talking loose pieces of floss or anything. Just put the spool somewhere that won’t get too wet, preferably next to your shampoo. Every time you take your shower, you’re going to look at that spool of floss. Maybe you’ll just look at it. But probably you’ll realize that brushing your teeth alone only stirs up 60% of the bugs on your teeth. If you snuck some floss in between those teeth a few times per week, you’d be making a change for the better. I mean, you’re already in the shower washing up your other parts, why not take a minute to clean up the spots in between your teeth?
Sugarless gum or mints: The last easy thing you can do for healthier teeth is sugarless gum. Or mints. Whatever makes your hair fly back. If you chew sugarless gum or suck on a sugarless mint for 5 minutes (but only five minutes) after meals and snacks you can stimulate your mouth’s natural clean up crew! Chewing sugarless gum stimulates your saliva glands to go to work. Stimulating your saliva flow can stop acid damage caused by the bugs in your mouth as well as acidy foods. And all you have to do is enjoy delicious sugarless gum or mints! See, I told you. Super easy!
So put down the barbells and diet books and realize that success in New Year’s resolutions is three easy steps!
Did this post seem easy? Did it give you resolve? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
I’ve recently had several patients complaining of a “popping jaw.” In many cases, it’s not them who are complaining. It’s anyone that they have to eat with.
“It doesn’t hurt or anything. It just makes a popping sound when I’m chewing. My mom is really grossed out by it.”
When I do an exam I find that their jaw has a very noticeable clicking when they open. Sometimes it’s both sides, but more often it seems like it’s only on one side.
Then, I ask the most important question that can be asked about a painless jaw pop.
“Do you chew gum?”
9 times out of 10 I get the sheepish look. Busted.
“Yes. I chew gum.”
“How often. Every once in awhile?”
“Maybe a little more than that.”
In fact, for some gum chewers it’s most of the time. If I were to generalize about who are my most common gum chewers/jaw poppers I would have to say that they’re probably female and in their mid 20’s. Sometimes a little older. And they probably needed a paper towel to throw their gum out before we cleaned their teeth. Luckily for them, they don’t have pain associated with the jaw pop. But as they age, that can change.
I know what you’re thinking. I’ve written about the magic of chewing sugarless gum for reducing tooth decay. It’s true. But if you go back and read closely I recommend 5 minutes or so. Not longer than it takes for the flavor to run out, anyhow.
Chronic gum chewers are working out their chewing muscles and jaw joints. A lot. These are muscles that don’t need the extra workout, though. Since we have to eat to survive, our regular day to day chewing, talking (or yelling, if you have small children) and living are plenty of exercise. Overuse of the muscles of mastication (chewing muscles) and jaw joints creates greater risk for a popping jaw, headaches and even chronic pain of the neck.
Have your knees ever popped when you run up the stair? I know mine do. That popping is a similar thing that goes on in your popping jaw joint. It’s a disk of cartilege and connective tissue that’s slipping between two bone surfaces. I know that’s gross sounding, but it’s exactly what’s happening.
Now, did your knees do that when you were a little kid? Probably not. But as we age and, in some cases gain weight, we continue to put more and more stress on our knees. We’re overusing them. So these joints react. Sometimes they pop when they’re used. And sometimes they can become painful and need treatment.
Gum chewing as a habit if a near perfect storm for jaw popping. I’m O.K. with a person chewing sugarless gum for a few minutes after meals and snacks. That can help prevent tooth decay and it can give you nice, fresh breath. But not for more than a few minutes. You could unintentionally causing problems for yourself down the road.
Did you find this post snappy? Did it make you crackle? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.