Antibiotic Prophylaxis: Prosthetic Joints and Orthopedic Implants

If you have had a joint replacement and taken antibiotics before dental work in the past, you may not need to make a trip to the pharmacy before your next procedure. The American Dental Association has found it is no longer necessary for most dental patients with orthopedic implants to have antibiotic prophylaxis to prevent infection.

What Is Antibiotic Prophylaxis?

Antibiotic prophylaxis (or premedication) is simply the taking of antibiotics before some dental procedures such as teeth cleaning, tooth extractions, root canals, and deep cleaning between the tooth root and gums to prevent infection. We all have bacteria in our mouths, and a number of dental treatments—and even daily routines like chewing, brushing or flossing—can allow bacteria to enter the bloodstream (bacteremia). For most of us, this isn’t a problem. A healthy immune system prevents these bacteria from causing any harm. There is concern, however, that bacteria in the bloodstream could cause infection elsewhere in the body.

Prior to 2012, premedication prior to dental procedures was common for joint replacement patients, even though there was little evidence to support the practice and experts recommended against its practice for most dental patients. In 2012, the American Dental Association and American Association of Orthopedic Surgeons published updated guidelines, stating that dentists “might consider discontinuing the practice of routinely prescribing prophylactic antibiotics”. In January 2015, the ADA’s Council on Scientific Affairs issued another guideline, which continued to discourage prophylactic antibiotic use for most patients with prosthetic joint implants. Guidelines are re-evaluated every few years to make sure that they are based on the best scientific evidence.

Why Don’t I Need Antibiotic Prophylaxis? 

Based on careful review of the scientific literature, the ADA found that dental procedures are not associated with prosthetic joint implant infections, and that antibiotics given before dental procedures do not prevent such infections.

In fact, for most people, the known risks of taking antibiotics may outweigh the uncertain benefits. Risks related to antibiotic use include nausea, upset stomach and allergic reactions, including anaphylactic shock (a severe allergic reaction that can be life threatening). Other risks include developing antibiotic resistance in bacteria, which can complicate treatment of infections such as strep throat, pink eye and meningitis; as well as increasing the risk of C. difficile infection, which causes diarrhea and other intestinal problems. Patients over 70 years old are also at increased risk of experiencing adverse  reactions to some antibiotics. 

Who Can Antibiotic Prophylaxis Help?

Depending on your personal medical history, you may still be a candidate for premedication. For example, antibiotic prophylaxis might be useful for patients undergoing dental procedures who also have compromised immune systems (due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk of orthopedic implant infection. It may also benefit others with heart conditions. Always talk with your dentist or physician about whether antibiotic prophylaxis before dental treatment is right for you.

The above article is from mouthhealthy.org

Lim and Yabu  
Geraldine Lim, DDS & Eric Yabu, DDS   
4174 Park Boulevard, Suite A  
Oakland, CA 94602  
(510) 530-7000  
OaklandLaserDentist.com

Ketosis Breath: When Your Diet Affects Your Oral Health

The ketogenic diet has created buzz in the health community and for good reason. Many have found success in restricting their carb intake so that the body burns fat instead of glucose to lose weight. If you're following a keto diet, you might notice some unpleasant side effects that accompany the positive changes on the scale. For example, so-called ketosis breath is a common complaint. Understanding keto breath is the first step to ensuring your diet doesn't impair your oral health.

Ketosis and Your Breath

If a lower-carb lifestyle is supposedly healthy, then why does it result in foul-smelling breath? The answer is in how your body breaks down fats. After swapping a typical carb-heavy diet for one that promotes fats and protein, your body goes into ketosis. As the University of California, San Francisco explains, ketosis is a process wherein your body begins to burn fat for energy, since glucose stores (your body's preferred source of energy) aren't readily available. While in ketosis, your body converts fat cells into three types of ketones, which are fat byproducts. One of these ketones, called acetone, is essentially unusable for your body's energy stores. 

Therefore, your body releases it via your urine and lungs, notes Medscape. It's acetone that gives your breath that distinctive "ketosis" smell, which, according to Medline Plus, can be compared to an overly sweet, fruity scent.

Keto Diet and Oral Health

When swapping carbs for healthy fats and proteins, your body undergoes several changes. While ketosis breath is often associated with a low-carb lifestyle, the diet may also have a positive effect on your oral health. After all, in avoiding carbs, you're also avoiding processed sugars, which the American Dental Association counts among the worst foods for oral health. Because oral bacteria thrive on sugar, reducing your sugar intake may reduce cavities.

A low-carb diet may also help reduce inflammation. A study in BMC Oral Health found that a diet low in carbohydrates and high in omega-3 fatty acids resulted in lower rates of gingivitis and inflammation in patients. So while going low-carb may make your breath smell, it may actually help improve your overall oral health.

Freshening Up

If you've noticed that you have keto breath and you still want to continue your keto diet, consider some of these methods to deal with the smell:

• Chew sugar-free gum to help stimulate saliva and freshen your breath.
• Adjust your intake of complex carbohydrates, such as leafy green vegetables and whole grains, while continuing to avoid refined carbs.
• Fill a water bottle and sip throughout the day.
• Continue good oral health habits. A keto lifestyle, while beneficial for oral health, is not a substitute for daily brushing and flossing.
• Add fresh herbs to water and tea. Herbs such as clove, cinnamon, mint and fennel are natural breath fresheners.

Starting and continuing a ketogenic lifestyle should only ever be done with the supervision and approval of a qualified health care professional. While it's true that a keto diet may offer benefits for oral health, it has a few drawbacks as well. By addressing some of the roadblocks, you can make sure that your keto diet is as healthy as it is successful. To keep you on track, lessen the smelly side effects by brushing with Colgate Total Fresh Mint Stripe Gel toothpaste. It has a minty blend of gel and paste that leaves your mouth clean and fresh. 

The above article is from colgate.com

Lim and Yabu  
Geraldine Lim, DDS & Eric Yabu, DDS   
4174 Park Boulevard, Suite A  
Oakland, CA 94602  
(510) 530-7000  
OaklandLaserDentist.com

Teeth Stains: Causes, Types, and How to Remove Teeth Stains

Teeth stain for many reasons, including your food and drink choices, oral hygiene, and medication use. Teeth stains occur on the surface of the tooth or below the tooth enamel and some people develop both types of teeth stains. 

 

Types of Tooth Discoloration (Stains)

Tooth discoloration can occur as a result of surface stains, due to actual changes in your tooth material, or because of a combination of both factors. Dental professionals have identified three main categories of tooth discoloration: 

• Extrinsic sTeeth Stains: An extrinsic tooth stain is staining on the surface of the tooth. It occurs when stain particles, such as pigmented residue from food or drink, build-up in the film of protein that covers the tooth enamel. Extrinsic tooth stains are typically caused by tobacco use or by regularly drinking coffee and tea, wine or cola drinks. This type of tooth stain responds well to regular dental cleaning and brushing the teeth with whitening toothpaste.
• Intrinsic Teeth Stains: An intrinsic tooth stain is staining below the surface of the tooth. It occurs when stain-causing particles work through the exterior of the tooth and accumulate within the tooth enamel. Excessive fluoride use and  also have been associated with intrinsic, especially in children. An intrinsic tooth stain is trickier to remove, but it can be done. An intrinsic tooth stain may require bleaching using professional or at-home chemical teeth-whitening products, such as Whitestrips.
• Age-Related Teeth Stains: Age-related teeth stains combine the results of both intrinsic and extrinsic tooth discoloration. Because the core tissue of your teeth, the dentin, naturally yellows over time, teeth discolor with age. As we age, the enamel that covers the tooth becomes thinner, allowing the dentin to show through. These intrinsic causes of discoloration combined with extrinsic causes such as the effects of certain foods, beverages, and tobacco, will cause most adults' teeth to discolor with age.

Stained Teeth Causes

Teeth stains have many causes. Certain foods and drinks can cause teeth stains, and as we’ve talked about, tooth discoloration is also a product of several biological factors, including the transparency of your tooth enamel.

There are many causes of discolored teeth—some of which could have possibly been prevented, and many of which are beyond your control. This comprehensive list can help you determine the cause of discolored teeth, and in many cases, help prevent further discoloring of your teeth:

• Food & Drink: Coffee, tea, dark sodas, red wine, and even a few fruits and vegetables are proven causes of discolored teeth.
• Tobacco: Both cigarettes and chewing tobacco can contribute to discolored teeth.
• Oral Care: Poor dental hygiene, such as inadequate brushing or flossing, can lead to tooth discoloration.
• Trauma or Disease: Any trauma, illness, or disease that affects enamel development in children—either in the womb or while teeth are developing (under the age of 8)—can cause discolored teeth. Trauma to adult teeth can also cause discolored teeth. In addition, there are a few diseases and disease treatments that can cause discolored teeth. Chemotherapy and radiation, for example, discolor teeth.
• Medical Treatments: Sometimes medical treatments can contribute to teeth stain, and several classes of medications including high blood pressure medications, chemotherapy, antihistamines and some antipsychotic medications can cause teeth stains.

To know how to remove a tooth stain, it helps to know what type of stain you are dealing with. Paul A. Sagel, a Procter & Gamble Research Fellow, has conducted extensive research into the science of tooth stains. Research by Sagel and others have shown that some stain particles remain on the tooth enamel, while others work through the tooth enamel over time and set beneath the tooth surface, which creates dullness and tooth stain.

Are My Teeth White?

Tooth color is subjective, and it can be hard to tell how well teeth-whitening products are working to remove or reduce teeth stains. A 2004 study in the Journal of Dentistry showed that even professionals disagree on tooth color when evaluating the same teeth, and a single professional can rate the whiteness of the same tooth differently on different occasions. One method of evaluating the effectiveness of whitening products involves taking high-resolution digital images of teeth and assigning numerical values to describe the whitening effects three ways: a decrease in yellowness, decrease in redness, and an increase in lightness.

Teeth Whitening for Older Adults

While everyone knows you get better with age, tooth stains are one of the least-favorite body changes that take place during the aging process. In fact, one of the three main categories of tooth discoloration is age-related discoloration, which is a result of several factors.

Why Are Seniors Susceptible For Tooth Stains?

First, as you age, the outer layer of the tooth’s enamel gets thinner over time, revealing the natural yellow color of the core tissue of your teeth, called the dentin. This dentin also yellows naturally with age. In addition, years of drinking tea, coffee, dark sodas, and wine can cause progressive tooth stains over time. Finally, damage or injuries to your teeth, which occur over time throughout your life, cause discoloration that can become noticeable with age.

How to Remove Teeth Stains

Fortunately, there are many treatment options for teeth stains. Keep your teeth healthy and looking great by maintaining a consistent oral health routine including twice-daily toothbrushing and daily flossing, twice-yearly visits to your dentist, and by limiting your consumption of teeth-staining beverages. Regular whitening maintenance will help keep them looking whiter and brighter.

 

Regardless of the type of tooth discoloration you have, there are many safe, over-the-counter,  teeth-whitening products available to help you makeover your discolored teeth into a beautiful white smile. Ask your dentist for recommendations on the best teeth whitening option to treat your age-related tooth stains and discoloration.

 

The above article is from crest.com

Lim and Yabu  
Geraldine Lim, DDS & Eric Yabu, DDS   
4174 Park Boulevard, Suite A  
Oakland, CA 94602  
(510) 530-7000  
OaklandLaserDentist.com