Posts for category: Oral Health

LocalAnesthesiaisaKeyPartofPain-FreeDentalWork

We can easily take for granted the comfort we now experience when we undergo dental work. For much of human history that hasn't been the case.

Local anesthesia has been a major factor in the evolution of pain-free dentistry. The term refers to the numbing of nerve sensation in the tissues involved in a procedure. This type of anesthesia is usually applied in two ways: topical and injectable.

We apply topical anesthetic agents to the top layers of tissue using a cotton swab, adhesive patch or a spray. Topical agents are useful for increasing comfort during cleanings for patients with sensitive teeth or similar superficial procedures. Topical anesthesia is also used in conjunction with injections as a way to prevent feeling the minor prick of the needle. In essence, you shouldn't feel any pain or discomfort from beginning to end of your procedure.

Injectable anesthesia deadens pain at deeper levels of tissue. This makes it possible for us to perform more invasive procedures like tooth extraction or gum surgery without using general anesthesia. The latter form is a more intense undertaking: it renders you unconscious and may require assistance for lung and heart function.

Most important of all, subtracting pain sensation from the procedure helps relieve stress: first for you and ultimately for us. If we know you're comfortable, we can relax and concentrate on the work at hand. The procedure goes much more smoothly and efficiently.

Many people, though, have concerns about how long the numbness will linger after the procedure. This has been viewed in the past as an annoying inconvenience. But in recent years, dentists have become more adept at fine-tuning the agents they use as a way to reduce post-procedure numbness. There's also promising research on chemical agents that can quickly reverse the numbing effect after a procedure.

All in all, though, using local anesthesia broadens the range of dental work we can perform without putting you to sleep. More importantly, you'll be able to relax as we perform procedures that could improve your dental health for years to come.

If you would like more information on pain-free dentistry, please contact us or schedule an appointment for a consultation.

BrushingandFlossingHardtoDoConsiderYourPowerOptions

Brushing and flossing are foundational to good oral health and an essential part of daily life. Practicing both these habits removes most disease-causing bacterial plaque from tooth and gum surfaces.

It doesn’t take much to manually perform them — a quality soft-bristle toothbrush, fluoride toothpaste and string floss. But what if you have a physical impairment that makes performing these tasks difficult to perform — or your mouth condition requires a little more “power” to adequately access and clean surfaces?

You do have power options for both brushing and flossing. Electric toothbrushes, of course, have been available since the 1950s. As with other technology, they’ve improved in quality and affordability over the last few decades. They’re available in various sizes, rechargeable or battery, and each with their own claims of cleaning ability.

The ultimate question, though, is: are they as effective at removing plaque as manual brushing? That’s been the subject of a number of comprehensive studies, including one conducted by the Cochrane Collaboration, a research organization. They evaluated a number of powered toothbrushes over various lengths of time. They concluded that some powered toothbrushes with a rotation-oscillation action had a statistically significant (though modest) reduction in plaque compared with manual toothbrushes.

As to flossing, admittedly it does take some dexterity to accomplish effectively. Traditional string flossing is also difficult if not impossible for people with braces or similar access restrictions to the teeth. An oral irrigator (or water flosser) is a viable alternative. Water flossers work by pulsating water at high pressure through special tips at the end of a handheld or countertop device. The pressurized stream penetrates between teeth and below the gums to flush away plaque.

Are water flossers effective? According to one recent study orthodontic patients were able to remove up to five times the plaque between teeth as those who used only a manual toothbrush.

When considering alternatives to your manual toothbrush or string floss, speak with us first. We’ll be happy to guide you toward the best form of brushing and flossing to do the most good in your situation.

If you would like more information on oral hygiene options, please contact us or schedule an appointment for a consultation.

SteelyDanFoundersDeathHighlightsImportanceofEarlyCancerDetection

Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome.┬áIf you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”

ToDetectOralCancerEarlySeeYourDentist

This month marks the 20th annual observance of Oral Cancer Awareness Month. Last year, over 50,000 people in the US were diagnosed with oral cancer, and over 10,000 people died from the disease. The 5-year survival rate for oral cancer is only around 57%, making it more deadly than many other types of cancer. But if oral cancer is caught and treated early, the 5-year survival rate jumps to over 80%. This is one reason why regular dental checkups are so important—we can be your best ally in detecting oral cancer in its early stages.

Oral cancer is particularly dangerous because it often develops without pain or obvious symptoms. Early detection greatly improves the chances of successful treatment, but signs of the disease frequently go unnoticed until the cancer is advanced. Fortunately, dentists and dental hygienists are trained to recognize signs of oral cancer in the early stages, when it is most treatable. Oral cancer can appear on any surface of the mouth and throat, with the tongue being the most common site, particularly along the sides, followed by the floor of the mouth. As part of a regular dental exam, we examine these surfaces for even subtle signs of the disease.

Screenings performed at the dental office are the best way to detect oral cancer, but between dental visits it's a good idea to check your own mouth for any of the following: white or red patches, lumps, hard spots, spots that bleed easily or sores that don't heal. Let us know if any of these symptoms don't go away on their own within two or three weeks.

Using tobacco in any form is a major risk factor for oral cancer, especially in combination with alcohol consumption. Although the majority of people diagnosed with oral cancer are over age 55, the fastest growing segment of new diagnoses are among young people due to the rise in cases of sexually transmitted human papillomavirus (HPV) in young adults.

A routine dental visit can do much more than preventing and treating tooth decay and gum disease—it might even save your life! If you have questions about oral cancer or are concerned about possible symptoms, call us as soon as possible to schedule an appointment for a consultation.

GoodOralHygieneJustasImportantforImplantsasforNaturalTeeth

Dental implants are known for their durability as well as life-like beauty. Thanks to their unique construction and ability to integrate with bone, they have a very high success rate and can last for decades.

But while they’re less problematic than other restorations, we still can’t “set them and forget them.” While the implants themselves aren’t susceptible to disease, the supporting gums, bone and adjacent teeth are. If you want them to last as long as possible, you’ll need to care for them and the rest of your mouth through daily oral hygiene and semi-annual office cleanings.

With that said, there are a few differences in how we perform hygiene tasks with implants. This is due to the way in which they attach to the jaw, as the titanium post is inserted directly into the bone. Natural teeth, on the other hand, are held in place by the periodontal ligament, a strong connective tissue that lies between the teeth and bone. The ligament holds the teeth firmly in place while also allowing minute tooth movement in response to changes in the mouth.

The ligament also has an ample blood supply that assists with fighting infection that may arise in the tooth and its supporting gums. Without this extra source of defense, infections that arise around an implant can grow quickly into a condition known as peri-implantitis and lead to rapid bone loss that could cause the implant to fail.

That’s why you and your hygienist must be ever vigilant to the buildup of plaque, the bacterial film that gives rise to dental disease, around implants and adjacent teeth. This includes removing plaque buildup from implant surfaces, although your hygienist will use tools (scalers or curettes) made of plastic or resin rather than traditional metal to avoid scratching the implant’s dental material. They’ll likewise use nylon or plastic tips with ultrasonic equipment (which uses high vibration to loosen plaque) and lower power settings with water irrigation devices.

Keeping infection at bay with effective hygiene is the number one maintenance goal with dental implants. Doing your part along with your hygienist will help you get the most of this investment in your smile.

If you would like more information on oral hygiene with dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance.”



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Dr. George Salem and Associates, P.C.

Braintree, MA Dentist
Dr. George Salem and Associates, PC
60 Adams Street
Braintree, MA 02184

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