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Posts for category: Oral Health

By Alexander Korwek, DDS, PC
October 20, 2021
Category: Oral Health
Tags: osteoporosis  
OsteoporosisCanCauseComplicationsForSomeTypesofDentalWork

October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.

This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.

In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.

In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.

The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.

It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.

Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.

You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.

Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.

If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.

By Alexander Korwek, DDS, PC
September 30, 2021
Category: Oral Health
Tags: tooth decay  
StopToothDecayBeforeItDerailsYourChildsDentalDevelopment

From birth to early adulthood, your child's teeth, gums and jaws develop at a rapid pace. And, for the most part, nature takes its course without our help.

But tooth decay can derail that development. The result of bacterial acid eroding enamel, tooth decay is the top cause for premature primary tooth loss in children. One particular form, early childhood caries (ECC), can rapidly spread from one tooth to another.

Many parents assume prematurely losing teeth that are destined to fall out soon anyway is inconsequential. But primary teeth play a critical role in the proper eruption of permanent teeth, serving as both placeholders and guides for those teeth developing just below them in the gums. A permanent tooth without this guidance can erupt out of alignment to create a poor bite that may require future orthodontics.

Being proactive about tooth decay lessens that risk—and the best time to start is when the first teeth begin to erupt. That's when you should begin their regular dental visits sometime around their first birthday.

Dental visits are an important defense against tooth decay. Besides routine dental cleanings, your child's dentist can offer various preventive treatments like sealants to stop decay from forming in the biting surfaces of back molars or topically applied fluoride to strengthen tooth enamel.

Daily home care is just as important in the fight against tooth decay. Oral hygiene should be a part of your child's daily life even before teeth: It's a good habit to wipe an infant's gums with a clean cloth after nursing. As teeth arrive, oral hygiene turns to brushing and flossing—perhaps the best defense of all against dental disease.

It's also important to watch their intake of sugar, a prime food source for bacteria that produce harmful acid. Instead, encourage a "tooth-friendly" diet of whole foods to keep teeth and gums healthy.

Even if they do develop tooth decay, there are effective treatments to minimize any damage and preserve affected primary teeth until they've served their purpose. By adopting these prevention strategies and prompt treatment, you can stay ahead of this destructive disease.

If you would like more information on preventive dental care for children, please contact us or schedule an appointment for a consultation.

By Alexander Korwek, DDS, PC
September 20, 2021
Category: Oral Health
EmmaRobertsConfessestoHavingaMajorSweetToothWhileExpecting

Emma Roberts, star of American Horror Story (and niece of actress Julia Roberts), welcomed her first child at the end of 2020. She confessed that her love of sweets made pregnancy challenging. She couldn't get enough of cupcakes with sprinkles and a Salt & Straw ice cream flavor called The Great Candycopia. But Roberts isn't unique. Hormonal changes in pregnancy often bring heightened cravings for certain foods. Unfortunately, this can increase an expectant mother's risk for dental disease, especially if they're consuming more sugary foods.

In fact, around four in ten expectant women will develop a form of periodontal disease called pregnancy gingivitis. It begins with dental plaque, a thin film that forms on tooth surfaces filled with oral bacteria that can infect the gums. And what do these bacteria love to eat? Yep—sugar, the same thing many women crave during pregnancy.

So, if you're expecting a baby, what can you do to minimize your risk for dental disease?

Practice oral hygiene. Removing dental plaque by brushing and flossing daily is the most important thing you can do personally to prevent both tooth decay and gum disease. It's even more important given the physical and hormonal changes that occur when you're pregnant. Be sure, then, that you're diligent about brushing and flossing every day without fail.

Control your sugar intake. If you have strong cravings for sweets, cutting back may be about as easy as stopping an elephant on a rampage through the jungle. But do give your best effort to eating more dairy- and protein-rich foods rather than refined carbohydrates like pastries or candies. Not only will reducing sugar help you avoid dental disease, these other foods will help strengthen your teeth.

Maintain regular dental visits. Seeing us for regular cleanings further reduces your disease risk. We can clean your teeth of any plaque deposits you might have missed, especially hardened plaque called tartar that's nearly impossible to remove with brushing and flossing. We'll also monitor your teeth and gums for any developing disease that requires further treatment.

Undergo needed treatments. Concerned for their baby's safety, many expectant mothers are hesitant about undergoing dental procedures. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association endorse necessary dental treatments during pregnancy, even if they include local anesthesia. We will make you have only a safe type of anesthesia, and we can advise you when it is prudent to postpone certain treatments, such as some elective procedures, until after the baby is born.

Emma Roberts got through a healthy pregnancy—cravings and all—and is now enjoying her new baby boy. Whether you're a celebrity like Emma Roberts or not, expecting a baby is an exciting life moment. Follow these tips to keep your teeth and gums healthy throughout your pregnancy, and be sure to let the dental team know of your pregnancy before any treatment.

If you would like more information about dental care during pregnancy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Pregnancy and Oral Health.”

By Alexander Korwek, DDS, PC
September 10, 2021
Category: Oral Health
Tags: teeth grinding  
KeepaWatchfulEyeonYourChildsTeethGrindingHabit

More than one parent has wakened in the middle of the night to an unnerving sound emanating from their child's bedroom. Although it might seem like something from the latest horror flick is romping around in there, all that racket has a down-to-earth cause: teeth grinding.

Teeth grinding is the involuntary habit of gnashing the teeth together when not engaged in normal functions like eating or speaking. It can occur at any time, but frequently with children while they sleep. Adults may also grind their teeth, but it's more prevalent among children.

While stress seems to be the main reason for adult teeth grinding, many health providers believe the habit in children is most often caused by an overreactive response of the neuromuscular system for chewing, which may be immature. Other conditions like asthma, sleep apnea or drug use may also play a role.

Fortunately, there doesn't appear to be any lasting harm from young children grinding their teeth, although they may encounter problems like headaches, earaches or jaw pain in the short term. Most, though, will outgrow the habit and be no worse for wear.

But if it persists beyond childhood, problems can escalate. Adults run the risk of serious cumulative issues like chronic jaw pain, accelerated tooth wear or tooth fracturing. It's similar to finger sucking, a nearly universal habit among young children that poses no real harm unless it persists later in life.

And as with finger sucking, parents should follow a similar strategy of carefully monitoring their child's teeth grinding. If the habit continues into later childhood or adolescence, or noticeable problems like those mentioned previously begin to appear, it may be time to intervene.

Such intervention may initially include diagnosis and treatment for underlying problems like upper airway obstruction, asthma or stress. For short term protection against dental damage, your dentist can also fashion a custom mouthguard for your child to wear while they sleep. Made of pliable plastic, the guard prevents the teeth from making solid contact with each other during a grinding episode.

Outside of some lost sleep, there's little cause for alarm if your child grinds their teeth. But if it seems to go on longer than it should, you can take action to protect their long-term dental health.

If you would like more information on teeth grinding, 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 “When Children Grind Their Teeth.”

By Alexander Korwek, DDS, PC
August 31, 2021
Category: Oral Health
Tags: tooth decay  
WhatYouCanDoToHelpYourChildAvoidToothDecay

So, when should you begin taking measures to prevent tooth decay in your child's teeth? When their teeth first begin to show? When all of their primary (baby) teeth are in? Or, wait until their permanent teeth begin erupting?

Actually, tooth decay can be a problem as early as two months of age, before a child's first tooth even comes in. In essence, then, dental disease prevention should be on your radar soon after your child is born. Here's what you can do to prevent the damage of tooth decay to their teeth now and its impact on their dental health in the future.

Start oral hygiene during nursing. Brushing and flossing are lifetime habits that reduce the risk of dental disease. When your children are young, you'll have to perform these tasks for them, ultimately training them to perform them on their own. But even earlier, before their first tooth, you'll want to clean their gums after feedings with a wet cloth to reduce disease-causing bacteria.

Initiate dental visits by age 1. It's appropriate on or before their first birthday, when most children already have a few primary teeth, to begin regular dental visits for cleanings and checkups. Seeing the dentist every six months at an early age will help your child stay well ahead of tooth decay. And starting visits early increases the likelihood it will become a regular part of their lives into adulthood.

Protect against decay. You and your dentist are partners in protecting your child from dental disease. Besides daily oral hygiene, you can also help by providing a dental-friendly diet, and especially restricting sugary snacks and avoiding sweetened liquids in bedtime bottles (including breast milk or formula). In addition to routine care, your dentist can also provide other measures to fight decay, like sealants or topical fluoride.

It's also important for you to set an example for your child to follow. Children soak up what's important to their parents—in this case, watching you take care of your teeth and seeing the dentist as a friend and ally against dental disease. That's your end goal: preventing dental disease now, and instilling the value of dental care that will last your child a lifetime.

If you would like more information on helping your child avoid tooth decay, 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 “Taking the Stress Out of Dentistry for Kids.”