Cosmetic Dentistry and Skin Care Blog

If you or a family member has rheumatic heart disease, bicuspid valve disease, aortic stenosis or a mitral valve prolapse, you’re probably used to taking prophylactic antibiotics prior to dental procedures. However, you may not be aware that the American Heart Association recently revised its antibiotic guidelines following their review of benefits vs. potential risks. After reading this valuable update regarding precautionary antibiotics, feel free to contact the Smile and Skin team with questions about your specific health condition. 

1. While antibiotics were previously recommended for a variety of heart conditions, the AHA now recommends the following: “Patients at the greatest risk of bad outcomes from infective endocarditis (IE) – an infection of the heart’s inner lining or the heart valves – should receive short-term preventative antibiotics before common, routine dental procedures.” This means that only patients who have received heart transplants or have artificial heart valves, serious congenital heart conditions or a history of serious endocarditis should receive prophylactic antibiotic prescriptions before going to the dentist. Remember to discuss your health history with Dr. Meola and his staff so they can make an educated recommendation about your need for antibiotics.
2. While there is limited evidence that prophylaxis works, the primary reason for the AHA recommendation change is due to the potential risks involved with some antibiotic doses. First, overprescribing of these prophylactic medications makes IE bacteria progressively more resistant to antibiotics. Second, some patients can have severe allergic reactions to antibiotics. At this point, physicians believe that antibiotics are best reserved for those with severe heart conditions, only.     
3. Finally, the AHA’s recommendations are based on evidence that infective endocarditis is far more likely to begin from bacteria entering the bloodstream through everyday activities, rather than through sterile dental procedures. According to Mayo Clinic physician, Walter R. Wilson, “…maintaining good oral health and hygiene appears to be more protective than the prophylactic antibiotics. This changes the whole philosophy of how we have constructed these recommendations for the last 50 years.”

If you’re concerned about IE or another serious health problem that may be impacted by secondary infection, ask the Smile and Skin team about the use of prophylactic antibiotics. Using the most updated guidelines and dental research, Dr. Meola and his team will assess your concerns and make recommendations that protect your health and address your specific medical condition.  

Do the words “root canal” bring anxiety, sweaty palms and a shiver down your spine? It’s a common reaction in many dental patients—but the fear is largely unfounded. To help you make an informed decision about the health of your teeth, it’s important that you have all the information. Read on for the real lowdown on root canal therapy.

Why Do I Need a Root Canal?

Root canal therapy is recommended when your mouth pain is caused by an irreversible tooth condition. For example, you may need a root canal because you’ve left a cavity untreated. As decay erodes your tooth, it eats through to the tooth’s pulp—or center. This allows bacteria into the pulp, which causes inflammation, reduced blood supply—and severe pain. Your dentist may also recommend a root canal if you’ve experienced a past trauma or severe tooth fracture and the tooth is dying from the inside out. While avoiding a root canal may seem like the least painful option, it could save you from increasing pain, dangerous abscess or complete extraction of the affected tooth.  

During your root canal procedure, the specialists at Smile and Skin will (1) remove the tooth’s pulp, (2) clean the tooth’s center and apply antibiotics, if needed, (3) fill the tooth’s center with a rubbery material (called gutta percha), and (4) seal the tooth with a crown, cap or other restorative filling.

Are Root Canals Painful?

While root canals have the reputation for being painful, it’s important to remember that they’re performed to eliminate existing pain. Prior to the procedure, Dr. Meola and his team will numb the area surrounding the affected tooth to prevent you from feeling pain during the procedure. However, for some patients—the anesthetic injections are not enough to relieve their root canal anxiety. In those cases, your reputable sedation dentist can help you to relax and make your appointment pain and anxiety free.  Don’t allow severe anxiety to prevent you from a much-needed root canal procedure. Instead, ask your cosmetic dental team about safe sedation options.

After a root canal is performed, it’s common for the tooth to feel tender and sore. You may require a soft diet for a few days, and your dentist may recommend the use of over-the-counter analgesics, like Tylenol, Motrin or Aleve. These low-risk medications should take care of post-procedural pain, and when an experienced dentist performs your root canal, your discomfort should be short-lived. Once your root canal heals, your tooth should be restored—both functionally and aesthetically. You’ll be surprised at how pain-free the process can be.

Plagued by tooth pain? Call Smile and Skin today to schedule your dental consultation or inquire about our extensive line of cosmetic dental procedures. 

Cosmetic Dentistry Experts

If your Boston dentist has recommended amalgams (silver fillings) to repair tooth decay or restore your decayed teeth, you may be wondering about how safe they are. In recent years, much concern has been raised about silver fillings and their mercury content. Because of this, many patients are leery of fillings—and may even avoid them altogether. Unfortunately, avoiding a filling can lead to unhealthy and dangerous complications, so it’s important to understand the truth about amalgams. Here are the facts:

1. While it’s true that amalgams are made of elemental liquid mercury mixed with other metal alloys, the mercury becomes nearly non-toxic when bound with other metals. Because this form of mercury it is not absorbed well through the digestive tract, it is not a health concern. In addition, the amount of mercury released by patient amalgams is extremely small when compared to our average daily mercury intake from water, seafood and other environmental sources.
2. Choosing not to fill your dental caries (cavities) can lead to ongoing health problems. A cavity is the result of an accumulation of decayed particles and bacteria, and if you go without filling the cavity, bacteria can enter your body through your jaw and gastro internal track. These spreading bacteria could lead to both bodily infection and general health concerns. 
3. Both the Food and Drug Administration (FDA) and the American Dental Association (ADA) have ruled, on numerous occasions, that silver fillings are not unsafe.
4. Amalgams are still in use because they are a durable, time-tested and affordable way of restoring decayed teeth. There are other options—including porcelain and composite resins—that are more cosmetically attractive.
5. It is estimated that less than one percent of the population is allergic to mercury, so mercury allergies are not a concern when it comes to amalgams. If you have a known mercury allergy, however, discuss other filling options with your Boston dentist.

Smile and Skin Cares about Your Health

The Fluoride Solution

Up until now, you may have thought of fluoride as only a toothpaste additive. But did you know that fluoride is often present in water and many kinds of food? And when used properly, it's also a big part of the tooth decay solution. Fluoride helps with tooth development in children, and it hardens the surface of existing teeth in adults and older kids. The proper amount of fluoride prevents demineralization-and makes teeth more resistant to enamel breakdown and decay.

So how do you get fluoride? In addition to the fluoride present in food and water, fluoride is available in toothpastes, over-the-counter and prescription mouthwashes, and gel or foam treatments. If you're at risk for tooth decay, your dentist may apply gel or foam fluoride directly to your teeth or place it in a mouth guard to ensure adequate coverage.

Who Needs Fluoride Treatments?

Fluoride intake is critical for infants, toddlers and children between six months and 16 years as teeth are developing and erupting. But fluoride intake should not stop after adolescence. Older teens and adults can also prevent tooth decay with regular, topical fluoride treatments.

If you have any of the following health concerns, your dentist may recommend additional, more intensive fluoride applications.

• Frequent tooth decay: If you have a high rate of tooth decay (1-2+ cavities a year), it could be an indication that you need regular fluoride treatments.
• Gingival recession (a form of gum disease): Gingival recession exposes tooth roots, making teeth more susceptible to decay.
• Dry mouth: Certain types of diseases, allergies, or medications can cause excessive dry mouth. Saliva is important to the breakdown of acids and food, and its absence may cause frequent cavities and enamel softening.
• Corrective hardware: Braces, retainers, crowns and bridges can keep teeth from receiving the fluoride they need through daily exposure. Your dentist may need to apply fluoride directly to brackets and appliances to prevent underlying tooth decay.

Improve Your Smile with Smile and Skin

If you're concerned about excessive tooth decay, ask the Smile and Skin team if you could benefit from fluoride treatments. Schedule a consultation with Dr. Meola today, and ask about our variety of dental maintenance and cosmetic procedures. We'll help you protect your teeth-and enjoy your smile!

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