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In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. John Zarrella and Dr. Peter C. Rider suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our Ashland office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

You may have heard this term the first time you or a friend got your wisdom teeth. That makes sense, as wisdom teeth are the teeth most often impacted in teenagers and young adults. But other permanent teeth can be impacted as well. What exactly do we mean by “impacted teeth,” and what can we do to treat them?

The term “impacted” means that somehow a tooth has been blocked from erupting properly. A tooth may be completely blocked by another tooth, erupt in the wrong space, or even come in from the wrong direction. Depending on the teeth involved, there are several different options for treatment.

From Baby Teeth to Permanent Teeth

Normally, when children lose a baby tooth, a permanent tooth is right there, ready to take its place. But teeth don’t always behave according to plan. Occasionally, that baby tooth just won’t budge, and the permanent tooth starts to erupt behind it. When this happens, a simple baby tooth extraction will often let the permanent tooth move into its proper position on schedule.

A more complicated situation develops when upper teeth are impacted because there isn’t enough space in the mouth for them. In this case, a device called a palatal expander might be used to gradually widen the upper jaw to allow the permanent teeth to erupt without crowding.

In other rare cases, a tooth (often the canine) fails to erupt and may require oral surgery to uncover it, followed by orthodontic treatment to guide it into position.

Impacted teeth can result from other causes as well, and every impacted tooth should be treated as quickly as possible. Left untreated, the teeth can fail to erupt at all or erupt in the wrong place, crowd other permanent teeth, damage the roots of the teeth near them, and lead to difficulties eating and dental pain.

Wisdom teeth

Wisdom teeth are often a problem because there is simply not enough room in the jaw for them.

Wisdom teeth that are completely impacted (still in the jawbone) can sometimes be left alone if they aren’t causing other problems. But if impacted wisdom teeth develop cysts, affect the teeth around them, or lead to other dental complications, they should be extracted.

Partially erupted teeth, those that have begun to emerge through the gums but don’t erupt fully, can be the source of different gum and tooth problems. Because the gum tissue overlaps the tooth, food particles and bacteria can become trapped, leading to rapid tooth decay and even infection. In this case, extraction is probably the best option.

Be Proactive

The term “impacted” actually comes from the Latin root meaning “pushed against.” But teeth that don’t erupt at the right time, in the right place, can have a different kind of impact on dental health and appearance. And the earlier we can catch these problems, the easier it is to treat them.

Regular exams and X-rays with Dr. John Zarrella and Dr. Peter C. Rider at our Ashland office will show the progress of the teeth even before they erupt, and if there will be the space for them to fit in the mouth properly. We may recommend a visit to the orthodontist by the age of seven to see if there are any signs of potential orthodontic problems.

Intervention at an early stage can prevent potential problems from becoming major ones. That is why it’s so important to be proactive when teeth are erupting in children and young adults. After all, a healthy, confident smile makes a real impact!

Fluoride is a mineral that plays an essential role in oral health. In fact, the significant reduction in American tooth decay in recent decades can be attributed to a greater availability of fluoride in public water supplies, toothpaste, and other resources. When it comes in contact with the teeth, fluoride helps protect the enamel from acid and plaque bacteria. In some cases, it can even reverse tooth decay in its earliest stages.

Despite the benefits of fluoride, tooth decay is still common, especially among teenagers. The Centers for Disease Control reports that cavities can be found in more than half of young teens and two-thirds of older teens over age 16. Many of those teens are deficient in fluoride, either due to a lack of public water fluoridation or the use of bottled water. So how can parents ensure their teens are getting the fluoride they need to facilitate strong, healthy teeth?

Monitor Fluoride Exposure

Dr. John Zarrella and Dr. Peter C. Rider and our team at Zarrella Dentistry recommend you start by measuring your teen’s fluoride exposure. Make sure you purchase fluoridated toothpaste for your household, and find out if your tap water is fluoridated. If your teen primarily consumes bottled water, examine the bottle to determine whether fluoride has been added. The majority of bottled waters are not supplemented with fluoride, but those that are will be clearly labeled.

Fluoride Supplementation

Dr. John Zarrella and Dr. Peter C. Rider may recommend topical fluoride treatments at routine dental exams. These treatments are painless for your teen and may help establish stronger enamel that is more resistant to plaque and tooth decay. If you have a public water supply that is non-fluoridated, we may recommend fluoride supplementation between visits. These can be administered as drops, tablets, or vitamins.

Keep in mind that fluoride is most important for children and teens under the age of 16. Be proactive about your teen’s oral health by speaking with us about your family’s fluoride needs at your next dental visit.

For more information about fluoride, or to schedule an appointment with Dr. John Zarrella and Dr. Peter C. Rider, please give us a call at our convenient Ashland office!

As you grow older, your mind may be preoccupied with the health of your bones, heart, or brain. However, our team at Zarrella Dentistry will tell you that keeping your teeth healthy is an equally important part of the aging process. Older adults are at increased risk for a variety of oral health conditions, which makes it essential for you to speak with your dentist to create a prevention plan that’s best for you.

Oral health conditions associated with aging

Just as the rest of your body continues to change as you age, your mouth changes, too. Certain conditions become more likely to develop as you reach older adulthood, including:

• Dry mouth. Although your salivary glands continue to produce saliva as you get older, medications and chronic health problems often cause dry mouth.
• Root decay. Your teeth have lasted you a lifetime, but improper nutrition or cleaning may lead to decay at the roots of your teeth.
• Diminished sense of taste. Your eyesight and hearing aren’t the only senses affected by aging. The ability to taste naturally diminishes over the course of older adulthood.
• Tissue inflammation. Are your gums tender, bleeding, or inflamed? Tissue inflammation may indicate gum disease or may be a consequence of wearing dentures that don’t fit well.
• Oral cancer. Risk for most cancers increases with age, and oral cancer is no exception. Older adults are at increased risk for oral cancer compared to younger individuals.

Ways you can prevent dental problems

Fortunately, many age-related oral health problems are preventable. Begin by improving your diet to include plenty of fruits and vegetables. Choosing water over coffee or soda will keep your teeth whiter and cavity-free. Also remember to practice good brushing habits to prevent cavities and gum disease.

Visiting the dentist at least twice a year is vitally important when you reach older adulthood. Your dentist is familiar with your oral health and may be the first person to notice a sore, discolored patch, inflammation, or other abnormality that indicates oral cancer or gum disease.

If you’re experiencing any problems with dental health, let your dentist know immediately. Together, you can troubleshoot solutions and create a plan that keeps your mouth and gums healthy.

For more information, or to schedule an appointment with Dr. John Zarrella and Dr. Peter C. Rider, please give us a call at our convenient Ashland office!