Office cleanings and other minor procedures are a routine part of regular dental care. For some people, though, a routine visit could put them at slight risk for a serious illness.
The reason for this concern is a condition known as bacteremia. This occurs when bacteria, in this case from the mouth and conceivably during an office cleaning or other routine dental procedure, enters the bloodstream. Although for most people this isn’t a great issue, there’s been concern that bacteremia could further compromise the health of patients with or susceptible to other conditions like endocarditis (heart inflammation), prosthetic joints or compromised immune systems.
This concern grew out of a number of studies in the early 20th Century that seemed to show a link between dental bacteremia and infective endocarditis. At about mid-century it became a common practice to administer antibiotics before dental work (usually 2 grams of amoxicillin or an equivalent about an hour before) to high risk patients as a way of protecting them against infection. The practice later expanded to other health issues, including many heart conditions.
Beginning in 2007, however, guidelines developed jointly by the American Heart Association and the American Dental Association reduced the number of conditions recommended for antibiotic therapy. Based on these guidelines, we now recommend pre-procedure antibiotics if you have a history of infective endocarditis, artificial heart valves, certain repaired congenital heart defects, or heart transplant that develops a subsequent heart valve problem. Patients with prosthetic joints or immune system problems are no longer under the guidelines, but may still undergo antibiotic therapy if believed necessary by their individual physician.
If you have a condition that could qualify for antibiotic therapy, please be sure to discuss it with both your dentist and physician. We’ll work together to ensure any dental work you undergo won’t have an adverse effect on the rest of your health.
If you would like more information on antibiotic therapy and dental care, 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 “Antibiotics for Dental Visits.”
For centuries, people who've lost all their teeth have worn dentures. Although materials in today's dentures are more durable and attractive than those in past generations, the basic design remains the same — prosthetic (false) teeth set in a plastic or resin base made to resemble gum tissue.
If you're thinking of obtaining dentures, don't let their simplicity deceive you:Â a successful outcome depends on a high degree of planning and attention to detail customized to your mouth.
Our first step is to determine the best positioning for the prosthetic teeth. It's not an “eyeball” guess — we make a number of calculations based on the shape and size of your jaws and facial features to determine the best settings within the resin base. These calculations help us answer a few important questions for determining design: how large should the teeth be? How far forward or back from the lip? How much space between the upper and lower teeth when the jaws are at rest?
We also can't forget about the artificial gums created by the base. How much your gums show when you smile depends a lot on how much your upper lip rises. We must adjust the base size to accommodate your upper lip rise so that the most attractive amount of gum shows when you smile. We also want to match as close as possible the color and texture of your natural gum tissues.
There's one other important aspect to manage: how your upper and lower dentures function together when you eat or speak. This means we must also factor your bite into the overall denture design. This may even continue after your dentures arrive: we may still need to adjust them while in your mouth to improve function and comfort.
Ill-fitting, dysfunctional and unattractive dentures can be distressing and embarrassing. But with careful planning and customization, we can help ensure your new dentures are attractive and comfortable to wear now and for years to come.
If you would like more information on removable dentures for teeth replacement, 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 “Removable Full Dentures.”