1. Who needs to take antibiotics before a dental visit?
  2. Are dental X-rays safe?
  3. Why should I have dental X-rays taken?
  4. How is the fluoride you offer as in-office treatment different from the fluoride in my toothpaste or mouthrinse?
  5. Should I stop my Aspirin or Plavix regimen before a dental extraction?
  6. Can having gum disease truly put me at risk for other health problems?

1. Who needs to take antibiotics before a dental visit?

   The guidelines for patients who need antibiotics prior to dental treatment have changed in recent years, the most recent one being from January 2015. This is because growing scientific evidence shows the risks of taking preventive antibiotics (such as a wide range of adverse reactions and drug-resistant bacteria) outweigh the benefits for most patients. Here are the conditions that do not need antibiotic prophylaxis:

  • Mitral valve prolapse;
  • Cardiac stents or pacemakers;
  • Rheumatic heart disease;
  • Bicuspid valve disease;
  • Calcified aortic stenosis;
  • Congenital heart conditions such as ventricular and atrial septal defects, and hypertrophic cardiomyopathy;
  • Total Joint replacement;
   The following conditions still require antibiotic prophylaxis:
  • Artificial heart valves;
  • History of infective endocarditis;
  • Cardiac transplant that develops a problem in a heart valve;
  • Certain specific congenital heart conditions (unrepaired cyanotic congenital heart disease, a congenital heart defect repaired with a prosthetic device during the first 6 months after surgery).
   If you have any further questions about the new guidelines, talk to your physician or to Dr. Gherman.
2. Are dental X-rays safe?

   The answer is absolutely yes! The thought of medical and dental X-rays can be scary to some patients. Most of us tend to forget there is natural radiation always around us, from cosmic rays and decaying radioactive elements (here in the U.S., we receive an average of 3.00mSv (millisievert) per year). The most common type of dental X-rays, the bitewing radiographs, create 0.038mSv of radiation, whereas a chest radiograph creates 0.080mSv, while a lower GI tract X-ray causes 4.060mSv (ADA figures). At Oasis Dental, we take digital radiographs, which create less radiation than traditional X-rays and are localized to the specific area needed to be viewed. We also use lead shields to minimize any scatter radiation effects, and only take radiographs when needed and dictated by your dental health and history.

3. Why should I have dental X-rays taken?

   Dental radiographs are a crucial aspect of an examination, as most areas such as in-between teeth, below the gum line, underneath crowns or fillings cannot be viewed and checked with the naked eye or dental instruments. Here are some findings dental radiographs help Dr. Gherman diagnose:

  • Decay between the teeth;
  • Caries recurring under fillings or at crown margins;
  • Abscesses or cysts;
  • Bone loss and bony defects;
  • Developmental abnormalities;
  • Cancerous and non-cancerous lesions.
   Dental X-rays allow Dr. Gherman to detect and therefore treat problems at an early stage, which may save you time, money, unnecessary discomfort, and ultimately, your teeth.
4. How is the fluoride you offer as in-office treatment different from the fluoride in my toothpaste or mouthrinse?

   Fluoride is an element that helps remineralize a tooth affected by acid, and it can sometimes stop or even reverse a small cavity. It is therefore important for both children and adults. The fluoride normally found in toothpastes is at a level of 1000 ppm (parts-per-milion) and about 250 ppm in mouthrinses. The in-office fluoride treatment Dr. Gherman offers at Oasis Dental is a varnish that attaches to the tooth structure for localized delivery. It not only provides a high level of fluoride of 22,600 ppm, but it also relieves sensitivity, has other minerals such as calcium and phosphate that redeposit and remineralize weakened enamel.

5. Should I stop my Aspirin or Plavix regimen before a dental extraction?

   In the majority of cases, the answer is no! Evidence shows the risks to your health by stopping the anticoagulant medication outweigh any potential benefits. At Oasis Dental, there are precautions we can take to further minimize post-operative bleeding for patients on anticoagulants. Dr. Gherman will use a local anesthetic with vasoconstrictor to minimize tissue bleeding, extract the tooth in the least traumatic fashion, pack the socket with absorbable hemostatic dressing, and place sutures as needed. Dr. Gherman will carefully check your medical history and discuss anticoagulation concerns with you. You may also check in with your physician, but do not preventively change your routine of taking medication in anticipation of a dental extraction, as this may cause complications.

6. Can having gum disease truly put me at risk for other health problems?

   The answer is yes! Periodontal disease is not only an infection of the gingival and bony tissues supporting the teeth, but also a chronic inflammation due to bacterial toxins and your own immune system’s response to them. Recent evidence shows relationships between periodontal disease and the following ailments:

  • Heart disease;
  • Stroke;
  • Diabetes;
  • Respiratory disease;
  • Pregnancy complications.
   The common thread is the underlying inflammation and the changes it causes in various systems, as well as the bacteria themselves. Here are some notable findings:
  1. Patients with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease, and active gum disease can worsen existing heart conditions.
  2. Patients with diabetes are more likely to have periodontal disease than people without diabetes, as they are more susceptible to contracting infections; also periodontal disease makes it more difficult for diabetics to control their blood sugar.
  3. Bacteria that grow in the oral cavity can be aspirated into the lungs to cause respiratory diseases such as pneumonia, or worsen existing lung conditions.
  4. Pregnant women who have periodontal disease may be more likely to have a premature baby.
   The more research is concluded on periodontal disease, the more noted is the connection between oral health and the remaining bodily health. At Oasis Dental, we take periodontal disease seriously and not only try to treat and control it, but try to educate patients in the need to be aware of their dental health.