Jeffrey L. Hardenburg DDS

Osteoporosis is a disease that weakens bones and increases the risk of fractures.

It affects about 10 million Americans of whom 8 million are women and another 34 million are at risk of developing it.

So this is a disease that affects more women than cancer, heart disease and stroke combined.

But what does it have to do with your dental care?

Well, many people in these categories are treated with a group of prescription drugs called oral bisphosphonates. Studies have reported that these drugs reduce bone loss, increase bone density and reduce the risk of fractures.

But some people have been alarmed and confused by recent news reports about oral bisphosphonates because of uncommon complications that have been linked to these drugs.

The drugs have been associated with osteonecrosis of the jaw (ONJ), a rare but potentially serious condition that can cause severe destruction of the jawbone.

The true risk posed by oral bisphosphonates remains uncertain, but researchers seem to agree that it appears very small.

Given the risks associated with osteoporosis and the proven benefits of oral bisphosphonate therapy, you should not stop taking these medications before discussing the matter fully with your physician.

If your physician prescribes an oral bisphosphonate, its important to tell your dentist so that your health history form can be updated.

In this case, some dental procedures, such as extractions, may increase your risk of developing ONJ, so your dentist needs to be able to take your full health picture into account.

When you visit a modern dental surgery, its hard to imagine the challenges of dental treatment without all the latest technology.

Yet specialists have been taking care of peoples teeth for thousands of years.

Here are some of the key developments over the last 300 years.

1723: French surgeon Pierre Fauchard – credited as being the father of modern dentistry – publishes the first book to describe a comprehensive system for the practice of dentistry.

1760: John Baker, the earliest medically-trained dentist to practice in America, immigrates from England and sets up practice.

1790: John Greenwood adapts his mothers foot treadle spinning wheel to rotate a drill.

1790: Josiah Flagg, a prominent American dentist, constructs the first chair made specifically for dental patients.

1832: James Snell invents the first reclining dental chair.

1841: Alabama enacts the first dental practice act, regulating dentistry in the United States.

1844: Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice.

1880s: The collapsible metal tube revolutionizes toothpaste manufacturing and marketing.

1890: Willoughby Miller notes the microbial basis of dental decay in a book which started a world-wide movement to promote regular toothbrushing and flossing.

1896: New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S.

1938: The nylon toothbrush, the first made with synthetic bristles, appears on the market.

1945: The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.

1950s: The first fluoride toothpastes are marketed.

1960: The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced in the United States. A cordless, rechargeable model follows in 1961.

While our teeth are normally very strong, they can crack for a number of reasons.

Reasons could include tooth decay, trauma/injury, grinding of the teeth or a stress fracture.

Sometimes, our jaw may be stronger than our teeth and the teeth can fracture when we bite heavily on food.

We can protect our teeth in some circumstances – for example it may be advisable to wear a mouthguard during sports.

Taking proper care of the teeth and regular visits to the dentist will help keep your teeth in good shape.

If a tooth cracks, it may become painful if the nerve is exposed and the area can become tender.

If this happens, rinse your mouth with warm water to clean the area and apply a cold compress to reduce swelling. Then call your dentist immediately.

Treatment will depend on where the tooth has fractured, how close it is to the nerve and the overall condition of the tooth.

A cracked tooth may be repaired with silver alloy, gold, porcelain or plastic. Or it may require a crown or overlay or bonding, which applies porcelain or enamel to the fractured tooth.

If you contact your dentist quickly, they will be able to take the most approriate action to preserve the tooth as much as possible.

Gum disease also known as periodontal disease – is an infection of the tissues surrounding and supporting the teeth and its a major cause of tooth loss in adults.

But its usually painless so you may not even know you have it.

Its caused by plaque a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

The early stage of gum disease is called gingivitis. In this stage, the gums can become red, swollen and bleed easily. At this stage, you can usually still reverse the disease by daily brushing and flossing.

The more advanced stage of gum disease is known as periodontitis. At this stage, the gums and bone that support the teeth can become seriously damaged. The teeth may then become loose, fall out or have to be removed by a dentist.

Its therefore very important to look out for any signs of gum disease. These signs include:

– Gums that bleed when you brush your teeth
– Red, swollen or tender gums
– Gums that have pulled away from the teeth
– Bad breath that doesn’t go away
– Pus between your teeth and gums
– Loose teeth
– Change in the way your teeth fit together when you bite
– Change in the fit of partial dentures

If you notice any of these signs, contact you dentist quickly and theyll help you take action to make improvements.

If you’ve been diagnosed with diabetes, its important that you let your dentist know so that they can give you the best care possible.

As more than 15 million Americans have diabetes, your dentist will be familiar with the issues and will give you the specialist care you need.

This is important because diabetes can lower your resistance to infection and slow the healing process.

Its important to tell your dentist:

– If you have been diagnosed with .diabetes
– If the disease is under control
– If there has been any other change in your medical history
– Names of all prescription and over-the-counter drugs you are taking

The most common oral health problems associated with diabetes are:

– Tooth decay
– Periodontal (gum) disease
– Salivary gland dysfunction
– Fungal infections
– Infection and delayed healing
– Taste impairment

If you have regular dental checkups and keep your dentist informed about your status theyll be able to help you reduce and manage these risks.

Bad breath – also known as halitosis – is an unpleasant condition that can cause a great deal of embarrassment.

And, for many people, its made even worse by the fact they don’t even know that they have it.

There are many possible causes for bad breath so, if you think you might have the problem, talk to your dentist.

What you eat affects what you breathe out. Certain foods, such as garlic and onions, contribute to objectionable breath odor and even dieters may develop unpleasant breath from infrequent eating.

If you don’t brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath.

Bad breath can also be caused by dry mouth (xerostomia) which occurs when the flow of saliva decreases.

One of the reasons why its especially important to talk to your dentist about bad breath is that it may be a sign of an underlying medical problem such as respiratory tract infection or gastrointestinal problems.

Persistent bad breath or a bad taste in the mouth can also be a warning signs of gum disease.

Smoking can also cause bad breath, stain teeth and reduce your ability to taste foods.

For all these reasons, you shouldn’t put up with the problem of bad breath. Talk to your dentist and find out what might be causing the problem.

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appoinment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a dental prophylaxis, or prophy and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

If your saliva flow is reduced, this can cause dry mouth which often leads to increased tooth and gum problems.

Dry mouth known as xerostomia – is a common problem especially among older adults. Its caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

The common problems associated with dry mouth include:

– Constant sore throat
– Burning sensation
– Problems speaking
– Difficulty swallowing
– Hoarseness or dry nasal passages

When there is not enough saliva to lubricate your mouth, wash away food and neutralize the acids produced by plaque, there is a risk of extensive tooth decay.

If you are at risk from this condition, your dentist can recommend various methods to restore moisture.

For example, sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

As dry mouth is a potential side effect of many prescribed and over-the-counter medications it is a very common problem.

These medications can include antihistamines, decongestants, painkillers, high blood pressure medications, muscle relaxants, drugs for urinary incontinence, Parkinsons disease medications, antidepressants and many others.

Fortunately there are many simple solutions available to reduce the risk to your oral health caused by dry mouth so talk to your dentist if you are on any kind of medication or you feel you may be at risk from this issue.

If youve lost all of your natural teeth, whether from gum disease, tooth decay or injury, complete dentures can replace your missing teeth and your smile.

Replacing missing teeth will benefit your appearance and your health.

Without support from the denture, facial muscles sag, making a person look older. Youll also find it harder to eat and speak things that people often take for granted until their natural teeth are lost.

There are various types of complete dentures.

A conventional full denture is made and placed in the patients mouth after the remaining teeth are removed and tissues have healed which may take several months.

An immediate complete denture is inserted as soon as the remaining teeth are removed. The dentist takes measurements and makes models of the patients jaws during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

And even if you wear full dentures, its important to visit your dentist regularly to maintain your overall oral health and get early warning of serious issues such as oral cancer.

You’ve probably heard people talking about plaque and maybe you’ve some idea of what it is.

But its useful to know a bit more about it so that you can do whats necessary to minimize the risks.

Plaque is a sticky film of bacteria that forms on teeth and gums.

When you’ve eaten a meal or snack, the bacteria in plaque release acids that attack tooth enamel. When this happens regularly, the enamel can weaken. This eventually leads to tooth decay.

The food we eat often causes plaque bacteria to produce acids. So, if you eat a lot of snacks, your teeth may be suffering acid attacks all day.

If you don’t remove the plaque through effective daily brushing and cleaning between the teeth, it can eventually harden into calculus or tartar.

Another effect of plaque is that it also produces substances that irritate the gums, making them red and tender or causing them to bleed easily.

If you want to prevent tooth decay and gum disease, make sure you have a balanced diet and avoid having too many snacks between meals.

When you feel like a snack, go for foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.