Posts for: April, 2014

By Edward Joseph, D.D.S.
April 28, 2014
Category: Dental Procedures
BoneGraftingforDentalImplants

Dental implants are a great choice for many people who need to permanently replace a missing tooth. Reliable and long-lasting, they offer a highly successful outcome, and can even help reduce long-term bone loss and damage to adjacent teeth. One of the best features of implants is that the titanium metal of which they're made actually becomes fused with your natural, living bone tissue.

But sometimes, an examination may show that where you have missing teeth, you may not have enough bone remaining to properly place an implant. Does this mean you're out of luck? Not necessarily!

Employing the refined techniques of bone grafting, regenerating bone tissue has become a standard procedure in periodontal and oral surgery. In many cases, it's possible to build up just the right amount of bone using a variety of grafting materials, in combination with other special techniques. This can enable patients who wouldn't otherwise be good candidates to enjoy the benefits of dental implants.

How does it work? Basically, by helping your body repair itself.

You may already know that bone is a living tissue, which can respond to its environment positively (by growing) or negatively (by resorbing or shrinking). When you've lost bone tissue, the trick is to get your body to grow more exactly where you want it. Once we know where — and how much — replacement bone is needed, we can place the proper amount of bone grafting material in that location. Then, in most cases, the body will use that material as a scaffold to regenerate its own bone.

Bone grafting is often done at the time of tooth removal as a preventive procedure or prior to the placement of an implant, to give the body time to re-grow enough of its own tissue. The procedure is generally carried out under local anesthesia, or with the aid of conscious sedation. Sometimes, if there is enough natural bone to stabilize it, it's even possible to place an implant and perform a bone graft at the same time.

So if you're considering dental implants, let us advise you on what's best for your particular situation. We have the knowledge and experience to help you make the right choices, and achieve the most successful outcome.

If you would like more information about bone grafting, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Can Dentists Rebuild Bone?


By Edward Joseph, D.D.S.
April 25, 2014
Category: Oral Health
Tags: medication   aspirin  
BeSureYourDentistKnowsYoureUndergoingAspirinTherapy

Acetylsalicylic acid (ASA), better known as aspirin, is an effective pain reliever and fever reducer. More recently, its anti-inflammatory properties have become part of the management of cardiovascular disease. But while regular use may benefit your general health, it could complicate your dental care.

Aspirin helps reduce inflammatory pain or fever by blocking the body’s formation of prostaglandins, chemicals that contribute to inflammation after trauma or injury. It also prevents blood platelets from sticking and clumping together. While this can prolong normal bleeding and bruising, it also helps the blood move freely through narrowed or damaged blood vessels, which reduces the risk of heart attack or stroke in at-risk cardiovascular patients. Due to side effects from prolonged aspirin use like kidney damage, stomach bleeding, or ulceration, physicians normally prescribe a low aspirin dosage (81 milligrams) to minimize these effects.

Because of its effect on bleeding and clotting, it’s important that every member of your healthcare team — including your dentist — knows how much and how often you take aspirin. The change it causes in your body’s clotting mechanism may also affect how dental procedures are carried out; by knowing you take aspirin regularly we can take extra precautions to ensure your safety.

In fact, if you’ve been prescribed aspirin for a heart condition, you may be tempted to stop taking it before a dental procedure out of fear of profuse bleeding. This is highly unadvisable — the sudden discontinuation could increase your risk of heart attack, stroke or even death. You should only discontinue aspirin treatment at the direction of your prescribing physician.

Another aspirin-related effect may involve your gums and other soft tissues. You may notice gum tissue bleeding after brushing or flossing; while this is normally a sign of periodontal gum disease, it could also be the result of your aspirin therapy. The only way to know for sure is to schedule a visit with us to examine your gums.

When it comes to aspirin or other blood-related therapies, the key is to communicate your health status with us, including all medications you are taking. With that knowledge we can provide you with the most informed and safest dental care we can.

If you would like more information on the effects of aspirin on your 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 “Aspirin: Friend or Foe?


By Edward Joseph, D.D.S.
April 17, 2014
Category: Oral Health
LooseTeeth-ASignofTroubleThatRequiresQuickAction

Loose teeth are an exciting rite of passage in childhood; in adulthood, they're anything but. In fact, a permanent tooth that feels loose is a sign that you need to make an appointment with our office right away. The quicker we act, the better chance we will have of saving the tooth.

What causes loose teeth? In the absence of a traumatic dental injury, the culprit is usually periodontal (gum) disease. This is a bacterial infection of the gum and/or bone tissues that surround and support your teeth. The infection is caused by bacterial plaque that sits on your teeth in the absence of effective oral hygiene. Over time, periodontal disease will cause gum tissue and eventually bone to detach from the teeth. As more of this supporting tissue is lost, the teeth will gradually become loose and (if the disease remains untreated) eventually fall out.

Loose teeth can also be caused by a clenching or grinding habit that generates too much biting force. This force can stretch the periodontal ligaments that join the teeth to the supporting bone, making your teeth looser.

Whether the cause of your tooth looseness is biological (gum disease) or mechanical (too much force), treatments are available here at the dental office. The first step in treating gum disease is a thorough cleaning to remove plaque and harder deposits on the teeth (tartar or calculus); this includes the tooth-root surfaces beneath the gum line. You will also be instructed on effective oral hygiene techniques and products to use at home. This type of therapy will promote healing of the gums that will cause some tightening of the teeth. Additional treatments will probably be necessary to gain the maximum healing response to allow the teeth to be most stable. For example, we may also want to temporarily or permanently splint the loose tooth or teeth to other teeth so that biting forces do not loosen them further.

There are other mechanical approaches we can employ to prevent a loose tooth from receiving too much force. For example, we can reshape the tooth by removing tiny amounts of its surface enamel in order to change the way upper and lower teeth contact each other. We also may suggest a custom-made nightguard to protect your teeth if you have a nighttime grinding habit.

The most important thing to know about loose teeth is that it's crucial to intervene quickly. So if you are experiencing tooth looseness, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Loose Teeth” and “Treatment for Loose Teeth.”


By Edward Joseph, D.D.S.
April 09, 2014
Category: Oral Health
Tags: oral health   bleeding gums  
DontIgnoreBleedingGums-ASignofTroubleAhead

Ninety percent of people have noticed bleeding from their gums when they brush or floss their teeth at some time or other. You may wonder if this is a result of brushing too hard — but that's not usually the case.

If your gums don't hurt — even if they bleed easily — you may think the bleeding is normal, nothing to worry about, or you're brushing too hard.

Bleeding from your gums is not normal!

It is an early warning sign of gum disease. In fact ten percent of those who start with bleeding gums go on to develop serious periodontal disease affecting the support for the teeth leading to tooth loss.

Then why do my gums bleed?

The way you brush your teeth is indeed a factor! Bacteria that normally reside in the mouth (in fact you need them to stay healthy) collect along the gum line in a biofilm. When the biofilm is not removed effectively on a daily basis, over time the gums become inflamed and bleed when touched. Other signs of inflamed gums — gingivitis — are redness and swelling, and even recession.

SO — the problem is not that you are brushing too hard, but that you are not brushing and/or flossing effectively. Both are important.

Three ways to stop bleeding gums before they lead to serious problems

  1. It all starts with brushing your teeth correctly at the gum line. Use a soft multi-tufted toothbrush. Hold it in the gum line and wiggle it gently until the tooth surfaces feel clean to your tongue — just like when you've had a professional cleaning. It doesn't take force, be gentle.
  2. It's just as important to remove biofilm from between the teeth where the toothbrush won't reach. If you are having difficulty flossing, we've got some easy demonstrations and instructional tips.
  3. Remember, as we say, “It's not the brush, it's the hand that holds it.”

Contact us today to schedule an appointment or to discuss your questions about bleeding gums. Bring your toothbrush and floss with you to our office and ask us to demonstrate proper oral hygiene techniques. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums: A very important warning sign of gum disease.”


By Edward Joseph, D.D.S.
April 01, 2014
Category: Oral Health
TakeHeedtotheSubtleWarningSignsofGumDisease

Periodontal or gum disease is a serious condition that could lead to tooth and bone loss. Unfortunately, you may not even realize you have it — the disease in its early stages can be difficult to detect. If you know what to look for, however, a few signs can tell you something isn’t quite right.

Bleeding gums after brushing, for example, are a likely indication that your gum tissues are inflammed due to an infection caused by bacterial plaque. Coupled with chronic inflammation from the body’s response to the infection, the unhealthy tissues bleed easily.

As the disease progresses, you may also notice changes in your gums’ appearance: redness at the gum line, as well as some slight swelling. Receding gums expose more of the tooth below the enamel crown. As roots become exposed to the oral environment, you’ll begin to notice painful sensitivity to hot or cold. In time, the disease may cause bone loss producing other signs like loose teeth or teeth shifting from their original position.

In some cases, gum disease can cause a painfully acute abscess. This occurs when the bacterial infection becomes isolated in a pocket of space between the teeth and gums. As the body attempts to fight the infection, its defenses are overwhelmed and the abscess becomes painful, swollen and filled with pus.

If you encounter any of these signs, it’s important to take action quickly to minimize the damage and stop the disease’s progress. Our first priority is to remove as much bacterial plaque and calculus as possible and may consider antibacterial and antibiotic treatments. This may take more than one session, but it’s necessary in stopping the disease.

Long-term success, though, will depend on improved oral hygiene (brushing and flossing), regular office cleanings to remove difficult to reach plaque and calculus, and checkups to monitor the condition of your gums. You can also lower the risk of reoccurrence with improvements in diet and life-style (such as quitting smoking). Instituting better hygiene and lifestyle habits, as well as keeping alert to any signs of recurring disease will go a long way in preserving your teeth and overall oral health.

If you would like more information about periodontal disease and its effect on your health, 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 “Warning Signs of Periodontal (Gum) Disease.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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