Dr Gatti's Blog a Lawrence Dentist Reflections

At Dr. Gatti’s Advanced Dental Studio we now have available the option of a paste free polishing method. Many of our clients have already experienced this revolutionary new way of having their teeth polished. The polishing agent is impregnated into the polishing cup, thereby eliminating the need to dip the cup into a traditional gritty polishing paste. The result is a polishing procedure without the grit and splatter!

A study by the University of Nebraska Medical Center’s College of Dentistry showed that the Butler Paste-Free Prophy is less abrasive on composite resin (tooth colored fillings) and enamel and provides a higher gloss finish than the paste products tested. The study shows it also maintains the original finish and gloss on porcelain, This is especially important for the many people with cosmetic restorations. In addition, tests conducted at the Indiana University School of Dentistry’s Oral Health Research Institute found that Butler Paste-Free Prophy cleans as well as traditional paste.

Of course, for those of you who prefer the traditional polishing method, we still have available the most up to date and leading polishing pastes available. Feel free to ask Dr. Gatti or one of our hygienists for more information.

Technology, new research and state of the art equipment can really make a difference in your smile!

At the Studio, we enjoy restoring a person’s smile by using various restorations such as porcelain crowns, veneers and Cerec restorations. However, prevention is always the best option and we now have a longer list of products that can actually help us remineralize enamel in ways we couldn’t before: that is from the bottom up. Remember that enamel breaks down under the surface first. Then after some time, the top layer caves in, creating a hole.

We’ve known for a long time that fluoride works on the surface of enamel. It is best when used frequently in small doses. It gives the enamel a chance to rebuild the fluorohydroxyapatite molecules that are acid-resistant and is very helpful in preventing demineralization. Xylitol is a product found in certain brands of chewing gum and mints which acts directly on bacteria and is very helpful in remineralization protocols. Other products being used to actually rebuild the enamel include amorphous calcium phosphate (ACP), casein phosphopeptide-ccalcium phosphate (CPP-ACP, also known as Recaldent), the arginine bicarbonate/calcium carbonate complex and calcium sodium phosphosilicate complex (NovaMin).

Sounds confusing, right? Let’s remember that, in order to maintain intact enamel, its imperative that healthy saliva be present. Healthy saliva has calcium, phosphate, fluoride, and bicarbonate among other things in it. Each has its own job to do and, when it’s not there, chaos happens, white spot lesions form in the enamel, and eventually it collapses in on itself, creating a hole, better known as a cavity.

What to use where becomes the next question. Of course, there’s no one answer. The bottom line is that you need a diagnosis; only then can you formulate a treatment plan and figure out what products are going to be the best fit. I highly recommend you talk with your dentist or a cosmetic dentist and seek his or her help in sorting out which products will be most helpful for you.

Medications you take for osteoporosis can have an impact on your dental health

Recent news reports have alarmed and confused dentists, as well as people who take bisphosphonates (bis-fos-fo-nates). That is because a condition known as osteonecrosis (os-tee-oh-ne-kro-sis) of the jaw (also know as OJN) has been reported in some patients who have taken these medications. Bisphosphonate associated osteonecrosis of the jaw, or BON, is a rare but serious condition that can cause severe damage to the jawbones.

Since there is so much confusion on the subject I wanted to give you a brief overview of the current recommendations and suggestions of what to consider.

First, this is a real event. However, the overwhelming majority of people (94%) diagnosed with BON are cancer patients who are receiving or did receive repeated high doses of bisphosphonates through intravenous (IV) infusion. The other 6% of people with BON were taking oral bisphosphonates for treatment of their osteoporosis.

Given this information there are practical matters to consider. First, osteoporosis and broken bones are serious. The statistics around hip fractures and mortality in people over 50 are somewhat frightening. Studies indicate that in many people, bisphosphonate medication can help reduce the chance of broken bones by increasing bone density. Some reports indicate that these medications may reduce the chance of hip fracture by 50% in people with osteoporosis.

So, like everything in life, there are risks and rewards. In the instance of osteoporosis, the benefits of these medications greatly outweigh the low risk of developing BON. Bottom line, if you are taking bisphosphonate medication, don’t go off your meds unless you have had a serious conversation with your physician. Practically speaking, if systemic conditions permit, initiation of bisphosphonate therapy should be delayed until dental health is optimized. It is imperative that the decision is made in conjunction with your treating physician and oncologist.

Once again, regular dental visits and excellent oral hygiene practices may be the best way to reduce your risk.