Rheumatoid Arthritis and Gum Disease

There are a number of health conditions that have consequences for a patient’s teeth and gums, and rheumatoid arthritis (RA) is one of the most common. Dr. Stephanie Herbst of Enid Dental Care understands her patients’ needs and wants patients with RA to know they can expect compassionate care for gum disease.

 When people have RA, their immune system attacks their synovium, which is a tissue that lines the joints. The attacked synovium swells up and hardens, sometimes causing joint deformities. Johns Hopkins recently examined the connection between gingivitis and rheumatism. They found that people with RA are twice as likely as the average person to have gum disease and six times as likely to have severe gum disease. It is true that people with rheumatism commonly have limited dexterity and find it difficult to brush and floss. But another study found that synovium and gum tissue share similar cellular structures. This could help to explain why gum disease is common in people with RA who have not yet lost the use of their fingers.

By maintaining regular dental check-ups, people with RA can keep their gum pockets as clean as possible. We can assist them by guiding them toward grips for toothbrushes and prescription throat moisturizers. RA is believed to be caused by genetic and environmental factors, but people can significantly reduce their risk of developing it by not smoking.

Dr. Stephanie Herbst operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Reasons for Extractions

Tooth extractions are a common procedure and usually go quickly and comfortably. But removing a tooth is not recommended lightly. At Enid Dental Care, now under the operation of Dr. Stephanie Herbst, we believe that patients should be fully informed about their health options, which is why we want them to know what kinds of issues would lead to an extraction.

In most cases, extractions are done in response to dental overcrowding. Modern peoples’ jaws do not usually grow large enough to accommodate the wisdom teeth (the backmost set of molars). As a result, the wisdom teeth commonly get stuck while erupting or force other teeth out of the way, ruining their alignment. Other teeth can be impacted, too, and although they wouldn’t usually be extracted, baby teeth might be removed if they don’t fall out and premolars are sometimes removed prior to orthodontic treatment.

There are a number of ways to save teeth that have been infected or injured, but sometimes they or the surrounding gum tissue are so compromised they need to be removed. This could happen if a tooth is cracked at the root. An implant that has become loose also needs to be removed, so patients with artificial teeth need to be especially vigilant about brushing.

Dr. Stephanie Herbst operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Types of Bridges

We’ve provided a lot of people with new teeth at Enid Dental Care. Thanks to advances in modern dentistry, there are now many options for tooth replacements. We wanted to take this opportunity to explain more about different kinds of bridges.

A bridge is a set of replacement crowns in one structure. A classical bridge was made up of two crowns which were placed over reshaped natural teeth, with a third crown suspended between them. Natural teeth tend to be more resilient than artificial ones so a dentist wouldn’t usually want to reshape them unless they need new crowns anyway. However, this method does have the advantage of leaving patients with their natural tooth roots.

It is also possible for dentures to be supported by implants. All-on-fours or all-on-sixes are bridges that are used to replace all the teeth in a jaw and are held permanently in place with normal-sized implants. Removable dentures can also be held in place with mini-implants. Partial implants have the advantage of allowing dentists to be more selective about which teeth a bridge replaces since they don’t require all the teeth in a row to be reshaped, but the denture itself will need to be replaced if the intervening teeth shift. Regardless of what kind of bridge a patient has, they will need to brush it on a daily basis.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Osteonecrosis of the Jaw

Patients at Dr. Dennis Morehart’s practice benefit from the experience and expertise of a Master in the Academy of General Dentistry. That means that Dr. Morehart is knowledgeable about oral surgery and the complications that can arise. To set patients’ minds at ease, we want to explain more about something they may have heard of: osteonecrosis of the jaw (ONJ).

The death of exposed jaw bone tissue is extremely rare but there is a small chance of it happening in people who are on bisphosphonate medications. These medications are used to prevent bone resorption. They are often taken in pill form for osteoporosis and through an IV to counteract the side effects of chemotherapy on people with cancer.  Cases of ONJ typically result from the much stronger IV doses.

In the absence of extreme periodontal disease or other infection, the only way jaw bone tissue would be exposed is as the result of a tooth extraction. For this reason, it is wise for patients to get dental work done before starting cancer treatments and to make sure all their medical care providers are fully informed of what the others are doing. But if ONJ does set in, it can be treated with antibiotic rinses.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Diabetes and Implants

As a Master in the Academy of General Dentistry, Enid’s Dr. Dennis Morehart is an expert in placing implants. Many people have benefited from jaw-stabilizing tooth replacements, but for a long time, implants were considered risky prospects for people with difficulty controlling their blood sugar. Now, new research is indicating that diabetes may not raise the probability of implant failure, after all.

There are two ways in which diabetes was thought to be relevant to implant placement: duration of healing and inflammation. Because diabetes restricts blood flow, diabetic people take longer to recover from wounds. In order to place an implant, an incision must be made into the gum tissue, which is then sutured and allowed to heal during the time it takes for an implant to integrate into the jaw bone. Another incision may be made when an abutment is placed on top. While it is true that the gums take longer to heal in diabetics, the integration process usually takes six months, giving them plenty of time. And while chronic inflammation is associated with the failure of implants to integrate, the new study found that people with uncontrolled blood sugar do not experience higher failure rates within the first year of placement. It is still beneficial to a patient’s health to control their blood sugar, but if they find this difficult, they may not necessarily be disqualified from getting fixed dental restorations.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Vertical Dimension Loss

As a Master in the Academy of General Dentistry, Dr. Dennis Morehart of Enid is has experience treating some of the most complicated oral health problems. In people who are missing several teeth, the loss of vertical dimension in the face poses a threat to their appearance, comfort, and overall quality of life. It can even lead to bite collapse, which is why we want our patients to know more about it.

The teeth help to stabilize the jaw bones. When tooth roots are removed, the tissue from the jaw bone dissolves, and the face shrinks. This causes wrinkles to develop in the skin in between the nose and the mouth and makes the lower part of their heads look disproportionately small. It can also trigger temporomandibular joint disorder (TMJD), resulting in pain throughout the jaw, head, neck, and shoulders. If the back teeth are missing, patients may attempt to chew with their incisors, causing the front teeth to be pushed horizontal and causing misalignment problems as well as loss of vertical dimension.

There are a few options for preventing or repairing this. When a full set of dentures are fabricated, dentists take care to match the height of the artificial crowns to the patient’s needs. The temporary dentures worn as part of the treatment help to ensure the crown size is correct. If larger implants are being used to secure dental bridges, the patient may have additional jaw bone material grafted on by a surgeon.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Tooth Sectioning

Recently, we described some of the reasons why a person might need to have a wisdom tooth removed. At Enid Dental Care, we always carry out extractions with maximal effort to keep the patient safe and as comfortable as possible. For that reason, wisdom teeth sometimes need to be cut into sections while being extracted.

The wisdom teeth are large and often unable to erupt fully. They can be trapped partially or completely beneath the gum line, in which case incisions will need to be made through which they can be removed. However, the wisdom teeth are also anchored by strong ligaments and have thick roots. Attempting to pull or elevate them out all at once may be impossible or require a great deal of force, which could hurt the patient or break the tooth accidentally. To avoid this problem, after the patient has been numbed, the tooth will be cut using a dental drill. The extraction site is bathed continuously with water to prevent heat damage and the smaller sections of the tooth can be removed with less force and through smaller openings.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Causes of Filling Failure

When patients suffer from tooth decay, Dr. Dennis Morhart’s Enid dental office is ready to help them. Our fillings are aesthetically pleasing and comfortable, but no filling lasts forever. Recently, scientists have conducted research on what causes fillings to fail, and we want our readers to know when they’re at risk.

Scientists are surprised to find that filling failure is associated with certain gene patterns. Therefore, it is especially important for people whose relatives have poor dental health to monitor their old fillings and maintain regular check-ups. But two of the biggest predictive factors were lifestyle related: smoking and alcohol. The scientists examined male smokers and found that their rate of filling failure was higher than that of male non-smokers. They also found that people of both sexes who consume alcohol have higher rates of filling failure. Because losing a filling is painful and potentially dangerous, we hope our patients will do everything they can to prevent this and will come to us if an old filling becomes sensitive or starts to leak. On a positive note, the researchers also found that white-colored composite fillings work just as well as old grey-colored amalgam ones, making these nicer-looking prosthetics a viable dental health option.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Mouth Ulcers

Mouth ulcers are a very common annoyance, but at Enid Dental Care, Dr. Dennis Morehart can provide patients with advice for managing their symptoms. There are, however, some differences between the causes of different kinds of ulcers which are important to know for managing oral health.

Cold sores are ulcers caused by the herpes simplex virus-1, which nearly everybody has. It is transferred through skin-to-skin contact as well as through sharing cups and utensils and lasts for the duration of a person’s life, but ulcer outbreaks are rare and usually clear up after a month. Other ulcers tend to be associated with physical damage to the mouth, which can be caused by misaligned bites and orthodontic brackets rubbing against the inside of the lips. Cankers are large white ulcers which have no certain cause but are hypothesized to be associated with stress and nutritional deficits.

Ulcers of all kinds usually heal on their own, but dentists can advise patients about topical cream to provide pain relief and infection-fighting medications. Dr. Morehart may also be able to identify physical problems in the mouth that are contributing to soft tissue damage.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.

 

Braces and Holiday Foods

We hope all our patients at Dr. Dennis Morehart’s Enid dental office enjoy the holiday season. This time of year can be challenging for people wearing braces, which is why we want to help guide them toward safe holiday foods they can enjoy comfortably.

There are two issues to keep in mind: which foods could damage the orthodontic wires, and which foods are safe but have high sugar contents and needs to be cleaned off the teeth quickly. With appetizer platters, it’s best to stay away from hard vegetables as well as dried fruit, but olives, cheese cubes, and pepper slices are safe. Vegetables are generally safe when boiled or baked, and people with braces may be particularly grateful for seasonal treats such as potato pancakes and winter squash.

Main courses such as brisket, turkey, and ham can be made tender enough to not present an issue, but deserts such as pies leave sugary food debris caught in brackets and orthodontic wires. It’s important for people leaving home for feasts and parties to remember to bring their Christmas tree toothbrushes and floss threaders. Also keep in mind that alcoholic drinks and eggnog have high sugar contents and that champagne is acidic, making it wise to drink water while consuming them and to brush teeth soon afterward.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit Enid Dental Care and fill out a contact sheet.

 

Bleeding Gums

Gingivitis is one of the most common oral health ailments, but that doesn’t mean people should have to endure it. If you see blood in the sink when you spit out your toothpaste, you’re not alone, but help is available. This week’s blog is devoted to the causes of bleeding gums.

Bacteria are part of a healthy oral ecosystem, but problems occur when they grow out of control. This can happen when there is a lot of food debris in the gum pockets. Bacteria would rapidly multiply, and as they eat, they would produce acid. The acid would stick to the plaque and tartar around the tooth root, irritating the gum tissue it comes in contact with. This causes gingivitis—gum inflammation—which is characterized by redness and bleeding.

Regular brushing can reduce bacterial growth, although it’s important to only use a soft-bristled toothbrush. Hard-bristled toothbrushes can bruise the gum tissue, worsening the problem. Pregnant women frequently experience gum bleeding due to hormonal changes, as do people on blood thinner medications. Smoking and dry mouth also create situations in which bacterial growth is more likely. It is especially important for these patients to maintain regular appointments for deep cleanings.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.

 

Back to School Check-Up

Patients of all ages should come in for cleanings twice a year, and if your children are due, there’s no better time than early in the school year. Caries, or cavities, are most common in children. If they are not treated, these little holes can become big problems.

The most recent information from the Centers for Disease Control says that as many as 20% of preteens and 13% of teenagers have untreated tooth decay.  This spells big trouble for kids’ academic performance and overall health. Tooth decay progresses, meaning that what’s just a small cavity today could become infected pulp or a cracked tooth months from now. Such a problem would necessitate a root canal. In the meantime, the child will be in pain, which will interrupt their sleep, diet, and concentration, and could cause them to be irritable. The National Institute of Dental and Craniofacial Research estimates that 42% of children have caries (including treated ones) in their baby teeth and 23% of children have caries in their permanent teeth, indicating that tooth decay is quite common. Given the likelihood of some kind of decay, it is better for children to get treated near the start of the year, so problems can be discovered before they’ve had a major impact and when they’re simple to treat.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.

 

Cleaning a Fixed Bridge

Bridges are one of the most reliable means of restoring teeth, but they require patients to learn a new way of caring for their oral health in order to get the maximal benefit. We highly value patient satisfaction and preventive care at Enid Dental Care, so we want to ensure our patients know all the tools that are available to them.

The gap in between the bridge and the gum line needs to be cleaned in a similar manner to the gaps between teeth. Some floss manufacturers make floss with stiffened tips so it can be pushed through the gap, but normal floss can be pulled through the gap with a tool called a threader. Similar in appearance to a soft sewing needle, threaders are used to pull floss over or under orthodontic wires and work the same way with bridges.

Some makers of electric toothbrushes and water picks also make tips for their devices which are designed for use on implants. Implant-supported bridges tend to have a larger gap, which allows larger food particles to get trapped but also allows for the use of larger brushes to dislodge them. A Christmas tree brush can be mounted on the end of a normal-sized toothbrush handle for this purpose.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.

 

Intrinsic Stains

At Enid Dental Care, Dr. Dennis Morehart gives high priority to patients’ cosmetic concerns. Most tooth stains are extrinsic, meaning that they only extend to the outermost layers of the teeth. But for intrinsic stains, a root canal may be necessary to restore the appearance of a patient’s smile.

Extrinsic stains are acquired from factors such as smoking and drinking dark liquids and can usually be reversed through bleaching. Intrinsic stains, though they can be masked with veneers and bonding, affect the teeth at a deeper level. Some common causes of intrinsic stains are the use of tetracycline antibiotics and overexposure to fluoride. However, they also can be caused by infection or trauma to the dental pulp, which puts patients at risk of developing an abscess.

Dr. Morehart and his staff will use advanced imaging technology to determine whether the patient has an infection. If so, they will use root canal therapy to remove the damaged pulp. Usually, root canals end with the tooth being filled and sealed, but for cosmetic reasons, it may be preferable to replace the entire crown.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.

 

Acid Reflux and Oral Health

What does heartburn have to do with teeth? In fact, quite a lot. At Enid Dental Care, Dr. Dennis Morehart observes many kinds of tooth erosion, and one of the most common is that caused by gastroesophageal reflux disease, also known as acid reflux or GERD.

Acid reflux happens when the sphincter between the esophagus and the stomach opens, allowing hydrochloric acid out of the stomach. GERD describes when this happens at least twice a week. Hydrochloric acid causes painful ulcers in the esophagus and when it gets as far as the mouth it can contribute to the erosion of the gums as well as the teeth and result in dry mouth.

As tooth enamel erodes, teeth become sensitive, discolored, and either pitted or flattened out. Remineralization therapies, such as fluoride treatment, can help protect enamel, but they cannot restore what has been lost. However, Dr. Morehart can reconstruct teeth through methods such as bonding and partial crowns. Patients can lower their risk of acid reflux by reducing their intake of fatty and acidic foods, such as citrus juice and onions, as well as chocolate and alcohol. They may also need to discuss with their general practitioner whether they need to switch out any medications that are harming their oral health.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.

 

 

How to Care for Dentures

When patients receive dentures, preventing dry sockets is the first order of business, but learning a new oral health regimen is the second. At Enid Dental Care, we understand that getting dentures can be frightening, which is why we want our patients to know that we are anticipating their needs by providing them with information about proper denture care.

There are many kinds of dentures, but what they have in common is that they need to be removed for cleaning every night. Doing this will also give the patient the chance to brush their mouth, including their tongue and any exposed metal, such as implants or a bar support. People should only brush their mouths with soft-bristled brushes, and the same is true while brushing their dentures. But patients should also take care to select a toothpaste which has been approved for use on dentures because toothpaste for normal teeth contains gritty minerals that scratch artificial teeth, which lack natural protective films.

Anytime they are not in the patient’s mouth, dentures should be left soaking in room-temperature liquid. The liquid may be water or a cleaning solution, but it must not be hot enough to warp the denture’s thin plastic. Although it is expected that dentures will need to be refitted on occasion, this should only be done in a dental laboratory by professionals.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.

 

Understanding Dry Sockets

While we work hard at Enid Dental Care to ensure our patients understand their post-operational instructions, complications are possible. One of the most common problems following a tooth extraction is a dry socket, so we want our patients to know how to prevent it and how to recognize if they develop one.

When a tooth is removed, it is very important that a blood clot be allowed to form over the extraction site. Without it, the socket will painfully dry out and be at risk of infection. Patients are advised to avoid sipping through straws immediately following surgery, so as not to knock the clot loose prematurely. It is also wise to forego the use of birth control, as it interferes with clot formation, and to avoid smoking or use of tobacco products (although dentists always recommend that).

When patients do suffer from dry sockets, they will usually feel severe pain about two days after the extraction. Difficulties are more likely to happen following complicated extractions which required the doctor to cut through bone or gum tissue. Patients should request an emergency appointment so they may be provided with painkillers, anti-bacterial pills, and medicated wound dressing to moisten the sockets. The dressings will need to be replaced every few days until the healing is complete, but patients usually make full recoveries.

Dr. Dennis Morehart, Master of the Academy of General Dentistry, operates Enid Dental Care at 2411 Heritage Trail, Ste #4, Enid, Oklahoma, 73703. To schedule an appointment, call 580-237-2213 or visit EnidDentalCare.com and fill out a contact sheet.