A lifetime of dental health


Dentistry today is characterized by “a complete commitmentto prevention,” says Dr. David Gundersen, a dentist at First Choice Dental’s Fitchburg location. Today’s dentists remind patients that their mouths are connected to the rest of their bodies, which means that a healthy mouth—including not only teeth but also gums—is inextricably linked to overall health.

“Our mouths are a pretty simple system,” says Dr. Gundersen. “It’s about the bacteria—the ‘beasties’—and not letting them take control.” A healthy diet, brushing, cleaning and regular dental exams all help to minimize the negative impacts of bacteria in the mouth, which produce acid that can lead to decay and periodontal disease. “If you have active periodontal disease, you have inflammation messengers that don’t just stay in your mouth; they travel through the rest of your body,” he says.

Prevention, Dr. Gundersen notes, is the foundation of good dentistry. And prevention ideally starts in childhood, with early visits to the dentist. Childhood dental visits focus on preventive measures and on establishing healthy habits. Preventive care includes fluoride varnishes and the application of sealants to fill grooves and pits where decay can start. With this type of help, kids learn that cavities are preventable and are thus encouraged to maintain their good habits.

In fact, Dr. Gundersen says he believes our society has the potential to create “a whole generation of kids who have access to preventive services…and we have the potential to eliminate all oral disease if we are committed to it.” No child, he says, should have their success in life derailed by troubles with their teeth.

That means, among other things, helping lower-income children get access to dental care and finding ways to make care more affordable for families without dental insurance. One solution for people without insurance is First Choice Dental’s Smart Choice Dental Plan, which offers an annual fee to help patients save on dental expenses.

“We as a society have access to the best dentistry in the world,” he says. “We have incredible technology, great dental schools, and great people coming into the profession. It’s wonderful that we have this quality of care; we just want to see as many kids get access to it as possible. We’re not there yet…but we’re getting there.”

While it’s ideal to establish a practice of twice-yearly dental visits in childhood and to maintain that throughout life, Dr. Aldrin Sangalang wants adults who have not seen a dentist recently to know that it’s never too late. “Even if it’s been a long time, we’re here to help and to get people on the right track again,” says Dr. Sangalang, a dentist at the University clinic of Dental Health Associates of Madison.

Dr. Sangalang notes that many people think they need insurance to see the dentist. But insurance is not required, he says, and even for those who don’t have it, an investment in regular checkups is the most important thing people can do to ensure what he describes as a “healthy dental baseline.” Furthermore, he says, dentists and hygienists are the first line of defense in identifying health issues related to the mouth, including oral cancers.

Even among people who do have dental insurance, a surprising number don’t use it for regular dental exams. Sometimes, Dr. Sangalang says, people postpone seeing the dentist because they expect to be chastised for having neglected their dental health. “My approach is to say, ‘Great! You took the first step by walking in here,’” he says. “Sometimes that can take courage.”

A first visit usually consists of an exam and full set of X-rays. But, says Dr. Sangalang, for new patients who are especially uneasy, he and his colleagues may start with just a mirror and “a quick, 30-second look,” without putting any instruments into the patient’s mouth. “We start by establishing trust,” he says, “and build upon that.”

Unfortunately, some patients are fearful because of unpleasant memories of dental work in their childhood. “Too often we’ve seen the 35-year-old who is in pain and will lose teeth because they had a bad experience at a young age,” says Dr. Sangalang. Therefore, he and his colleagues strive to ensure that children’s early encounters with the dentist are positive. Initial visits focus on establishing trust, along with a quick oral exam. “We want them to know we’re here to help them,” he says.

On average, Dr. Sangalang sees patients for the first time at age 3 or 4. “Even if we can’t do a full cleaning,” he says, “it’s an acclimation to the dental environment.”

Dr. Gene Sorensen and Dr. Joel Crane of Lodi Valley Dental in Lodi echo the sentiment that regularly scheduled dental exams are important for patients of all ages. “In addition to the early childhood visits that form the foundation of good dental habits, Dr. Crane says, “we’re also concerned about timing, when kids are about 12 years old and their permanent teeth are coming in.”

If crowding poses a potential problem, for example, the ability to address it at an early stage can help reduce the amount of orthodontia that’s needed. In both children and adults, regular checkups make it possible to catch an issue when it’s small and more easily treated, rather than allowing it to become more complicated. 

Dr. Sorensen notes that many people are anxious about possible pain associated with dental treatments. Methods of anesthesia and sedation have evolved and offer a variety of ways that patients can be treated in greater comfort. For patients who receive injected anesthetic, strong topical anesthetics are better than ever at numbing the gum before the shot is administered. Alternatively, for work on the front six teeth, Lodi Valley Dental offers Kovanaze, a nasal spray that numbs the front region of the mouth.

Sedation is another option, especially for patients who are leery of needles. For oral-conscious sedation, a patient simply takes two pills shortly before a procedure. Another type of sedation, nitrous oxide—or “laughing gas”—is administered by inhalation. In either case, says Dr. Sorensen, “patients are comfortable and practically sleepy throughout the appointment and may have little memory of the procedure.”

In addition to methods that improve patient comfort, other newer techniques make it possible to detect potential problems at an earlier stage. For example, a tool called a DIAGNOdent pen uses a laser to read tooth density, making it possible to detect early bone loss.

Both Dr. Crane and Dr. Sorensen want patients to know that once a problem is identified—even  something seemingly minor and painless—it’s best dealt with promptly. “If a physician said you had a small spot on your lung, you wouldn’t wait until it hurt,” says Dr. Sorensen. “The same principle applies to taking care of your dental health.”

Door Creek Dental’s Dr. Hien To-Schwalbach says that some people are unaware of the many ways their dentist can improve overall health and quality of life. Scanning technology and dental lasers are two developments that have significantly changed the way dental care is provided. 

Hand-held dental scanners make it possible, in most cases, to fabricate a crown without taking impressions, and to do so in a single visit. That eliminates the need for a patient to schedule additional visits and undergo anesthetic multiple times.

In addition, dental lasers have several applications. For example, a laser can be used instead of a drill to treat small cavities in children and adults, in most cases comfortably and without an anesthetic.

Dr. To-Schwalbach also uses the dental laser to perform a service that is not widely available: treatment of tongue-tie and lip-tie issues. Tongue-tie occurs when the frenum­—the membrane between the tongue’s underside and the floor of the mouth—is too short, thus restricting movement of the tongue. Lip-tie is a similar condition of the membrane between the upper lip and gum. In infants, both conditions can interfere with breastfeeding. Tongue-tie can cause speech problems in older children and can contribute to snoring and sleep apnea in adults, says Dr. To-Schwalbach. Dentists who have been trained can evaluate and treat babies, children and adults with tongue-tie and lip-tie restrictions and significantly improve their quality of life.

Dr. To-Schwalbach reminds patients that it’s important to visit the dentist twice a year, when they are not in pain. Most cavities and gum disease are painless at first, she says. “Both conditions take time to cause pain,” she notes, “and by the time they hurt, there has been irreversible damage to the teeth and gums.”

She says many people have the misconception that regular, good-quality dental care costs more than they can afford. But, she says, “the amount of money that you would invest in getting yearly X-rays plus two exams and two cleanings per year is equivalent to the cost of owning a cell phone.” And the benefits can last a lifetime.

While it’s difficult to overstate the value of regularly scheduled checkups, we also need to think about the nature and focus of our dental exams, says Dr. Jay Hazen at Dentistry for Madison. People often approach a dental exam with the expectation of getting either “good news” or “bad news,” perhaps about cavities or about a particular tooth or two. “If you didn’t get a cavity, that’s great when you’re 15 years old,” says Dr. Hazen. “But as we mature, the focus of exams should be directed toward the long-term needs of our teeth.”

Even as we are living longer, most people—and a growing percentage in our society—are keeping all or most of their teeth for their entire lives. In his work at retirement homes, Dr. Hazen observes that the healthier residents generally have most of their own teeth; the less healthy ones don’t. It would be hard to say which is the cause and which is the effect, but there’s no doubt that in older adults, healthy teeth and gums are key to good health and overall well-being. They make it possible for people to enjoy favorite foods, maintain good nutrition, and feel confident in their social lives. 

At earlier stages in life, says Dr. Hazen, “we need to think about preserving what we have now, instead of waiting until the wheels fall off.” That means addressing today the problems that are likely to cause trouble down the road, such as an imperfect bite or a missing tooth.

In addition to future well-being, care for the “doorway to our body” has more immediate effects. “More and more studies show the connection between dental and periodontal health and the rest of the body,” says Dr. Hazen.

People who have gum disease often don’t realize it, but whether we’re aware of the infection or not, the disease-causing bacteria from the mouth can enter the bloodstream and appear in seemingly distant infections—in the heart, for example, or around prosthetic joints.

A dental laser device called PerioLase makes it possible to clean gum tissue, which can promote healing and, if detection is early enough, even encourage bone re-growth. “Once you eliminate infection, your body wants to fix things,” Dr. Hazen says. “And after the infection is treated, “people tell me they feel healthier, and I believe it.”

Like most journeys, the path to achieving and maintaining good dental health can begin with a few deliberate steps. And following that path will promote the healthy teeth and gums that can contribute to our overall health now, and for as long as you live. •

Source : http://www.channel3000.com/madison-magazine/home-and-lifestyle/a-lifetime-of-dental-health/624992215


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