What is a "Premed" and How Does it Apply to my Dental Care?

The term premed is short for "premedication" and applies to a small fraction of dental patients who experience very specific health complications. These complications can include people who have had artificial joints placed, artificial heart valves placed, organ transplants, history of heart infection, or congenital heart defects. In these specific health conditions, your dentist may prescribe a antibiotic to be taken approximately 1 hour prior to dental treatment (this includes hygiene therapy!). 

During a typical dental visit, bacteria can be released into the bloodstream. When certain medical conditions exist, the bacteria within the bloodstream are given the opportunity to attach themselves to the artificial valves, the prosthetic joints, or the malfunctioning heart. If this occurs around a prosthetic joint, it can lead to severe infection and joint failure. If this occurs around the heart or the heart's lining, it can create a condition known as "infective endocarditis", or heart infection.

Artificial joint infections and heart infections are extremely dangerous conditions, and can result in joint failure or heart failure. If there is a medical condition present that warrants a premedication, the dentist or dental hygienist may even refuse to administer treatment until the premedication has been taken.

The purpose of a premedication is the prevention of very dangerous complications. A premed is taken very seriously by dental and health professionals, and prescriptions can be quite easily obtained. The "usual" prescription is derived from the penicillin family of antibiotics, so be sure to let your dentist know if you have any medication, food, or material allergies. 

For more information, please visit the website for the American Heart Association.
http://www.americanheart.org/presenter.jhtml?identifier=3047051

Why is the dentist asking me all of these health questions?

I hear this question once in a while at the dental office.  Why in the world do I have to fill out this huge list of questions about my health, my medications, my surgeries, etc?  I'm just getting my teeth filled, or cleaned...

Frequently people forget the simple truth: The mouth is connected to the body.  Just because it's "just your teeth", it doesn't mean it's not connected.  We as a society have, at some point in history, stopped considering the health of the mouth as part of the overall health of the body.

The simple and obvious reason for the dentist to need health information is that at nearly every visit, we adminster drugs.  The anesthetics used to numb teeth for fillings, crowns, and other procedures are medications, and it's important for us, as healthcare providers, to know exactly what drugs may already be in the body prior to administering more.  Secondarily, there are other health conditions, such as heart, joint, and blood issues that may affect whether or not we can treat a patient without consulting with that person's physician.

On top of all this is the growing medical knowledge that oral health is linked to the health of the entire body.  We know that diabetes is connected to oral health problems, and we know that oral health problems contribute to systemic problems like cardiovascular disease, high blood pressure, and even alzheimer's.

So, next time you visit the dentist's office and the receptionist gives you a health history to update or fill out, please remember that your dentist needs all the information he can get in order to give you the treatment you deserve.  Questions about this?  Feel free to ask.  Email our office at info@benchmark-dental.com.  You can also visit our website for some educational videos, which can be found at http:www.http://benchmark-dental.com/patientEducation.html

First Snow

Today was our first official "snowy day" here in Riverton Wyoming, which means winter is officially here, and allergy season is finally over (thank goodness!). Winters in Wyoming are notoriously intense, with temperatures reaching into the -40*F for short periods during the deep winter months. Right now is a good time to make an appointment for an exam, have a cleaning with our hygienists, or to finish up some existing work before winter really hits! The only thing worse than a toothache... is a toothache during a Wyoming blizzard!

Why do people get cavities?

I see people on a regular basis who have a large handful of small, superficial cavities that will require fillings.  These are new cavities that haven't been there long enough to cause major damage, cavities in patients who had their last checkup 1-2 years ago.  In these patients, my concern is not how big these cavities are, or where they are, or how to take care of them.  Rather, it is what? and why?  What is causing them?  Why is there a relatively recent occurrence of simultaneous decay?  

When I start questioning them I learn universally that they have a relatively new habit.  These include cough drops, sweet tea, coffee, and other sugared items.  They sip, snack, and suck on these little things throughout their day, giving themselves repeated small amounts of sugar a few times per hour.  Why does this cause decay?  

Decay is caused by bacteria, and bacteria are, as we all know, very small.  They don't require much food to replicate rapidly.  What they thrive on is frequency.  They need repeated feedings, irrespective of how large.  In fact, it would be better to quickly eat a 5 pound bag of sugar (at least for your teeth) than it would be to eat a teaspoon every half hour.  

Here's how this works: When you take something into your mouth that has nutritional value, it has nutritional value to the bacteria in your mouth as well.  Each time you eat or sip something, the bacteria of the mouth are fed.  These bacteria then do like every other living thing on this planet: they eat and then they release by-products.  In short, they eat and poop.  Those by-products are acidic.  This acid that is dumped onto the tooth causes surface damage in the form of demineralization, or breakdown of the mineral content of the tooth.  If the feeding frenzy ends and no more food is brought into the mouth, the saliva can repair and remineralize the tooth surface.

However, in the scenario we discussed earlier,  the patient is engaging in repeated small snacks and sips, the cycle of eating leading to acid by-product release occurs at each snack and/or sip and lasts 20-30 minutes each.  I think you might be seeing where this is going now.  These repeated acidity spikes in the mouth cause repeated damage to the teeth that can't be repaired by the saliva.  The tooth then begins to break down over time due to this acid bombardment.  

So, why do people get cavities?  It's due to concentration, not quantity.  It's the small snacks, that mug of coffee that sits on the desk all morning, and the gatorade bottle that starts the day full and ends empty that cause the decay.  We should all examine our diets and make sure that we aren't engaging in this behavior.  

Obviously, just eliminating one bad habit from your life may not be the cure-all.  You still need to brush and floss daily, use fluoride toothpaste, and visit your dentist regularly for cleanings and checkups.  Give that a try and let me know how it works for you! 

Allow me to introduce us!

Hello blogging world!  Please allow me to introduce myself.  My name is Dr. Joshua  Fowler, and I’m a general dentist.  I graduated from the University of Louisville School of Dentistry in 2007, and I have been in private practice continually since then.  I’m passionate about creating and maintaining beautiful smiles.  I hate to see people in pain.  I hate to see people dislike their smile.  These facts being as they are, I am here to try to send some knowledge out into the universe regarding oral health, smile cosmetics, and overall dental knowledge.  If I can help someone out there have a healthier mouth, a brighter smile, or less discomfort, I will have reached my goal.  I’m privileged to work with a sharp business partner named Dr. Spencer Smith.  He is a graduate of the University of Iowa College of Dentistry.   We have learned over the last few years working together that we have very similar philosophies and goals for our patients’ oral health and wellbeing. 

For now, I’d like to start by saying a few things about cosmetics.  One of my big problems with the world right now is the disdain for the word “cosmetic”.  I hate it when I hear someone say, “It’s just cosmetic.”  Let’s face it, cosmetics matter.  Studies show that the smile is one of the first things people notice when we meet them.  It’s just a simple fact that our smile is a multifunction organ.  It doesn’t just serve for eating.  Our smiles are important in social acceptance, achieving an education, having solid self-esteem, finding a mate, obtaining gainful employment, and others I could name.  If we are constantly self-conscious about the cosmetics of our smile, life can become difficult.  Here’s the good news: It doesn’t have to be!  There is a solution for every frustration that anyone has about their teeth.   Whether it’s straightening, whitening, repairing, etc., we can help.  If I’m not close enough to be your dentist, feel free to email me and I’ll do my best to advise (let’s face it, I can’t diagnose via email!) you, help find a dentist that will make you comfortable, or whatever I can.  I love seeing my patients smile.  I love it when I got to help them get the smile they wanted!  So, the next time you start to say, “It’s just cosmetic,” stop and remember the importance of the cosmetics!