Dental Health FAQs
Washington DC & Bethesda – Chevy Chase

How does my dental health impact my medical health?

Recent studies have noted that periodontal disease may put people at increased risk for heart disease, diabetes, stroke, respiratory disease, and osteoporosis. The high cost of treating these ailments can have a huge financial impact on the American family.

How safe are dental X-rays?

Advances in X-ray equipment, especially digital imaging technology, allows us to get a good x-ray image using much less radiation than was previously required. A typical dental X-ray image exposes you to a low dosage of 2 or 3 mrem. If, in fact, an X-ray is taken such that the cone is not centered, a part of the film is not even exposed, which points out how a dose comes from an X-ray. Combine this with the fact that all patients wear a lead apron during X-ray exposure, and you have a low risk factor.

The National Council on Radiation Protection (NCRP) says that the average resident of the U.S. receives about 360 mrem every year from background sources. This comes from outer space, radioactive materials in the earth, and small amounts of radioactive material in most foods we consume.

As your dentist, we will gain valuable information from the x-rays to aid in keeping your teeth healthy. It is in your best interest to have dental x-rays considering the small amount of radiation you will receive from them.

How do you help patients who avoid going to the dentist due to fear or pain?

We recently completed a major reconstruction on one of our patients, who had not been to a dentist in twenty-five years because of her fears regarding dental treatment. How did we accomplish this? With compassion and understanding and talking her through the process. For long appointments, we offered her anti-anxiety medication. In addition, we applied gentle techniques from anesthesia to the actual work, along with our stereo head phones connected to our Sirius radio, which blocks out those noxious sounds.

In short, dental anxiety does not have to keep you from taking care of your dental needs. once you have met our caring, interactive staff, you feel more at ease. We will review your treatment options and answer your questions, knowing that stress and anxiety are often associated with the unknown. We want you to be comfortable with expressing your concerns, and, when you feel that it is necessary, we will premedicate you with an anti-anxiety medication. Communication is the key. Our compassionate dental team is committed to your good dental health and we will work along with you to achieve that success and take control of your fears.

How do you assist patients with dental anxiety?

On an as needed basis, we premedicate our patients with an anti-inflammatory and/or anti-anxiety drug. We offer one of our XM radios to provide the music or talk programs of your choice-to block out our noise. In the area to be anesthetized (numbed), we apply a topical numbing gel prior to giving a super preanesthetic with the same acid-base balance as your tissues, reduces any stinging sensations. The anesthetic is also warmed so that you are receiving it at body temperature. This, along with a relaxed body promotes a clear and relaxed mind. These comfort measures help invoke that relaxed state. We offer anti-anxiety medications for our patients are very anxious about dental procedures.

How does Acid Reflux affect my dental health?

Gastroesophageal acid reflex disease, or GERD, causes stomach acids to back up into the esophagus and sometimes into the mouth. It may often be confused with indigestion. Individuals may be at risk of serious damage to the esophagus, including developing esophageal cancer.

We often notice tooth erosion and periodontal problems. Acid reflux predisposes an individual to an increased decay rate. Other symptoms can include sinus infections, heartburn, difficulty swallowing, cough, hoarseness and bad breath.

Treatment strategies can include prescription medication, eating smaller meals, not eating a meal after 9:00 PM, avoiding foods like tomato, citrus foods, raw onions, spicy foods, chocolate, alcohol and coffee. If extensive damage has occurred to your teeth, crowns may be an option to repair the problem.

Why do I have bad breath?

Certain foods, health conditions and habits can cause bad breath. In many cases, proper dental hygiene can improve bad breath by preventing plaque from accumulating. Try following these steps: brush your teeth after you eat, floss at least once a day, brush your tongue, clean any removable appliance thoroughly once a day, drink plenty of water, and change your toothbrush every three to four months. If, despite practicing proper dental hygiene, your bad breath persists, schedule an appointment so that we can help determine the cause and whether a physician should be consulted. In some instances, a gastrointestinal evaluation is indicated.

What do I need to tell my dentist about my medications?

Prescriptions and over-the-counter medications, such as antihistamines, aspirin, and anticoagulants, can have an effect on your oral health. Being aware of the side effects can help you maintain your dentition. Whatever medications you are taking, be sure to keep us informed. That information can help us provide safe and effective dental care.

How do intravenous IV Bisphosphanates affect my dental health?

Bisphosphonates are drugs used for the clinical treatment of osteoporosis, multiple myeloma, Paget’s disease, and the treatment of metastatic breast, lung and others cancers. Bisphosphonates inhibit bone resorption by decreasing the activity of the cells that remove old, injured, and dying bone. Bisphosphonates are dispensed orally or intravenously.

Patients receiving IV bisphosphonate therapy are most at risk for BRONJ (bisphosphonate-related ostenonecrosis of the jaws). This condition can cause severe and often irreversible and debilitating damage to the jaw following periodontal surgery, implant placement, or tooth extraction.

Before starting oral or IV bisphosphonate therapy, all patients should get a comprehensive dental examination and have all treatment performed (restorative, periodontal and especially extractive).

I grind and clench my teeth. What should I do?

Many patients grind or clench their teeth, a condition known as bruxism. This grinding may also put unintended pressure on the muscles and tissues of your jaw resulting in tooth and other jaw disorders, headaches and ear pain. The symptoms of this disorder are often referred to as TMJ/TMD (Temporomandibular Joint Dysfunction), and can, sometimes, be confused with a migraine headache. In addition to headache symptoms, we have even seen patients who have double vision and other signs.

An incomplete bite is frequently a major cause of TMJ as the muscles of the jaw are continuously seeking a solid contact. This is corrected via a minor bite adjustment. In addition, we recommend a custom fit, durable acrylic night guard to protect your teeth and diminish other TMJ type symptoms. If you have any of the symptoms or are not sure of why you have nagging head and neck aches, we recommend that you schedule for a complete occlusal (bite) examination.

Are dental amalgams (silver fillings) safe?

Yes. For more than 100 years, dental amalgams have been used to restore teeth. Because silver dental filling contain mercury, there has been concern regarding its safety. The FDA has posted a precaution on its website but only for two groups, pregnant women and young children. Both are already urged to limit mercury from another source seafood because too much can harm a developing brain.

What are the advantages of Tooth-Colored Restorations over Amalgams?

Amalgam restorations, which over time, corrode, leak, and cause stains on your teeth and gums, can now be replaced with today’s tooth-colored fillings. These restorations (porcelain inlays, onlays, and composites) are more esthetic, add strength to weakened teeth, provide a superior fit, and are very strong thanks to new bonding technologies.