My Blog
By Dr. Sanford M. Cates
November 28, 2021
Category: Oral Health
Tags: oral health   gum disease  
KickingtheSmokingHabitBoostsYourHealthIncludingTeethandGums

Quitting smoking is hard. The love affair between your brain and nicotine chains the habit to your daily life. But it's still worth the effort to quit to save your health from disease—including those that impact your teeth and gums. And, there's no time better to launch your "kick the habit" project than the American Cancer Society's Great American Smokeout day this November 18.

As to smoking's impact on your teeth and gums: Two-thirds of America's 32 million smokers contend with gum disease. A smoker's risk for tooth decay is also higher, as well as their prospects for implant failure.

So, why is smoking hazardous to your oral health?

Primarily, nicotine constricts oral blood vessels, which in turn reduces the nutrients and antibodies reaching the teeth and gums. Your mouth thus struggles to fight bacteria that cause tooth decay or gum disease.

Inadequate blood circulation can also hide signs of gum disease like swollen, reddened or bleeding gums. Instead, a smoker's gums may look deceivingly healthy, although you may have a gum infection that could be well advanced when it's finally diagnosed.

Gum or bone grafting also depends on good blood flow, or the grafts may not fully regenerate new tissue. The situation's similar for an implant: Its titanium post needs bone to grow and adhere to its surface to acquire sufficient strength and stability. But slow wound healing due to poor circulation can interfere with this process and cause an implant to fail.

For your mouth's sake, as well as the rest of your body, quitting smoking could help you avoid these problems. But as an ingrained, addictive habit, your body needs to "unlearn" it to stop it. Here are some ideas to help make that process easier.

Nicotine Replacement Therapy. Under your doctor's guidance, you can take medications that deliver nicotine to the body without smoking, and gradually reduce its concentration. This approach can be costly, however, and cause unpleasant side effects.

Brand fading. With this technique, you continuously switch to cigarette brands with less nicotine. This gradually acclimates your body to lower concentrations of the chemical, and eventually wean off it entirely. Here's an online site listing nicotine strength by brand.

Don't do it alone. Quitting smoking doesn't need to be a solo act. Developing relationships with those who don't smoke or who are also quitting can make it easier. One way is to attend a smoking cessation group for support and encouragement from others who're also trying to quit.

Above all, speak with your doctor or dentist to learn more about what you can do to stop smoking. It can be difficult, but the rewards—especially for your oral health—are well worth it.

If you would like more information about smoking and oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Strategies to Stop Smoking.”

By Dr. Sanford M. Cates
November 18, 2021
Category: Oral Health
Tags: oral hygiene  
DentalHygieneandCareCriticalDuringCancerTreatment

After months or even years of radiation or chemotherapy, the words "cancer-free" is music to your ears. Your joy and relief, though, may be tempered by the toll these treatments can take on the rest of your body—including your mouth.

Both of these treatments can destroy healthy tissue along with targeted cancer cells. If the focus has been on the head and neck regions, they could damage the salivary glands to the point that they won't produce adequate saliva flow.

A lack of saliva can have a detrimental effect on your oral health. Saliva buffers and helps lower oral acid levels that soften and erode enamel and increase the likelihood of tooth decay. Saliva also supplies antibodies that fight disease-causing bacteria. Otherwise, bacteria—and the risk for disease—can rapidly grow.

If these or other scenarios occur, you may experience dental damage, even tooth loss. Fortunately, we can restore an injured smile in various ways, including dentures, bridges or dental implants. But we should also attempt to limit the potential damage by taking steps to prevent dental disease during cancer treatment.

The most important of these is to brush and floss daily. Everyone should practice these hygiene tasks to remove disease-causing dental plaque, regardless of their health status. But because some natural disease-fighting mechanisms in the mouth may be disrupted during either radiation or chemotherapy, it's even more important if you're a cancer patient.

It's equally important to maintain as much as possible regular dental visits during cancer treatment. Dental cleanings provided during these visits remove any residual plaque and tartar (hardened plaque), which further lowers your disease risk.

Your dentist can better monitor your overall dental condition during frequent visits and provide as much treatment as you can tolerate. They can also enhance your protection against disease by prescribing antibacterial mouthrinses, fluoride applications or products to boost saliva production.

Some teeth and gum problems may be unavoidable; in that case, you may need post-treatment dental care to restore your oral health as needed. But caring as much for your dental health as you're able during cancer treatment could help you realize a better outcome.

If you would like more information on dental care during cancer treatment, please contact us or schedule an appointment for a consultation.

EmmaRobertsConfessestoHavingaMajorSweetToothWhileExpecting

Emma Roberts, star of American Horror Story (and niece of actress Julia Roberts), welcomed her first child at the end of 2020. She confessed that her love of sweets made pregnancy challenging. She couldn't get enough of cupcakes with sprinkles and a Salt & Straw ice cream flavor called The Great Candycopia. But Roberts isn't unique. Hormonal changes in pregnancy often bring heightened cravings for certain foods. Unfortunately, this can increase an expectant mother's risk for dental disease, especially if they're consuming more sugary foods.

In fact, around four in ten expectant women will develop a form of periodontal disease called pregnancy gingivitis. It begins with dental plaque, a thin film that forms on tooth surfaces filled with oral bacteria that can infect the gums. And what do these bacteria love to eat? Yep—sugar, the same thing many women crave during pregnancy.

So, if you're expecting a baby, what can you do to minimize your risk for dental disease?

Practice oral hygiene. Removing dental plaque by brushing and flossing daily is the most important thing you can do personally to prevent both tooth decay and gum disease. It's even more important given the physical and hormonal changes that occur when you're pregnant. Be sure, then, that you're diligent about brushing and flossing every day without fail.

Control your sugar intake. If you have strong cravings for sweets, cutting back may be about as easy as stopping an elephant on a rampage through the jungle. But do give your best effort to eating more dairy- and protein-rich foods rather than refined carbohydrates like pastries or candies. Not only will reducing sugar help you avoid dental disease, these other foods will help strengthen your teeth.

Maintain regular dental visits. Seeing us for regular cleanings further reduces your disease risk. We can clean your teeth of any plaque deposits you might have missed, especially hardened plaque called tartar that's nearly impossible to remove with brushing and flossing. We'll also monitor your teeth and gums for any developing disease that requires further treatment.

Undergo needed treatments. Concerned for their baby's safety, many expectant mothers are hesitant about undergoing dental procedures. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association endorse necessary dental treatments during pregnancy, even if they include local anesthesia. We will make you have only a safe type of anesthesia, and we can advise you when it is prudent to postpone certain treatments, such as some elective procedures, until after the baby is born.

Emma Roberts got through a healthy pregnancy—cravings and all—and is now enjoying her new baby boy. Whether you're a celebrity like Emma Roberts or not, expecting a baby is an exciting life moment. Follow these tips to keep your teeth and gums healthy throughout your pregnancy, and be sure to let the dental team know of your pregnancy before any treatment.

If you would like more information about dental care during pregnancy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Pregnancy and Oral Health.”

By Dr. Sanford M. Cates
October 29, 2021
Category: Dental Procedures
Tags: oral hygiene   dentures  
DoThese2ThingsForYourHealthsSakeIfYouWearDentures

Today's dentures are more comfortable, more functional and more life-like than ever before—so much so that you might forget you have them in. Even so, dentures do have some downsides, and constant wear only amplifies those.

Our biggest concern is the effect dentures can have on bone health. Older bone is constantly replaced by newer bone, and the forces generated while chewing help stimulate this new growth. When a tooth is lost, however, this growth stimulus vanishes with it for that area of the bone. This may result in a slower growth rate, which can eventually lead to lost bone volume and density.

Dentures can't restore this lost stimulus, and may even make the situation worse. That's because traditional dentures rest on the bony ridges of the gums where the teeth once were. This can put pressure on the underlying bone, which can accelerate bone loss—and even more so when wearers leave their dentures in continuously.

Dentures can also contribute to disease if they're not regularly removed and cleaned. Besides oral yeast infections, bacteria-laden dentures can contribute to the production of a protein called interleukin-6 produced by the white blood cells. If a significant amount of this protein passes into the blood stream, it can increase body-wide inflammation and foster a systemic environment conducive to serious diseases like pneumonia.

If you wear dentures, then, it's good for your health (oral and otherwise) to incorporate two practices into your daily life. The first is to remove your dentures at night while you sleep. Not only will this help slow the progression of bone loss, it will also give your gums a chance to rest and recover from denture wear.

It's also important to regularly clean your dentures, either with an antibacterial soap or a special denture cleanser. During storage, keep your dentures in clean water or a peroxide-based solution designed for dentures. This will reduce the accumulation of bacteria on your dentures that can cause disease.

Dentures restore the dental function and smile appearance that a person loses with their teeth. Taking care of your dentures (and giving your mouth a daily rest from them) will help promote good oral and general health for you and a longer life for your dentures.

If you would like more information on denture care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleeping in Dentures.”

By Dr. Sanford M. Cates
October 19, 2021
Category: Oral Health
Tags: osteoporosis  
OsteoporosisCanCauseComplicationsForSomeTypesofDentalWork

October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.

This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.

In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.

In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.

The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.

It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.

Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.

You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.

Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.

If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.





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