Karen P. Meyers, DDS

Birmingham, MI

1875 Southfield Rd, Birmingham, MI  48009
Phone: 248-646-2450
Experience Excellence in Dental care

Heart Disease and Dental Care

Meyers_Blog_6_REDO_No 28627237There are various heart conditions that require special precautions when it comes to caring for teeth and the mouth. Chronic and acute conditions, including a cardiac event (heart attack), high blood pressure, angina, stroke or congestive heart failure, should be discussed with the dentist or your physician prior to any dental procedures.

The notion of a healthy smile is more than (pun alert) lip service: healthy teeth and gums keep the rest of you healthy, including those with heart disease. Someone with heart disease needs to be extra vigilant in maintaining a healthy mouth by practicing good oral hygiene and regularly visiting the dentist. It is also important to follow your physician’s or the dentist’s instructions when they prescribe particular medications, namely antibiotics, prior to dental procedures.

Infective Endocarditis

Infective Endocarditis is a relatively uncommon infection of the heart valves, but can be life threatening. The infection occurs when bacteria or other microorganisms enter the body and reach the heart; a common way this happens is through the mouth. To prevent infective endocarditis in patients with a weakened heart, antibiotics are usually prescribed and should be taken before doing certain dental treatments.

The American Heart Association recommends taking antibiotics before dental treatments for patients with:

  • Previous history of infective endocarditis;
  • Prosthetic (artificial) heart valves;
  • Recipients of heart transplant who have cardiac valvular disease;
  • Some congenital heart defects.

The American Heart Association also advises taking antibiotics before the following dental treatments:

  • Tooth extraction;
  • Endodontic procedures (root canals);
  • Placement of implants;
  • Tooth or implant cleaning, if bleeding is anticipated;
  • Intraligamentary local anesthetic injections;
  • Re-implantation of natural teeth after dental avulsion (a tooth that falls out completely after an accident);
  • Periodontal procedures (gum exams, cleanings, and surgeries);
  • Placement of orthodontic bands, but not brackets;
  • Placement of antibiotic fibres or strips below the gum line.

Heart Attack

Someone who’s had a heart attack should wait at least six months before having dental treatments. It’s important to give your dentist a detailed list of the drugs taken to prevent complications. For example, if a heart attack patient takes anticoagulants, the blood is less likely to clot and treatments like tooth extraction may need a temporary modification of the drug intake.

Angina

Like a heart attack, an angina attack can be felt like pain that starts in the chest and radiates to the lower jaw.

Some drugs such as calcium channel blockers might cause gingival hyperplasia (overgrowth of the gums), which can start as soon as one month after someone starts taking the drug. Some people’s gums become so large they have difficulty eating and surgery is necessary to make the correction. If the dentist diagnoses that problem, the patient must follow detailed hygiene instructions and have more frequent cleanings.

Patients with stable angina can be treated like any other patients and proceed with any dental treatment. But people who suffer from unstable angina should not receive elective dental procedures and concentrate only on emergency treatments.

Congestive Heart Failure

Many medications prescribed to treat congestive heart failure may cause dry mouth (xerostomia) or an altered sense of taste (dysgeusia).

There are usually no special concerns in undergoing dental treatment for someone being treated for mild-to-moderate congestive heart failure if they have no complications or side effects.

Pacemaker

A pacemaker is a medical device that uses electrical impulses to regulate the beating of the heart. It’s important to inform your dentist if you have a pacemaker because all dental electromagnetic devices should be avoided.

More thorough dental treatments should be postponed several weeks after surgery. If an emergency dental procedure must be conducted, the dentist or the physician may prescribe pre-treatment antibiotics.

For more information, ask Dr. Meyers about your heart health and any upcoming dental procedures.

9 Surprising Habits Killing Your Teeth

Are you destroying your pearly whites without realizing it? You might be doing permanent damage if you’re a nail biter or using your teeth to rip off the price tag from that new dress.

Stop and heed this advice: Brush your teeth twice daily, floss daily, regularly visit your dentist and have a good, balanced diet. All of those things are going to protect you from damaging your teeth and enamel.

The American Dental Association has developed a list of surprising ways you’re damaging your teeth and Dr. Meyers has culled the top 5:

     1. Overdoing sugary food and drinks – even cough drops

Forget cookies, cupcakes and candy. Those are obvious cavity-promoting foods. Astonishingly enough, even things like throat lozenges can be bad. But we also want to think about where we might be getting other sources of sugar, like sports drinks and not enough water.

The good news is you can help stave off cavities by using toothpaste recommended by your dentist and keeping the sugary snacks to a minimum.

     2. Lack of water

Skip the energy drinks, flavored sports waters and ice teas if you want to dodge cavities. Instead, drink H2O. Not only is it good to hydrate your body, but it’s good to hydrate your mouth.

A dry mouth can be an environment where it’s easier for bacteria to cause cavities. Fluoride is found in tap water and some bottled water, and can ward off tooth decay. That’s why it’s important to drink as much as possible.

     3. Nail biting

Get those fingers out of your mouth! When we bite our nails, we put our jaws in a protrusive position, meaning the lower jaw projects out and moves in a repetitive, unnatural way. It can cause pain and discomfort in the jaw, plus wear down the enamel on your pearly whites.

     4. Heavy brushing

Go easy on your chompers, because brushing aggressively can abrade your teeth. Not only can it strip the teeth of their enamel, promoting cavities and decay, but it can also cause the gums to recede.

     5. Consuming acidic food or drinks

People who have acid reflux or drink lemon water can expect to see damage to their teeth, says the ADA. Acidic foods can strip the teeth of their natural enamel. Citric fruits and fruit juices, sparkling water with lemon and even certain salad dressings are so acidic that they can cause the tooth’s enamel to erode.

     6. Using your teeth as tools

You had that one friend in college who could pop open a beer with his mouth. Have you seen him since? Using your teeth as tools to open bottles, rip off tags or for any purpose besides chewing food can cause serious fractures. These can worsen over time and become infected.

     7. Thumb sucking

It sounds innocent, but thumb sucking is considered a trauma, dentists say. The habit pushes on the upper palate, forcing permanent teeth to move or spread apart. And it’s a hard one to break.

Dentists can talk to parents about proper dental care and ways to break the habit, such as using praise when a child doesn’t suck his or her thumb rather than criticism when they do, or encouraging the child to limit their thumb sucking to bedtime rather than all day.

     8.  Smoking

This is a given. Smoking has proven health consequences – like increasing the risk for oral cancer and respiratory conditions – and that extends to teeth. Huffing on cigarettes also increases plaque and bacteria, which can lead to gum disease.

     9.  Chewing ice

You take a sip of your soda, catch a couple ice cubes in your mouth and what do you do? Chew them, right? Bad move. Don’t do this often – or ever – if you want to prevent a painful injury. Ice is very hard and can cause breakage of teeth and fillings.

8 Tips for Near-Instant Fresh Breath

bad breathIt’s no secret that certain foods don’t do your breath any favors. Dr. Meyers has several suggestions for how to reduce stinky oral-related dilemmas, starting with limiting foods that are associated with less than pleasant scents.

“Garlic, onions, coffee, alcohol, meats, juices and carbonated beverages are just a few of the foods and drinks linked to bad breath,” she says. “Breath odor is most commonly created by volatile sulfur compounds that can be found in many of these items or that can be created when they are ingested.”

Not following a proper oral hygiene routine, which includes regular dental visits, can also contribute to the problem. “Fresh breath starts with a healthy and clean mouth,” Dr. Meyers says. Below are several items you can ingest or things you can do in an effort to make sure your breath is always pleasantly fresh ¾ and keep your mouth healthy, too.

Drink (More) Water

You already know that drinking water is beneficial. Water keeps you hydrated, which helps with a number of physiological aspects like boosting brain health and improving skin’s elasticity; it also acts as a great natural breath freshener.

Drinking water helps flush away odor-causing bacteria that thrive in a dry mouth. Consuming enough water daily also helps to free up food items on the tongue. This, in conjunction with proper oral hygiene, reduces the accumulation of bad breath-causing particles that can become trapped in your mouth.

Probiotic Yogurt

Most yogurts contain some probiotics, but look for labels that specify “fortified with vitamin D” and “contains probiotic bacteria.” Probiotics are the good bacteria that can help change the “balance of power” in your mouth from a bad bacteria population to a good one. Healthy populations of good bacteria will naturally freshen your breath.

Got Milk?

In addition to fortified yogurt, milk — from fat-free to whole — has been found to fight bad breath. We can thank milk’s fat and water content for breath-freshening ability, particularly when garlic is the culprit, according to eatthis.com.

Guzzle Green Tea

Green tea contains polyphenols, which naturally help freshen breath. Added value benefits include that green tea may play a role in preventing tooth decay, fight certain kinds of mouth cancers and boost your weight-loss efforts.

Chomp on Xylitol vs. Sugar

Reach for gum and mints that contains xylitol, a sugar alcohol that doesn’t feed bacteria, instead of sugared chewing gum. Chewing gum will promote saliva production, which will then create a slippery coating on teeth and gums that keeps bacteria from sticking. Wash down each meal with a mint or gum with xylitol for about five minutes.

Xylitol is a low-glycemic food that doesn’t promote dental cavities. Just watch that your furry friends don’t get into the xylitol. While it’s safe for humans, it can be harmful or even deadly when ingested by animals.

Crunch on Raw Red Bell Peppers

Vitamin C-rich foods, like red bell peppers, are great when it comes to keeping bad breath at bay (broccoli’s another good choice). Foods rich in vitamin C reduce the bacteria populations associated with mouth odor.

An Apple a Day…

If you love garlic, turn to a raw apple to keep your breath pleasant. A raw apple neutralizes the mouth odors that arise when you eat raw garlic. In fact, a study published in the Journal of Food Science confirms the power of a raw apple to combat offensive breath caused by garlic. When participants consumed garlic and were given raw, heated or juiced apple (one of the many foods tested in the study), those who ate raw apple had significantly reduced bad breath within 30 minutes. Raw lettuce also did the trick, according to the study.

Go Herbal

Try turning to tea tree, thyme, oregano, clove, cinnamon and cardamom to tame toxic breath. Chewing leaves or a pod of these herbs will help freshen breath. Green herbs should be fresh since some of the herbs’ volatile oils are lost when dried. Parsley, basil, and mint are also beneficial herbs in beating foul mouth odors into submission.

 

Importance of Dental Health for Diabetes Patients

Meyers_Blog_12_157941644Some people may not associate their smile with a healthy life, but the mouth is the gateway to the body and having a healthy mouth is the start to having a healthy body.

While diabetes can have serious effects on your body, it may also take its toll on your teeth. It’s practically common knowledge now that diabetes affects your body’s ability to process the sugars in foods we eat. But what does that have to do with your teeth?

For starters, even mild diabetic individuals produce far less saliva than non-diabetics, due to medications taken to manage diabetes. But why does that matter? To begin, not only does less saliva affect how food tastes, but it is also a critical component in protecting your teeth from cavities and forming plaque. In short, as a diabetic, you are more likely to get cavities, experience plaque buildup, and have an increased risk of dental infection.

This means that diabetics should brush their teeth at least twice a day (electric toothbrushes are the best at removing plaque) for two minutes with fluoride toothpaste, and floss at least once a day. These steps, along with regular cleanings with your hygienist or dentist, are essential to removing plaque.

If plaque and bacteria aren’t completely removed from your teeth daily, you’ll produce calculus (and not the hard math class, but much worse). Calculus is hardened plaque that cannot be removed by flossing and brushing, but requires your dentist or hygienist to remove it.  If the calculus is not removed, gums will swell and more easily bleed. The consequences of swollen gums that bleed more easily is the development of the mouth disease periodontitis.

Periodontitis destroys the bone that supports your teeth. In time, the bones that keep teeth in place will recede around your teeth and, left untreated, will result in teeth that loosen and ultimately fall out. The most nefarious part of gum disease is that, because it’s not painful, it can go unnoticed without regular checkups and it only presents with pain once it’s too late and your teeth are too loose to be salvaged, which results in them having to be and removed.

The best way to know if you are developing or already have periodontitis is to visit your dentist at least twice a year. There are additional things that diabetics can do to prevent tooth loss: monitor and managing your blood sugar, maintain a healthy diet, limit alcohol consumption and stop smoking. For good dental — and overall — health, keep healthy food chooses in mind; drink plenty of water; eat whole, grains, fruits, vegetables, lean proteins, low fat and fat free dairy foods.

And brush, floss and use a rinsing agent!  These steps, combined with proper diabetes management and regular dental visits, will go a long way in maintaining a healthy and beautiful smile.

My Crown Fell Out – What Should I Do?

crown-art-gold-and-black-shutterstock_519659668While unlikely, it is possible for a crown to come unstuck (“debond”), especially if it’s knocked or if you happen to bite into something hard or very sticky. Not surprisingly, it can be both unsettling and worrisome. Worse yet, what do you do if you’re unable to see your dentist for a day or two, or possibly longer, depending on the circumstance?

First Rule of Thumb: Don’t panic. If it’s not lost or swallowed, carefully take the crown out of your mouth to avoid the risk of swallowing it or, much graver, breathing it into the windpipe.

On the off chance a cap is swallowed, it will eventually work its way through the digestive system without causing harm, but… it’s a gonner. Don’t think about retrieving it.

Ideally, you’d make an appointment with your dentist as soon as possible to get the crown properly fixed back into place. Of course, that’s in a perfect world. If you still have the crown, but aren’t able to get to the dentist, clean and sterilize the cap with some Milton sterilizing fluid (sold in most drug stores), dry it and put it safely into a small container.

It’s important to keep the underlying tooth from which the crown came clean by carefully brushing with a soft toothbrush. Note: the tooth may still be alive (vital) and will likely be sensitive to hot or cold drinks and food — best to avoid them.

If the underlying tooth is non-vital it won’t hurt, but it’s important to try and prevent any food debris from lodging into any gaps that may be present if it’s a crown with a post attached.

If the tooth is right at the front of your mouth, you’ll understandably be anxious to temporarily fix it until you can see the dentist. There are temporary cements you can buy at the drugstore, but these materials aren’t strong bonding agents and may not hold the crown securely.

There could be a risk of it coming loose while you sleep and it being swallowed or inhaled, so it’s best to manage without it if you possibly can. You can always try chewing gum … people have been known to use it in a pinch.

If you decide to re-fix a crown with temporary cement, take care not to put pressure on it while eating or brushing your teeth since it is easily dislodged. However, whatever you do to temporarily fix the problem, don’t EVER use something like “SUPER-GLUE,” it’s not only dangerous, it will likely ruin the crown and tooth.

Your best bet is to get to the dentist as soon as you can; in the interim keep the area clean and be mindful of what you eat.

Your Dentist: The First Line of Defense Against Oral Cancer

Team Rehab, Dr. MeyersOne of the significant reasons to have regular visits to the dentist is for the oral cancer screening that occurs during your visit. Oral cancer is a cancer of the mouth that affects either the lining of the mouth or corrodes the deeper tissues like bones, muscles and nerves in the mouth. It can affect the tongue, mouth, jaw and salivary glands.

Your dentist is looking for these symptoms of oral cancer:

  • Small growths or sores around the lining of the mouth of lips.
  • White or red patches on the mouth, tongue or tonsils
  • Loose teeth or dental appliances
  • Gum disease, including swollen and bleeding gums.
  • Any changes in the tongue
  • Any changes in the movement of the jaw

Your dentist will visually examine the entire oral cavity. She may touch various parts of your mouth in her search for abnormalities. In addition, she will review your dental x-rays, paying particular attention to any changes in the images of your teeth and jaws

In addition, you might be aware of other conditions that you need to share with your dentist, like:

  • Changes in your throat or hoarseness
  • Mouth sores that don’t heal after two weeks
  • Difficulties chewing or swallowing
  • Speech impairments
  • Mouth issues that are interfering with sleep.
  • Persistent dry mouth.

If your dentist finds abnormalities, she may recommend a biopsy, CT scan, MRI or PET scan.

Oral cancer can be treated effectively, but treatment is much more successful when the cancer is diagnosed as early as possible.

Oral cancer cannot be completely prevented, but there is a high correlation between oral cancer and use of tobacco products and heavy use of alcohol. Cigarettes, pipes and cigars all carry a risk of oral cancer, as does snuff (chewing smokeless tobacco). The highest oral cancer rates involve a combination of both tobacco use and heavy drinking. If you consume tobacco and/or alcohol, you need to be screened regularly for oral cancer.

The good news if  you  are thinking of quitting smoking is that research has shown that after 3 to 5 years of smoking abstinence, oral cancer risk declines by 50%.

It also appears that smoking electronic cigarettes (“vaping”) may also pose a risk. More research is needed in this area.

Finally, HPV (human papilloma virus) also contributes to mouth cancers.

Oral cancer is a serious disease, often preventable, whose early diagnosis could be life-saving and improve the quality of your treatment and the quality of your life.

Now That Your College Student is Back Home

studying-703002_640 (2)When college kids come back from spring semester, they have a few things on their mind: eating their favorite meals, connecting with home town friends and catching up on their sleep.

As parents, we notice the changes that a year of school has brought to our kids. They seem older, but still child-like. They keep strange hours, sleep on every horizontal surface and at any time of day and night, need their car again, bring some activity and excitement and drama back into the house, and behave in many ways more like peers and less like kids.

What is less noticeable is what is going on in their mouths. Typically, college students are somewhat less compliant in terms of regular oral health care during their year away, especially that freshman year. So, it’s very important as part of the summer to do list (along with securing that summer job or internship) to schedule a dental exam.

The post college summer oral health exam should include:

  • Thorough teeth and gum cleaning, especially if it has been more than six months since a previous visit to the dentist. College students tend to have tartar and plaque build-up from inadequate brushing and flossing especially if combined with increased alcohol consumption
  • Thorough examination of all teeth and gums to identify decay or early problems that can get addressed before they worsen
  • Panoramic x-rays to determine if wisdom teeth need to be removed.
  • Discussion of oral health practices to stave off tooth and gum diseases. Tobacco and alcohol use should be discussed as well as oral health symptoms that require immediate visits to the dentist.

For the college student, the timing of the possible removal of impacted wisdom teeth is critical. Not every child grows wisdom teeth and they do not all need to be removed, but for those that do, the summer break between semesters is an ideal time to schedule the removal, as the recovery takes a few days. Removing wisdom teeth during the summer also prevents a painful episode mid-semester when the teeth erupt.

A reminder of the typical symptoms of  wisdom teeth eruption:

  • Visible tooth behind the molars.
  • Swollen or irritated gums in the back of the mouth.
  • Bad breath
  • Pain when chewing on the molars
  • Jaw pain

So, hug your college student if they let you. Open up your wallet and your hearts when they get home. And schedule that dental exam for them (even better if they’ll schedule it for themselves!)

Read our previous blog about wisdom teeth removal.

Nurse Practitioners and Dentists Learning to Work Together

collaborationIn this country we have health care providers and we have dentists. The best dentists understand that oral health is a huge part of our overall health. And now medical professionals are coming on board too and are beginning to understand that connection.

The idea of breaking down the barriers between dental practices and primary care practices is being studied in the Boston area. Northeastern University’s School of Nursing is joining forces with the Harvard School of Dental Medicine to create an interprofessional program, which has received grant money from the United States Department of Health and Human Services. The training program not only will increase the education and knowledge of the professionals who participate. Even more importantly, the program targets medically underserved populations, who have also been inconsistent in accessing dental care.

The students in this program will be learning about both dental care and primary care. They will participate in both disciplines’ clinical rotations and they will learn to coordinate care of clinical patients.

The hope is that patients who receive dental care and primary care in the same setting will have improved outcomes. A dental patient, for instance, who is suffering from severe periodontitis would automatically be evaluated by the nursing staff for other disease conditions that can be caused by this condition. On the other hand, a primary care visit would also include questions about eating and about the condition of a patient’s teeth so that dental issues are addressed in a timely manner.

The combined practice could prove to be particularly helpful in dealing with older adults with chronic diseases, particularly those who have diabetes.

This approach may not work for everybody, but could be quite effective in improving health outcomes for the targeted population.

In addition, it may shed light on ways that doctors and dentists can work together in referring to one another and in treating patients with chronic or complicated disease processes.

Athletes and their teeth

athletes busWe often consider athletes the epitome of good health: muscular, fit, and always needing to be in peak performance shape. But apparently, athletes the world over have a higher incidence of untreated dental health issues than you would normally imagine.

Toothaches affect athletes quite a bit. In fact, a recent worldwide study assessing athletes in 25 sports found that an astounding 55% of them had tooth decay. In addition, 1/3 of the athletes had gingivitis (inflamed and bleeding gums). 18% of the study participants admitted that toothaches negatively affected their performance and even their ability to participate in a game.

What’s going on here and what lessons for the sports fans are there?

It’s not surprising, but what is hurting these athletes is lack of attention from a dentist, poor oral health behaviors, and drinking sports drinks to excess.

Probably the most significant of the above issues is that very few sportsmen and sportswomen took the time to see a dentist; the vast majority hadn’t seen a dentist within the past year.

In addition, these same athletes were away from toothbrushes for too long. Long days of training and traveling often meant too many hours in between brushing and flossing.

Finally, a reliance on sugar and carbohydrate- heavy foods and drinks meant that cavity-producing bacteria spent too much time on teeth. Carbo-loading diets before races and meets as well as drinking sports drinks (often big-time sponsors of meets and games as well as tournaments) wreaked havoc on their teeth.

So, what should athletes and even the couch potatoes who watch them do?

  • Visit the dentist regularly.
  • Brush your teeth often and for enough time. Floss regularly too.
  • It’s ok to eat carbohydrates and drink juices, but you must follow it up by rinsing with water and brush your teeth as soon as possible afterwards.
  • High fluoride toothpaste is recommended for anybody who has such high carbohydrate intake.

Your Money and Your Mouth

photo courtesy of www.seniorplanning.org

photo courtesy of www.seniorplanning.org

Perhaps one of the least comfortable topics of discussion between patients and dentists is money. But patients should not shrink from having that discussion.

Dentists know that:

  • Money is an issue for most people.
  • Patients want to be able to plan to pay for the dentist’s services to the best of their ability.

Your dentist does not automatically know your financial situation. So it’s better to discuss billing and how much procedures will cost prior to a visit.

Some cost-saving measures to consider:

  • Dental insurance is usually a good deal when it is part of group coverage. If your employer offers group dental insurance, it usually covers all of your cleanings and X-rays and will discount several procedures.
  • Most dental insurance has a spending cap and many have a deductible for services other than exams and cleanings.
  • Make sure you know the specifics of your policy. For many families, the spending cap is per person, and includes orthodontia, meaning that orthodontia can be discounted but not entirely.
  • In Michigan, Medicare does not include dental coverage. If you will be aging out of group coverage and into Medicare, schedule a dental exam and any procedures before your coverage lapses.
  • Dental insurance bought on the marketplace may still save you money, depending on your ability to save and what you expect your dental expenses to be. Be sure to check out AARP and professional organizations that you belonged to when you or your partner worked.
  • Be sure that you check with your dentist as to which dental insurance plans she participates in.
  • And check with the dentist’s bookkeeper and insurance coordinator regarding which insurance plans seem to be the most cooperative regarding timely payment and transparency regarding coverage.
  • If you must go without dental insurance, spend money wisely and come in for exams when they are scheduled. Doing without may cost you much more down the road.

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Tuesday:9:00 AM – 5:00 PM
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Karen P Meyers, DDS 
1875 Southfield Road, Birmingham, MI  48009

Phone: 248-646-2450

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