Karen P. Meyers, DDS

Birmingham, MI

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

February: Children’s Dental Health Month

young child cleaning teeth in bathroom iStock_000010951173XSmall (2)February is Children’s Dental Health Month.

When do you think a child should go to the dentist for the first time? The answer may surprise you.

The American Dental Association recommends that children see a dentist within six months of getting their first tooth. Furthermore, the ADA says that all children should see the dentist no later than their first birthday, regardless of how many teeth have erupted by then. At this first pediatric visit, the dentist will examine the gum, any teeth that have broken through, as well as the tongue and jaw. Be aware that cavities can be present in teeth, even before they have erupted through the gumline.

Cavities still plague many young people and account for many days of missed school and missed work time for parents. According to the National Institute of Dental and Craniofacial Research, 42% of children ages 2-11 have cavities in their baby teeth. Parents and caregivers mistakenly believe that the baby teeth are “disposable” and that cavities in them are not significant. They could not be more wrong. Cavities can cause pain, issues with eating, and impact the gum. Cavities need to be treated with cleaning and filling. Pulling teeth is not usually an option, as this causes misalignment.

Early intervention and working in partnership with a dentist to take care of children’s oral health care needs are paramount. Habituating your children to visit the dentist regularly sets up good oral health habits for life and prevents serious dental issues.

How to Get Your Kids to Brush and Floss

child brushing teethIt’s important for kids and adults to get regular dental care through twice yearly cleanings. While at the dentist’s office, your kids will get a gentle and thorough teeth cleaning. But your kids can’t live at the dentist’s office. So, make sure you and your dentist work together to make the lessons from the cleaning cross the threshold into your own home. Some suggestions:

  • Turn your child’s brushing and losing into a game or a competition. There are products out there to help kids brush for long enough. That is the crucial issue, as children underestimate two minutes, which is the minimum amount of time to get teeth properly cleaned. Play a favorite song or video that lasts at least two minutes.
  • Switch to an electric toothbrush. Kids like a “machine” as opposed to an inanimate toothbrush.
  • Attach something large to the ends of dental floss. This give the kids something easier to grip.
  • Make sure your kids really understand the dangers of poor oral hygiene. They should understand that teeth can “get sick” and even “hurt” if we don’t clean them well. Have these discussions without frightening the children, however.
  • Let children choose the elements of their oral health hygiene, including their favorite toothpaste, the color and type of toothbrush they want and even their cups.
  • Brush and floss your teeth when they brush and floss theirs. Be their best role model so they can “do as you do”.

Make the teeth cleaning process regular and fun and ensure that it lasts for long enough, too. Together, you’ll be able to keep the cavities at bay and enjoy years of good dental health.

Poor Dental Care in Nursing Homes is a Health Crisis

nursing homeIf you or a loved one live in a senior facility, you are aware of the many tasks that workers are asked to perform: helping the residents eat, including getting to a dining room when able, assistance with dressing and toileting and providing basic medical care.

One of the tasks that nursing home workers are supposed to address, but often fail to, either due to time constraints, lack of training or no directive on the part of management is care of residents’ teeth.

In nursing homes across the country, residents suffer with cavities, gum disease and sometimes even broken or cracked teeth, mostly because of inadequate or totally nonexistent oral hygiene. The care of residents’ teeth varies by location and by management. In addition, some patients are more difficult to manage, including residents with musculoskeletal conditions that inhibit keeping their mouth open wide, those residents who suffer dementia, and those who recoil when being touched.

This is now a crisis, one that impacts not just the teeth, but the overall health of each resident.

Residents can be in terrible pain from tooth and gum issues. Worse, missing teeth inhibits eating and can lead to aspiration of food, which can lead to pneumonia, which affects 10% of senior citizens.

Research on oral health care in old age homes has been conducted in 11 states and the numbers tell the story: In Kansas, 30% of the residents had “substantial oral debris on at least two-thirds of their teeth.” More than one-third had actual tooth decay. Wisconsin was no better. Their researchers found 31% of residents who actually had broken teeth with visible roots.

Those residents with dentures are not immune from the poor care. Their dentures are not regularly examined for fit and are often lost. The one advantage of dentures is that it is easier for the staff to clean them.

Complicating the situation is that these residents receive health care benefits through Medicare, but Medicare excludes most aspects of dental care.

In order to improve the situation, there will need to be some advocates for oral health care legislation for those in senior living facilities.  Additionally, individuals will have to insist on better care for residents in each home with which they are associated.

Diabetes and the Dentist: Helping You to Be Healthy

glucose monitorDid you know that November is Diabetes Awareness Month?

Diabetes is a complicated chronic disease that affects many systems within the body, including your teeth and gums.

What are important facts to know about diabetes and dental health?

  • Poorly managed blood glucose levels (your sugars) put you at greater risk for gum disease and tooth decay.
  • It goes both ways. Not only does diabetes cause periodontal disease, but rampant periodontal disease can lead to higher glucose levels.
  • If you notice bleeding gums, this is an early sign of periodontitis (gum disease). Make an appointment to see your dentist right away, so you can begin treatment before more serious issues including gum erosion and tooth loss develop.
  • Diabetics are also at risk for other mouth problems: dry mouth, fungal infection (thrush) and mouth sores that are slow to heal. If you experience these systems (a sore area of the mouth that doesn’t heal, a funny taste in your mouth or continuous dry mouth), see your dentist right away.
  • Diabetics have to be hyper-vigilant about brushing their teeth and flossing.
  • Diabetics, because of their heightened risk of gum inflammation, should use the softest bristled toothbrushes available and brush in gentle circles. Ask your dental hygienist and dentist to observe you as you brush, so they can help refine your technique.
  • Make sure you tell your dentist and hygienist if you are diabetic, so they can be a part of your overall health care team.

Monitor your blood glucose as directed, watch your carbohydrate intake and exercise regularly to maintain a healthy weight. All of these will lead to better-controlled diabetes, which in turn can positively affect your oral health.

Cancer and Cavities: How Your Dental Health Care Providers Are Partners in Your Cancer Fighting Regimen

cancer ribbonIf you or your loved one is battling cancer, we know how overwhelming the entire process can be. You have to be on top of numerous appointments with all kinds of doctors for treatments, bloodwork, scans and tests. At the same, you are trying to live as normal a life as possible, fitting in work and family.

What does any of this have to do with your teeth?

Some of the side effects of cancer treatment can also have an impact on your mouth. Here are a few things to consider:

  1. See us before you start treatment: If you know you are going to begin an extensive cancer treatment, regardless of your last cleaning, schedule an appointment for a quick cleaning and examination before your chemotherapy or radiation starts. Call the office and explain why you need to schedule the appointment and when you expect your treatments to begin. Starting your mouth in the best possible shape prior to chemotherapy and radiation could head off some other problems down the road. In addition, any dental issues that you have put off (like that filling) need to be addressed at this time.
  2. Modify your care of your teeth. You should continue to brush your teeth at least twice a day, but buy a new softer toothbrush (the softest you can find). You can continue to floss, but don’t insert anything sharp into your mouth like a toothpick. You may not be aware of inflamed gums and introducing sharp objects can injure you and open an avenue for further infection, especially if you have a weakened immune state.
  3. Decrease the amount of cavity-producing foods. You might want some comfort foods during this stressful time, but try your hardest to eliminate or reduce your intake of sugary sweets, sticky foods and soft drinks containing sugar. Quit or reduce smoking, too! All of these aforementioned items contribute to cavities, which your mouth may not be as effective in combating during treatment.
  4. Fight off dry mouth. Certain chemotherapy drug regimens as well as radiation therapy to the head and neck can damage the salivary glands. As a result, you may experience occasional or consistent dry mouth (called xerostomia), which can affect speech, chewing and swallowing. The lack of saliva can also contribute to increased plaque development as saliva helps to wash away bacteria and plaque, which can contribute to cavity development. That’s why it’s important to have a cleaning prior to treatment. If you experience xerostomia, drink often, chew sugarless gum and discuss other drug options to help with this side effect with your health care team.
  5. Your mouth may become inflamed. Again, certain radiation and chemotherapy components are to blame for causing inflammation of the insides of your mouth as well as your lips. When it is severe, this can cause enough pain to inhibit eating. It is very important to keep up your nutrition intake during cancer treatment. Call your dentist if this occurs, and we will work together with your physicians to determine the best course of action.
  6. Mouth infections can crop up. The body’s ability to fight infection is compromised during cancer treatment. That is why your white blood cell count is constantly monitored. Be aware that a low white blood cell count means that you are at risk for all sorts of infections, including infections of the mouth. Be vigilant during these vulnerable times by practicing the very best hygiene including hand washing. Keep your hands away from your face and mouth as much as possible and avoid sick people and crowds during these times as well.

As soon as you’re done with treatment, schedule another appointment so we can deal with any issues that occurred. Most doctors and dentists recommend waiting a couple of months after your last cancer treatment to see the dentist again unless there is an oral health emergency.

Cancer can be complicated. Let your oral health care providers be part of your team.

I’d Rather Have a Root Canal!

root canalRoot Canals in jokes and in offhanded remarks have become shorthand for an unwanted medical procedure. It is true that nobody looks forward to a root canal, but we are fans of the unloved root canal, because of the serious dental problems that they solve.

Consider these facts about root canals:

  • Root Canals Can Save the Tooth. In the past, a tooth that was damaged and nearly dead was a candidate for removal. Now with timely and appropriate root canal procedures, the tooth can be saved, and the patient can avoid having an implant or worse, having a hole where that tooth was, which adversely affects eating and your appearance, too.
  • Root Canals Get Rid of Pain. We are sure you have seen someone who was complaining about the incredible tooth and mouth pain they were in that had to be fixed with a root canal. This pain was in the pulp, the interior of the tooth. The only way to fix the pain is a root canal. Performed expertly and with appropriate anesthesia, the actual root canal procedure is relatively painless and the previous extreme discomfort is (almost) magically gone.

A root canal is performed by taking out the diseased core of the tooth, which is called the pulp. The pulp, which is the soft tissue beneath the enamel and the dentin, contains blood vessels, nerves and connective tissue. The pulp connects to the root canals, around which are the roots of your teeth, the parts of your teeth that are rooted to the gum.

During the root canal, the infected pulp is removed, the tooth is thoroughly cleaned and disinfected and then the tooth is sealed with a rubber-like material. After recovery from a root canal, the patient is fitted with a crown or a filling for the top of the tooth.

Root canals might not be your idea of fun, but they are a dental miracle in many ways, saving teeth and alleviating pain.

Too Many Choices: The Toothpaste Dilemma

toothpasteWe hope you regularly brush your teeth and are regular consumers of toothpaste. How did you select your toothpaste?

There are more varieties of toothpaste than ever before. Many offer exactly what you need. Other toothpaste products may be making claims without providing much added value, despite the higher price.

What should a toothpaste contain?

  • A mild abrasive which scrapes away the debris that accumulates between brushing.
  • Detergent which causes the toothpaste to “foam up”
  • Some sort of flavoring agent which helps the experience to be a bit more pleasant (particularly for children)
  • Fluoride (recommended to strengthen tooth enamel, which then prevents cavities from forming)
  • ADA (American Dental Association) approval. This means that the brand has been investigated by the ADA and meets their standards for toothpaste ingredients.

Your toothpaste may also have some of these components:

  • Breath enhancers (typically contains triclosan) or some sort of minty flavoring (which has a very short duration)
  • Sensitive formulas. If you complain that your teeth are sensitive, especially during brushing, look for toothpaste that incorporates potassium nitrate or strontium chloride, as they may reduce tooth sensitivity
  • Whitening agents. Some toothpastes may have mild abrasives like silica which can aid in reducing surface stains.
  • Tartar control: Different ingredients may inhibit tartar build-up including zinc citrate, pyrophosphates and triclosan. The best defense against tartar build-up is brushing at the gum line and regular dental cleaning.
  • Microbeads will often act as a mild abrasive (like a face scrub). However, microbeads are now being banned in certain states, as they are being found inside fish in rivers and lakes who mistake the beads as eggs. We suspect that microbeads will not be in toothpastes for much longer.

In general, stick with brands that have ADA approval and buy the most economical brand that you like enough to brush for long enough.

E-Cigarettes: The Newest Danger to Youth?

e cigarettesYou may not be aware of the electronic cigarette fad. So called e-cigarettes are “smokeless” cigarettes. They consist of a battery used to create heat, a cartridge (which contains water, some type of flavoring, and quite often nicotine) and a vaporizer. Some people call “smoking” these e-cigarettes “vaping”, because of the creation of vapor.

Advocates of vaping often tout these cigarettes as “healthy alternatives” to tobacco smoking and even promote their use to smokers who are trying to quit.

However, American and Canadian dentists and researchers are now beginning to question the safety of these e-cigarettes, especially as their use among youth has skyrocketed. It is estimated that 2 million American middle and high school students are using e-cigarettes recreationally. This statistic is particularly significant, because it shows a huge growth in e-cigarettes’ popularly among young people, as now three times as many kids are vaping than were reported as recently as 2013.

E-cigarettes contain flavors that make them more palatable to young people, and they are often directly marketed to young people. Of particular concern is the effect of e-cigarettes on oral health.

The National Institute of Dental and Craniofacial Research (NIDCR), a division of the National Institute of Health, recently announced a new research initiative. The Food and Drug Administration admits that not enough research has been conducted on the safety of e-cigarettes. However, the Centers for Disease Control want parents to know that nicotine is addictive and considered an impediment to brain development for adolescents. E-cigarettes very often contain nicotine and are often promoted as safe alternatives to tobacco products.

The NIDCR research will focus on whether the cells and tissues of the mouth are negatively affected by vaping.

In the meantime, the Canadian Dental Health Authority has come down even stronger in opposition to teenage vaping and has advocated for the following changes in Canadian law:

  • A ban on e-cigarettes sales to minors.
  • A ban on flavorings in cartridges and e-liquids.
  • A ban on e-cigarette use in public places and workplaces.

Lunch box Lessons: Healthy Mid-day choices for Your Mouth

lunch boxWhether you are packing a lunch for yourself, your partner or a child, it’s good to remember that healthy lunch choices can also keep your teeth and gums healthy.

Consider these choices as you prepare lunches for all of your loved ones:

  • Include food from several food groups, and don’t ignore fruits, vegetables, grains, dairy and protein.
  • Fruit is a great source of something sweet. If you find that you or your child find the fruit to be “too much of a bother”, take some time to cut up the fruit and see if the fruit gets eaten. Kids often times won’t eat a whole apple or a pear or an orange, but if it is sliced up and immediately put into an air tight container or zipper bag, it suddenly becomes much more user friendly.
  • Make sure your child drinks milk if it is available to them. Adults and kids who can tolerate milk can include dairy in many other forms: packaged string cheeses, yogurts and cottage cheese. Ending your meal with cheese is great for keeping tooth decay at bay.
  • Try not to pack sticky foods, which leave sugary residue on the teeth for the rest of the day.
  • Also avoid foods that could become lodged in between teeth like popcorn.
  • Try to avoid packaged sweet treats if your kids will willingly forego them. They just add calories and more sugary residue to the surface of the teeth. Even though fruit contains sugar, the water in the fruit helps to wash away the sugar content.
  • Salads are great for everybody; they can be low calorie but packed with added protein and they take a long time to eat. Throw in a sealed container of salad dressing and a plastic fork. Tell yourself (and your kids) that you are packing a salad bar in a bag and be creative with dinner’s leftovers: some green peas, a little cut up chicken breast, shredded cheese, corn, crunched up tortilla chips…the choices are endless.
  • Choose whole grain breads and crackers over white breads and crackers

Packing lunch can be a chore, but with planning, creativity and wise choices, you can create lunches that are healthy for your body and your mouth.

Touchdowns and Teeth: The Best Mouth Guards

mouth guardSports are in season.

Everything athletic seems to be gearing up, whether it’s school sports teams or travel or recreational leagues: football, field hockey, boys and girls soccer, tennis, fall softball and baseball, cross country and we’re sure there are more.

Some of these sports have a lot of protective equipment, like football. Some, like tennis have absolutely no required protection. Sports protective equipment includes shin guards, helmets, and shoulder pads.

Reasonable sports protective equipment should also include mouthguards. Some sports do have mandatory “no mouthguard, no play” policies. These include football, ice hockey and field hockey

A 1995 study on mouthguards reveals the following statistics about mouth injuries:

In football, where mouthguards are required, .07% of the injuries are orofacial.

But in basketball, where mouthguards are typically not required and absolutely not required, 34% of the injuries are orofacial.

According to the Australian Dental Association, studies of mouthguard users and nonusers have consistently shown that “mouthguards offer significant protection against sports-related injuries to the teeth and soft tissues. Mouthguards provide a resilient, protective surface to distribute and dissipate forces on impact, thereby minimizing the severity of traumatic injury to the hard or soft tissues.”

The American Dental Association recommends fitted mouth guards for all sports participants who have any chance of orofacial contact.

There are different types of fitted and non-fitted mouthguards:

  • Stock mouthguards
  • “Boil and bite” mouthguards
  • Custom fit mouthguards

Stock mouthguards are extremely cheap, and are often given away for free. They are not personalized or fitted at all. They provide little or no protection. They can be uncomfortable and they certainly are unlikely to remain in place during sports practice or games.

Boil and Bite mouth guards are so-called because they require you to boil them and bite down to help them fit. These boil and bites are available at sporting goods stores; they are inexpensive (under $30).

Boil and bite guards are most likely better than nothing at all. But boil and bite guards are not always the best option. They can move around if the first impression is inaccurate. Poorly fitting mouthguards may inadequately protect the teeth and gums. Boil and bites also are shorter, and don’t cover the back teeth. In addition, athletes sometimes cut or fold the guards to try to make them feel better or fit better. Cutting the guards makes them less protective.

Custom mouthguards are fitted by your dentist and then formed to fit your mouth after the dentist has taken a stone impression of your mouth. These custom mouthguards are also made of a type of plastic composite, but are thicker and more durable than boil and bites. They also take into account how the user bites down and the idiosyncrasies of each mouth, including missing teeth, erupting teeth, orthodontia and implants. In addition, the dentist can provide additional protection if the patient has had a history of a previous dental injury or even concussion.

All athletes should recheck their bite guards if there has been a change in bite, due to oral surgery, tooth extraction, or significantly for student athletes, installation or removal of orthodontia.

All athletes should inform their dentists about their athletic involvement and decide together on the best mouthguard choice.

Hours

Monday:9:00 AM – 5:00 PM
Tuesday:9:00 AM – 5:00 PM
Wednesday:Closed
Thursday:8:00 AM – 4:00 PM
Friday:By appointment only
Saturday:By appointment only
Sunday:Closed

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Karen P Meyers, DDS 
1875 Southfield Road, Birmingham, MI  48009

Phone: 248-646-2450

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