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Posts for tag: oral health

By Sirisha Pulapaka, DDS
November 05, 2020
Category: Oral Health
Tags: oral health  
DontLetAcidRefluxDiseaseRobYouofYourTeeth

Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.

That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.

GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.

Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.

But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.

If you're diagnosed with GERD, here's what you can do to protect your teeth.

  • Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
  • Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
  • Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).

You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.

GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.

If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”

By Sirisha Pulapaka, DDS
September 26, 2020
Category: Oral Health
Tags: oral health   vaping  
StudiesShowVapingMayNotBeSaferforOralHealthThanTobacco

There's ample evidence tobacco smoking increases your risk for tooth decay and periodontal (gum) disease. But the same may be true for electronic cigarettes (E-cigs): Although millions have turned to “vaping” believing it's a safer alternative to smoking, there are growing signs it might also be harmful to oral health.

An E-cig is a device with a chamber that holds a liquid solution. An attached heater turns the liquid into a vapor the user inhales, containing nicotine, flavorings and other substances. Because it doesn't contain tar and other toxic substances found in tobacco, many see vaping as a safer way to get a nicotine hit.

But a number of recent research studies seem to show vaping isn't without harmful oral effects. A study from Ohio State University produced evidence that E-cig vapor interferes with the mouth's bacterial environment, or oral microbiome, by disrupting the balance between harmful and beneficial bacteria in favor of the former. Such a disruption can increase the risk for gum disease.

Other studies from the University of Rochester, New York and Universit? Laval in Quebec, Canada also found evidence for vaping's negative effects on oral cells. The Rochester study found astringent flavorings and other substances in vaping solutions can damage cells. The Quebec study found a staggering increase in the normal oral cell death rate from 2% to 53% in three days after exposure to E-cig vapor.

Nicotine, E-cig's common link with tobacco, is itself problematic for oral health. This addictive chemical constricts blood vessels and reduces blood flow to the mouth's tissues. This not only impedes the delivery of nutrients to individual cells, but also reduces available antibodies necessary to fight bacterial infections. Regardless of how nicotine enters the body—whether through smoking or vaping—it can increase the risk of gum disease.

These are the first studies of their kind, with many more needed to fully understand the effects of vaping on the mouth. But the preliminary evidence they do show should cause anyone using or considering E-cigs as an alternative to smoking to think twice. Your oral health may be hanging in the balance.

If you would like more information on the effects of vaping on oral health, please contact us or schedule an appointment for a consultation.

By Sirisha Pulapaka, DDS
September 06, 2020
Category: Oral Health
Tags: oral health  
AShinglesOutbreakCouldInterruptYourDentalCare

A shingles outbreak can be painful and embarrassing. It could also interfere with many areas of your life—including your dental care.

Known medically as herpes zoster, shingles is a viral form of chicken pox. The virus can lie dormant for many years or decades in people that had chicken pox as a child, breaking out later in life (sometimes repeatedly). It's estimated about a quarter of people who had chicken pox as a child, about 90% of adults, will experience a shingles outbreak.

In the beginning, a person with shingles may notice an itching or burning skin irritation, as well as numbness or sensitivity to touch. In time, a red, crusty rash can develop, usually forming a belted or striped pattern on the torso, head or facial areas. The patterning is caused by the virus's disruption of nerves that serve those parts of the body.

Shingles could impact your dental care because it can be contagious early in an outbreak. As such, it can be transmitted to other people via contact with the rash or through airborne respiratory particles. Dental staff members or other patients who are pregnant, undergoing cancer treatment or with other conditions that compromise their immune systems can develop serious health problems if they contract the virus.

If you have an upcoming appointment, it's best then to let your dentist know you've been diagnosed with shingles. If your treatment involves physical contact that could spread the virus, they may wish to reschedule you until the outbreak clears up.

There are ways to hasten the healing process with antiviral treatments like acyclovir or famciclovir. For best results, these treatments should begin within 3 days of a shingles outbreak. There is also a shingles vaccine that can help you avoid an outbreak altogether. The U.S. Centers for Disease Control (CDC) recommend it for adults over 60.

Having shingles can be painful and stressful, and pose a major interruption of your daily life and routine. With proper management, though, it can be contained so you can get on with your life—and your dental care.

If you would like more information on managing shingles and dental 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 “Shingles, Herpes Zoster.”

By Sirisha Pulapaka, DDS
June 08, 2020
Category: Uncategorized
Tags: oral health  
InTheseUncertainTimesWeStillCareAboutYourDentalHealth

During this year's National Public Health Week in April, health issues like vaping and the opioid crisis are taking a back seat to what is front and center on everyone's mind: the novel coronavirus (COVID-19). This highly contagious viral infection is upending business as usual for most of the world in a way unlike anything we've experienced. Nothing is “normal” right now, including dental care.

As with other aspects of daily life, you can expect disruptions in dental care because of COVID-19, especially involving routine visits. But with that said, we're working hard to ensure your teeth and gums aren't overlooked during this global crisis. We are here for you, so please call us for any questions you may have, and especially if you are experiencing dental pain.

If you do need to visit the dentist for treatment, you might be concerned about potentially exposing yourself or others to COVID-19. Like every business that interacts with the public and especially all healthcare providers, dental offices are implementing extra precautions during this time to protect both patients and staff against infection.

This isn't something new: The dental profession as a whole has strict protocols for preventing infection that have been in place for several years. Infection control is a top priority for dentists at all times, not just during outbreaks like COVID-19. Here are some of the things we do—and are expanding because of the novel coronavirus—to keep you safe during dental appointments.

Barrier protection. Dental providers routinely use disposable items like gloves, face masks or eyewear to prevent disease spread during procedures that involve close contact with patients. For extra precautions with COVID-19, we're adding more of this type of barrier protection.

Sterilization and waste disposal. Instruments and equipment that we use repeatedly are thoroughly sterilized to remove all microorganisms, including coronavirus, from their surfaces. For disposable items used during treatment, we keep these separate from common waste and dispose of them according to strict protocols for handling bio-medical waste.

Disinfection. Even though the main pathway for spreading COVID-19 is through respiratory droplets in the air, we're continually disinfecting office and treatment surfaces that the virus might potentially contaminate. In doing so, we're using substances recommended by the U.S. Centers for Disease Control (CDC). By the way, you can find a list of such products at //www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf.

These are uncertain times for all of us. But while we're cooperating with social distancing and other measures to slow the spread of COVID-19, we're still here partnering with you to keep your family's teeth and gums healthy.

If you would like more information about special dental precautions during this time, don't hesitate to contact us. To learn more, read the Dear Doctor magazine article “Infection Control in the Dental Office.”

By Sirisha Pulapaka, DDS
November 21, 2019
Category: Oral Health
Tags: oral health   dentistry  
MonitoringBloodPressureisAlsoImportantDuringDentalCare

You may think your blood pressure is only important to your general health — but it can also affect your dental care. That’s why it’s increasingly common for dental providers to include blood pressure monitoring for patients during routine visits.

High blood pressure is a risk factor for several major health conditions including heart attack, stroke and diabetes, and is one of the most common diagnoses in the United States. Even so, many people don’t know their blood pressure is abnormally high. It may be discovered during an annual health visit, or not at all. Since many people visit their dentist twice a year for cleanings, taking a blood pressure reading during these visits increases the chance of detecting a high pressure.

In one study published in the Journal of the American Dental Association, the researchers looked at dental patients who had not seen a doctor in the previous twelve months and who underwent blood pressure screening during a regular dental visit. Seventeen percent of those studied learned they were at increased risk for cardiovascular disease.

High blood pressure can also have a direct effect on how we treat your teeth and gums. For example, we may have to adapt and become more diligent about preventing dental disease if you’re taking a blood pressure drug that could trigger reduced saliva flow (dry mouth), a factor in tooth decay. Certain local anesthetics may also contain substances like epinephrine that constrict blood vessels, which can increase blood pressure. To avoid this if you’re hypertensive, we may need to adjust the dosage of anesthetic drugs to lessen this effect.

Monitoring blood pressure in the dental office is a good example of how all healthcare services can interact with each other. At the very least, a blood pressure check at your next cleaning could alert you to a potentially dangerous condition you didn’t even know you had.

If you would like more information on the relationship of blood pressure and other medical issues to dental health, 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 “Monitoring Blood Pressure.”



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