Maneet Dharia DDS, FIDIA

Ash Kaushesh DDS, MAGD, MaCSD, DDOCS, DABOI/ID
Implants, General, Cosmetic & IV Sedation
211 Swanson Avenue
Lake Havasu City, AZ 86403
(928) 854-8540

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By Serenity Dental
October 15, 2017
Category: Oral Health
Tags: chewing tobacco  
ChewingTobaccoisJustasAddictiveandDangerousasSmoking

Ask people about the “Great American Smoke-Out,” and many could tell you about this annual promotion encouraging tobacco smokers to quit. Ask them about “The Great American Spit-Out,” though, and they may look puzzled. That’s because most of society’s attention is on quitting smoking; but the truth is smoking isn’t the only tobacco habit that needs to be kicked.

Whether chewing tobacco or the more finely ground snuff, smokeless tobacco is a popular habit especially among young athletes. It doesn’t receive the attention of smoking tobacco because it’s perceived as less dangerous. The truth is, though, it’s just as hazardous — especially to your oral health.

While any form of tobacco is considered a carcinogen, smokeless tobacco in particular has been linked to oral cancer. This is especially dangerous not only because oral cancer can lead to physical disfigurement and other negative outcomes, but it also has a dismal 58% survival rate five years from diagnosis.

And because it too contains highly addictive nicotine, smokeless tobacco can be just as difficult to quit as smoking. Fortunately, the same techniques for smoking cessation can work with chewing habits. Nicotine replacements like nicotine gum, lozenges and patches, as well as Zyban, a cessation medication, have all been shown helpful with quitting smokeless tobacco.

Often, however, it takes a change in perception — taking chewing tobacco down from its pedestal of “coolness” and seeing it for what it is: a dangerous habit that increases the risk of cancer, cardiovascular disease and even decreased sexual arousal and function. And although not life-threatening, it can also give you bad breath, dry mouth and an assortment of dental problems that incur financial and social costs. Teeth and gums in that environment aren’t so cool.

The first step is to consider the consequences of continuing the chewing or dipping habit and making the decision to quit. You may also benefit from the help of others: counselors experienced with tobacco cessation programs or a support group of others trying to quit. Following through aggressively will help ensure smokeless tobacco won’t lead to the loss of your teeth, health or life.

If you would like more information on quitting smokeless tobacco, 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 “Quitting Chewing Tobacco.”

FollowTheseCommonSenseStepsWhenYourChildhasaToothache

A child's toothache is no fun for either the child or the parent. But if you're faced with this situation, don't panic — unless they have a fever or you notice facial swelling, it's unlikely an emergency.

 Instead, take the following steps:

Find out where it hurts and for how long. Tooth pain can stem from a lot of causes, including decay or a localized area of infection called an abscess. See if your child can tell you if it's coming from one particular tooth or from a general area. Although children can't always judge how long they've hurt, try to get a general idea so you'll know if you need to call us sooner rather than later.

Look for problem signs in the mouth. As you look where they say it hurts, see if you can see brown spots or cavities on any teeth — this would indicate tooth decay. Look also at the gums or inner areas of the mouth for sores or swelling. Unless they've had an injury, this could indicate an abscess.

Try to dislodge any food shards between teeth. It's also possible the pain is coming from a piece of hard food like a popcorn kernel wedged between their teeth. Help them gently floss between the teeth to see if you can dislodge any.

Try to ease the pain. Although you may not need to see us immediately, your child's mouth still aches. You can help relieve it temporarily with a child's dose of ibuprofen or acetaminophen. You can also apply an ice pack to the outside cheek for swelling, but don't apply the ice directly to the skin, which can burn it. And don't rub aspirin or other pain relievers on the gums — they're acidic and can irritate soft tissue.

See us for a full examination. It's wise to have any tooth pain checked — the question is often how soon. You should see us the same day or first thing in the morning if the pain has persisted for more than a day or night, pain relievers haven't eased the pain or they have fever or facial swelling. If the pain is short-lived you can usually wait until the next day — but do get it checked out.

If you would like more information on treating your child's toothache, 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 “A Child's Toothache.”

By Serenity Dental
September 15, 2017
Category: Dental Procedures
Tags: extractions  
SimpleToothExtractionsareaCommonDentalProcedure

When a tooth is beyond repair due to disease or injury, it may be necessary to remove it. A “simple” tooth extraction is among the most common in dentistry and certainly not the agonizing procedure depicted in common lore.

They’re referred to as simple extractions because the shape of the tooth and root allows for a fairly straightforward and uncomplicated removal. An example would be the normally cone-shaped upper front tooth that doesn’t offer a lot of resistance during the extraction process.

The process itself is fairly straightforward. Teeth are held in place by the periodontal ligament, an elastic tissue made of tiny fibers that attaches the tooth to the supporting bone. These fibers can be dislodged from the tooth with some careful manipulation — in the hands of an experienced dentist there’s a deft “feel” to the fibers loosening. Once they’ve detached, it requires little effort to remove the tooth; with the aid of local anesthesia, you won’t feel anything but a little pressure.

Immediately after the tooth is removed, we commonly insert bone grafting material in the socket to minimize bone loss until a permanent replacement like a dental implant can be installed after tissue healing. We then place sterile gauze over the site for a few minutes to control bleeding and, depending on the size of the wound opening, we may also place a few stitches to close it. We then give you instructions for caring and cleaning the site over the next few days, and prescribe antibiotics to reduce the chance of infection and anti-inflammatory drugs for any discomfort.

Although a simple extraction is a routine procedure, it’s important to perform a proper assessment of the tooth and the surrounding bone beforehand, including x-rays to determine the tooth’s exact shape and position. If we discover a complication that makes a simple extraction impractical (like multiple roots at acute angles), we may then refer you to an oral surgeon for a more complicated surgical extraction.

It’s our hope you’ll have your natural teeth for as long as you live. But if you must have one removed, you can rest assured it’s a common — and uneventful — experience.

If you would like more information on tooth extraction, 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 “Simple Tooth Extraction.”

StayAheadofGumDiseaseRe-InfectionwithPeriodontalMaintenance

If you've undergone treatment for periodontal (gum) disease, you know how involved it can be. After several sessions of plaque and calculus (hardened plaque deposits) removal, your swollen, red gums finally begin to regain their healthy pink color.

But with gum disease, the battle may be over but not necessarily the war. If we don't remain vigilant, there's a high chance you'll experience a re-infection.

That's why periodontal maintenance (PM) is so important for gum disease patients after treatment. Plaque, the thin film of bacteria and food particles responsible for the infection, can grow again on your tooth surfaces as it did before. You'll have to practice diligent, daily brushing and flossing to curb that development.

But it's also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For most people that's usually twice a year, but for gum disease patients it could be up to four times a year, especially just after treatment. And there's more to these visits than cleaning.

Since our goal is to reduce the chances of re-infection as much as possible, we'll thoroughly examine your teeth, gums and any implants for signs of disease (we'll also include an oral cancer screening). We want to assess the health of your teeth and gums and to see how well you're doing hygiene-wise with plaque control.

If we find signs of gum disease, we'll discuss this with you and schedule a new round of treatment. The sooner we initiate treatment, the better your outcome. In some cases, we may perform procedures that make it easier to access and clean areas where plaque tends to build up.

Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it re-occurs. Keeping up diligent PM will help ensure your gums continue to stay healthy.

If you would like more information on after care following periodontal (gum) disease, please contact us or schedule an appointment for a consultation.

CertainTreatmentsforOsteoporosisCouldComplicateOralSurgery

Although periodontal (gum) disease is the most common cause of bone loss in the mouth, women at or past menopause face another condition that could cause complications with their oral bone health — osteoporosis.

While normal bone goes through a balanced cycle of resorption (the dissolving of bone tissue) and re-growth, osteoporosis, a hormone-induced disease, tips the scale toward resorption. This reduces bone density, which weakens the bone and makes them more susceptible to fracture.

Some studies have shown a link between osteoporosis and existing gum disease; however, the greater concern at present from an oral health standpoint regards the side effects of a certain class of drugs called bisphosphonates used in the treatment of osteoporosis. Bisphosphonates slow excessive bone resorption, which helps restore normal balance to the bone growth cycle.

Some long-term users of bisphosphonates, however, may develop a complication in their jaw bone known as osteonecrosis in which isolated areas of the bone lose vitality and die. This can complicate certain types of oral surgery, particularly to install dental implants (which rely on stable bone for a successful outcome). While research is still ongoing, it does appear individuals at the highest risk of osteonecrosis are those with underlying cancers who receive high-dose intravenous bisphosphonate treatment every month for an extended period of time.

It’s important then that you let us know before any dental procedure if you’ve been diagnosed with osteoporosis and what treatment you’re receiving for it. If you’ve been taking a bisphosphonate for an extended period of time, we may recommend that you stop that treatment for three months (if possible) before undergoing oral surgery. While your risk of complications from osteonecrosis is relatively small, adding this extra precaution will further reduce that risk and help ensure a successful outcome for your scheduled dental procedure.

If you would like more information on osteoporosis and oral 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 articles “Osteoporosis & Dental Implants” and “Good Oral Health Leads to Better Health Overall.”





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