Taking Prescriptions? Some Supplements Can Cause Problems.
Posted on Sep 27, 2016 by William J. Claiborne, DDS MS
As baby boomers age, a growing number are turning to alternatives to prescription medications. Thus, there has been a growing demand for natural supplements. It is estimated that over 15 million Americans are using vitamins and herbal supplements along with prescription medications.
Surveys estimates show that herbal supplements are used by 12 – 24% of the American adult population with usage of those aged 65 and older doubling from 1999 to 2002.
Since supplements are available over the counter (OTC), many adults don’t see them as medications. So, when a new patient is completing their medical history form, these are not always listed. They should be.
Both medical and dental health care providers need this information to determine how these supplements will effect your body’s ability to clot properly during procedures that cause bleeding. Too, excessive bleeding can occur when these supplements are not acknowledged prior to procedures.
A number of aging adults take prescription medications to prevent arterial or venous thrombosis and stroke. When completing your medical history form, most patients readily acknowledge their use of these medications and understand that some drugs increase bleeding during certain procedures or hamper their ability to clot when bleeding. Knowing the patient is on these medications enables the medical or dental caregiver to monitor bleeding and clotting before complications arise.
However, patients are less informed that the use of OTC medications can impact bleeding in conjunction with their prescription medications. Yet, according to the Natural Medicines Comprehensive Database, approximately 180 dietary supplements have the potential to interact with warfarin and more than 120 may interact with aspirin, such as clopidogrel (Plavix) and dipyridamole (Aggrenox).
The National Institutes of Health (NIH) identified these supplements as having the potential to cause adverse bleeding interactions:
• Dong Quai
• Omega-3 fatty acids in fish oil
• Ajoene in Garlic
• Vitamin E
• St. John’s Wort
• American Ginseng
The Centers for Disease Control and Prevention (CDC) shows the supplements having the highest sales include ginseng, ginkgo blob, garlic, St John’s wort and ginger. It is not unusual for a patient to take up to seven dietary supplements at the same time with some taken inconsistently.
In addition, the following herbs may affect blood clotting:
• High doses of Vitamin E
• Coenzyme Q10
While more studies are needed to determine precisely how these supplements alter bleeding or interact with prescription medications, it is important for medical and dental professionals to have consumption information in order to properly plan for procedures.
Warfarin (Coumadin®, Jantoven™), an oral anticoagulant, is used prevent and treatment VTE (venous thrombo-embolism), PE (pulmonary embolism), and atrial fibrillation (A-Fib) patients who are at risk of embolism. Warfarin is highly affected by medication use. In fact, more food and drug interactions have been reported for warfarin than with any other prescription medication.
A study in England noted a high number of patients were taking herbal supplements along with warfarin. In a survey of nearly 1400 patients, it was found that nearly 9% regularly took one or more of garlic, ginseng, ginkgo biloba, feverfew, ginger, and St. John’s
wort. Yet, nearly all admitted to failing to share this information with any of their health care professionals.
In addition to many herbal supplements, alcohol has been found to increase bleeding in warfarin users along with Vitamin C and Cranberry juice. However, the herbal supplements that tend to complicate clotting ability the most during bleeding include:
• Cat’s claw
• Dong quai
• Evening primrose
• Green tea
• Horse chestnut
• Red clover
In addition to Aspirin’s ability to reduce mild to moderate pain, inflammation, and fever, it is also used in the prevention of myocardial infarction (MI) and cardiovascular problems, such as stroke. Aspirin may also be advised as added therapy during procedures like coronary bypass. While many users of Aspirin realize it “thins the blood,” many regular users fail to notify their dental professional.
As a periodontist, I perform a number of procedures that cause bleeding to tissues in the mouth. It is important for your safety and a successful outcome of your procedure to have this information prior to treatment planning.
While filling out those often-lengthy medical history forms seem daunting, the information they provide is necessary. It is also necessary that it be complete. Herbal and vitamin supplements taken regularly should always be listed.
If you have questions, please call 828-274-9440.
Use HSA Funds Or Insurance Benefits Before End Of Year
Posted on Sep 22, 2016 by William J. Claiborne, DDS MS
As we’re staring October in the face, we realize that the end of 2016 is right around the corner. This typically prompts many of us to assess that list of things we wanted (or needed) to accomplish during the year. If you’re like me, there are a few things still hanging.
Each year, we begin with a number of goals. Now, we must face reality as to what we accomplished. Did we have our annual physical? Did we stick to our exercise/weight loss plan? Did we add to our retirement plan? And so on.
With three months to go in the year, this is no time to panic, but to act. However, as a periodontal specialist, I want to be sure your list includes a couple of items, whether you began the year with them or not. As you look at unused insurance benefits or available HSA funds, this is an excellent time to tend to 2016 goals.
First, did you have an Oral Cancer screening? If you had your 6-month dental check-ups and cleanings, that was likely a part of one of the visits. It’s wise to be certain, however. If you’re not sure, call your dental office and ask.
Did you stick to your daily brushing and flossing commitment? You can prevent much in the way of costs and treatment time by avoiding dental problems in the first place. Twice daily brushing (at least two minutes per time) and daily flossing is an excellent way to keep oral bacteria levels under control. Go further by using a tongue scraper each day. Or, brush your tongue at the end of brushing your teeth. This removes an enormous amount of oral bacteria that has taken up residence in your tongue.
Did you accomplish dental repairs to prevent tooth loss? Although I don’t place crowns, I see patients occasionally who have unfortunately lost a tooth because they postponed having one crowned. When your dentist finds cracks or fractures in teeth, he or she may advise having the tooth crowned. This is also the advice for teeth that are overloaded with fillings. If the tooth breaks below the gum line, it requires removal in most cases. Losing a natural tooth leaves you with a new list of expenses and treatment time. A crown can help you avoid this.
Did you achieve the smiling confidence you wanted? For people who wear dentures or partials, the associated discomfort and instability while chewing can be miserable. Dental Implants can solve these problems, restoring a dependable, secure bite. And, because Dental Implants are designed to last a lifetime, they are a wise investment. Begin with a consultation to discuss your best options.
Do you feel good about the appearance of your smile? People who smile often not only appear happier, they are. Research has shown that smiling releases brain chemicals called endorphins. These give us a happiness boost. And, it has also been found that people who smile often live, on average, ten years longer than frequent frowners (who actually decrease their lifespans by a year, on average).
Your smile is not only a part of your facial appearance, it complements your personality and supports your overall health and well-being. Be as dedicated to a healthy smile as you are having a healthy body because, when it comes right down to it, a healthy smile and a healthy body are meant to work as one.
Your Comfort Is Always A Priority
Posted on Sep 20, 2016 by William J. Claiborne, DDS MS
As a Periodontist, it’s not unusual to see a new patient who has developed gum disease because he or she was too afraid to go to a dentist for regular care. What’s truly sad about this is that, by the time they arrive at my office, far more extensive work is needed than that required for routine 6-month checkups and cleanings.
Our office is a judgement-free zone. This means that we do not lecture patients nor judge them for the state of their oral health. We understand that many people do the best they can at having a healthy mouth and circumstances aren’t always in their favor.
We also know that many people avoid dental care because of a deep rooted fear associated with dental visits. Much of this stems from a traumatic experience in the past, often with a dentist who was rough, too rushed or uncaring. This is a shame, especially since it can be the catalyst of otherwise healthy adults who end up suffering with oral decay, gum disease and tooth loss.
As a periodontal specialist, I try to help patients to understand that it’s not just their smiles that suffer when oral bacteria run rampant. Periodontal (gum) disease is an inflammatory disease. This potent bacteria can enter the bloodstream through tears in weakened gum tissues, triggering inflammatory reactions elsewhere in the body.
The bacteria of gum disease has been associated with heart disease, stroke, high blood pressure, memory loss, arthritis, diabetes, preterm babies, some cancers and impotency. As research continues, new correlations are revealed at an alarming pace.
Regardless of a patient’s fear level – or even patients with no dental fears – we make comfort a priority at every visit. In addition to standard relaxation and numbing measures, we offer oral and I.V. sedation.
Oral sedation is a pill form of sedation. It is taken prior to the patient arriving at our office. By the time the patient is seated in the treatment chair, they are typically in a fully relaxed state.
I.V. sedation, also known as ‘twilight sleep,’ is an in-the-vein sedation. This puts patients in a deeper, sleep state.
While both oral and I.V. sedation erase most (if not all) memory of the procedure afterward, oral sedation has a quicker recovery period. However, I.V. sedation puts the patient ‘under’ to a greater degree. With both, you are monitored by advanced equipment and trained staff members to ensure your safety and comfort.
Our goal is to make every visit for every patient one that is a pleasant experience. And our track record is very high in this regard. We like that our patients know that we want them to feel comfortable throughout each procedure.
If you have avoided dental care (or know someone who has) and wish to discuss concerns about comfort, please call 828-274-9440. You’ll find we have a friendly, caring staff and an office that’s structured to make your visit pleasant.
Tooth Loss NOT Natural Part Of Aging Process
Posted on Sep 12, 2016 by William J. Claiborne, DDS MS
Many of us can remember spending the night at our grandparents’ homes and being shocked to see their teeth soaking in a glass. Seeing our grandmother’s smile in a glass by the sink was a pretty unsettling sight!
While our grandparents may have been resigned to an eventual life with dentures, modern dentistry knows tooth loss need not be the case. Poor oral hygiene was not always the cause of tooth loss, either. Many in our grandparents’ era were taught to use a stiff toothbrush and baking soda and scrub their teeth hard. They thought that seeing blood in the sink meant they were doing a good job.
Today we know better. Substances such as baking soda and hard bristle toothbrushes are too abrasive for tooth enamel. Once enamel is worn away, the tooth becomes vulnerable to decay and cracks. Using modern techniques in brushing, flossing and keeping sufficient moisture in the mouth, adults can enjoy a naturally-healthy smile that lasts a lifetime.
In a five-year National Health and Nutrition Examination Survey, the statistics of tooth loss among older adults has declined somewhat over the years. However, still today those over the age of 65 only have an average 18.90 remaining teeth. Sadly, over 27% of seniors over the age of 65 have no remaining teeth at all.
The repercussions of tooth loss go far beyond the challenges of wearing dentures. Yet, dentures only contribute to the problems. The problem begins under the gums where your teeth were once held by the jaw bone. Without tooth roots to provide stimulation to the jaw, the bone begins to shrink. This process, known as “resorption,” leads to eventual tooth loss. This sets into motion a domino effect. It is a fact that the tooth beside where a tooth is now missing will be the next to go.
It is also a fact that people with their natural teeth live, on average, ten years longer than denture wearers. This is likely due to the ability to eat a healthy diet and stay active socially. People who wear dentures tend to decline social invitations since most are centered around food. The fear of embarrassing slips and uncomfortable rubbing makes most events seem a challenge.
You CAN keep your teeth all your life! Here are ways to help…
• Daily brushing and flossing is the gold standard in removing oral bacteria from the mouth. Brush for two minutes each time with a soft to medium bristle tooth brush using a fluoridated toothpaste. Use a swirling motion rather than a back-&-forth scrubbing motion. Floss daily. Brush your tongue or use a tongue scrapper to remove bacteria embedded in the grooves of the tongue.
• Be committed to your 6-month exams and cleanings, which give your mouth a periodic clean slate by removing accumulated tartar. Tartar is the cement-like attachments to teeth that the Hygienist scrapes off during cleanings. These are actually hardened colonies of oral bacteria that eat away at gum tissues and tooth enamel. These check-ups can also catch problems while still small.
• Keep your mouth moist. A dry mouth enables the growth of oral bacteria. Drink plenty of water throughout the day. Limit foods and beverages that are caffeinated, which are drying to oral tissues. These include coffee, tea, colas and chocolate as well as spicy foods. If you take medications that have drying side effects, use an oral rinse designed to replenish moisture. Also, chew sugarless gum to help promote saliva flow.
• Limit carbs and sugar. The acids produced in the mouth by carbohydrates and sugary foods and beverages create an ideal environment for bacterial reproduction. While all foods trigger an acid attack in the mouth for 20-30 minutes after eating, sugar and carbs super-charge the reproduction of oral bacteria. This acid also softens tooth enamel, making them especially vulnerable.
When teeth are lost, adults encounter a complicated set of issues – and hard decisions. As a Periodontal specialist, I’ve seen how simple measures can save people greatly in treatment time and expense AND prevent problems like gum disease, cavities and tooth loss.
If you have started to lose natural teeth already, let us help you halt the process! Call 828-274-9440 to schedule a consultation so we can discuss how you can regain your oral health for a lasting, healthy smile!