As we age, our bone strength and density naturally declines. If you’ve ever seen an adult who is permanently hunched over when they stand or walk, that’s commonly due to severe osteoporosis. Avoiding such health issues has motivated millions of adults to take bisphosphonates to minimize, prevent or counteract further bone loss. An unfortunate side effect of bisphosphonates, however, is bone necrosis.

Bone necrosis is a condition that occurs when there is loss of blood to the bone. Because bone is living tissue that requires blood, an interruption to the blood supply causes the bone to die and eventually collapse. Osteo-necrosis of the jaw develops when the jaw bone fails to heal after a minor injury or disruption to the bone that requires healing — for example, having a tooth pulled or an implant placed.

Although the risk level for those who take oral bisphosphonates (such as Fosamax, Actonel, Boniva) is low, a higher risk exists for those taken as part of cancer therapy.  These are given intravenously (such as Aredia, Bonefos, Didronel, Zometa) to reduce bone pain and abnormally high calcium levels in the blood.

The precise cause-and-effect relationship between bisphosphonate use and jaw osteo-necrosis is still unknown. The Mayo Clinic estimates the risk is 0.1 percent, meaning the condition occurs in 1 out of every 1,000 taking bisphosphonates over the period of a year or more. Although the risk is low, it still exists.

Taking bisphosphonates does not prevent one from having dental implants or other dental procedures. For example, we have our dental implant patients stop taking the medication six months prior to the placement procedure. Once their implant treatment is complete, they can resume bisphosphonate medication.

Other medications can also have adverse effects when your dental professional is not informed of all you are taking. For example, Coumadin, a blood thinner, can cause a greater degree of bleeding during extractions and other procedures. This is why it is important to provide your dentist with a list of all medications you take and the dosage of each. This includes herbal supplements.

Our goal is to create an ideal outcome for every procedure you have in our office. If you have questions, call (828) 274-9440.

As a Periodontist, I’ve heard every reason in the book why people don’t floss. And, for every reason, there is an even better one to make daily flossing a priority!

Flossing removes food particles that become wedged between teeth. It also helps remove the sticky buildup of bacteria that forms plaque. Keeping oral bacteria at a minimum helps to prevent bad breath, cavities, gingivitis and gum disease.

Everyone can floss easily with some basic pointers and a little practice. For easy flossing instructions, read up on these tips:

• Use about 18 inches of floss. Nylon floss (waxed or unwaxed) is inexpensive but can shred between teeth with tight contact points. If this occurs, try the single filament floss (although higher-priced), which slides easily between teeth and is shred-resistant.
• Use a mirror with good lighting so you can see the inside of your mouth.
• Wind the floss around the middle fingers of each hand with a couple of inches hanging loose to work with.
• Stretch the floss between your thumbs and index fingers and slide it in-between your teeth, curving the floss around the base of each tooth and beneath the gumline. Avoid popping the floss down between the teeth. This can tear tender gum tissue. Remove the floss using the same back-and-forth motion, moving it up and away from the teeth.
• About every 3-4 teeth, loosen the floss from fingers and retighten to use clean sections. This will also keep your fingers from becoming uncomfortable.

Do this every night for one week. After seven nights, flossing should be easy enough to do in about half the time it took on the first night. You may also find you no longer need the mirror!

Our Hygienists are terrific instructors. Their goal is to help you avoid problems in the first place. Flossing is definitely an effective means of doing so.

If your gums are tender or bleed when you brush, you already have the beginning stage of gum disease. Call (910) 254-4555 to arrange an examination as soon as possible. Gum disease only worsens without treatment, which can eventually lead to tooth loss.

The best way to prevent gum disease and cavities is to keep bacteria in the mouth to a minimum. Of course, brushing and flossing are important. But, many people do not realize how crowded and crooked teeth can contribute to the growth of oral bacteria.

When teeth are jammed against one another, they create crooks and crevices that are ideal hiding spots for bacteria. These areas are typically more difficult to clean and provide a haven for the accumulation and reproduction of bacteria.

As a Periodontist, I work in unison with a number of Orthodontists. As the Orthodontist straightens teeth, I tend to gum health to help the patient achieve and maintain a healthy smile.

If you have crowded and/or crooked teeth, use extra measures during brushing and flossing to ensure optimal cleaning in those areas. Ideally, you will want to consult with an Orthodontist to determine what is needed to realign your teeth for an attractive, healthy, natural smile.

Call (828) 274-9440 to learn more about maintaining healthy gums while in orthodontic treatment.

As a Periodontist, I see the destruction that sugar can do to teeth and gum tissues. Most any form of sugar is an ideal food for oral bacteria. Yet, a sugar alcohol named Xylitol actually inhibits bacteria growth that can contribute to cavities.  It is primarily used as a sweetener in chewing gum, mouthwash and some toothpastes.

An added benefit of chewing gum with Xylitol is its ability to increase saliva flow. Saliva is the mouth’s cleansing agent when brushing isn’t possible. Its flow helps to move oral bacteria out of the mouth, which can lower the bacteria that attack teeth and oral tissues.

The goal is to keep oral bacteria at a minimal level. When brushing after meals isn’t possible, chewing gum or rinsing with products containing Xylitol is a wise alternative.