Dry socket: Symptoms, risk factors, and treatment.

Dr. Krape Cosmetic & Specialized Dentistry knows no one likes having a tooth extracted. Developing a complication such as dry socket after a tooth extraction may be some people’s worst nightmare.

With proper care, dry socket can be avoided. If it does develop, it is only a temporary condition that will resolve quickly with appropriate treatment.

What is dry socket?

Dry socket, also known as alveolar osteitis, is a painful complication that sometimes happens after having a tooth extracted.

After a tooth has been removed, a blood clot normally forms where the tooth was. The blood clot protects the underlying bone, tissues, and nerves as the site heals.

In cases of dry socket, the blood clot does not form or is dislodged, leaving the bone and nerves exposed.

Risk factors

Not everyone who has a tooth extracted will develop dry socket. Dentists are not certain what causes dry socket, but certain factors can increase the risk of developing it.

These factors include:

  • smoking
  • using chewing tobacco
  • use of oral contraceptives or estrogen replacement therapy
  • not following care instructions after the tooth extraction
  • poor oral hygiene
  • infections in the gum or teeth around the extraction site
  • having had dry socket in the past
  • using a drinking straw after the tooth extraction

Symptoms

The symptoms of dry socket are easy to identify. While no two cases of dry socket are the same, common symptoms include:

  • severe pain at the site of the extraction within 3 days
  • missing blood clot at the extraction site
  • bone visible at the extraction site
  • foul smell coming from the mouth
  • bad taste in the mouth
  • pain radiating from the tooth socket to the ear, eye, temple, or neck on the same side

While a certain amount of pain and discomfort is normal after having a tooth pulled, worsening pain or severe pain is not normal.

Anyone experiencing severe pain that does not improve after a tooth extraction should see their doctor or dentist to rule out dry socket or other complications.

Diagnosis

A dentist or oral surgeon will likely suspect dry socket for any case of severe pain following a tooth extraction, but will also examine the person for signs of any other complications.

If necessary, the person will be sent for X-rays to rule out a bone infection, or to see if fragments of the bone or roots of the extracted tooth remain and are causing the pain.

Treatment

Hands of a man and woman holding up a dental x-ray.
In some cases, a dental X-ray may be required to diagnose the cause of pain.

The treatment for dry socket consists primarily of pain management. A dentist will likely do the following to manage the symptoms:

  • flush the socket to remove any irritating debris
  • pack the socket with medicated dressings
  • prescribe pain medication

After the dentist or oral surgeon treats dry socket in the clinic, the person will need to continue with home care for several days.

Home treatment usually includes:

  • gently flushing the socket with a saline solution or medicated rinse for several days
  • continuing to take pain medication as needed

Anyone with dry socket should keep any follow-up appointments with their dentist or oral surgeon to ensure proper healing.

Management and lifestyle changes

While medical management of dry socket will help relieve pain and promote healing, self-care at home is equally as important.

A person may need to make lifestyle adjustments while treating dry socket.

These changes include:

  • stop using chewing tobacco
  • quit smoking
  • rinse mouth gently with warm water several times a day or as directed by a dentist
  • take care when brushing teeth around the affected area
  • drink plenty of clear liquids
  • avoid foods that will irritate the area
  • avoid carbonated beverages
  • avoid drinking through a straw
  • use hot and cold packs on the jaw or cheek as directed

Prevention

Woman breaking a cigarette in half.
Quitting smoking can reduce the risk of developing dry socket.

Before surgery, a person having a tooth extraction can do the following things to reduce the risk of developing dry socket:

  • stop smoking or using other tobacco products, including chewing tobacco
  • research dentists and oral surgeons thoroughly to ensure they have sufficient experience in removing teeth
  • stop taking any medications that interfere with blood clotting as directed by a doctor or dentist

Immediately following the surgery, the oral surgeon will take several precautionary measures to prevent dry socket. These steps include:

  • packing the affected area with sterile gauze
  • prescribing antibacterial mouthwash or oral gel to use following the surgery
  • prescribing antibiotics if needed

At home, a person can take further steps to prevent dry socket after the surgery. These include:

  • resting following the surgery
  • avoiding sports and other activities that may knock the blood clot out of place
  • drinking lots of water after the surgery and avoiding carbonated, hot, and alcoholic drinks
  • eating only soft foods the day after the surgery
  • taking care when eating to avoid disturbing the wound until it has healed
  • avoiding any tobacco products for the first several days following surgery
  • practicing good oral hygiene as directed by the dentist or doctor
  • avoiding the area immediately around the healing wound when brushing teeth for the first day following surgery

Outlook

Dry socket, though very painful, usually improves soon after beginning treatment if a person follows the doctor’s instructions.

However, a person being treated for dry socket should follow up with their doctor or dentist to ensure no other complications have developed.

After developing dry socket once, a person is at higher risk to develop it again following another tooth extraction.

Last reviewed Sun 2 July 2017 By Jenna Fletcher Reviewed by Christine A. Frank, DDS

 

Diabetes causes shift in oral microbiome that fosters periodontitis, Penn study finds.

Doctor Krape Cosmetic & Specialized Dentistry continues to keep you informed as to the new studies, trending techniques and medical advances that can affect or change the way Dentistry is practiced, which can affect the overall health of not just your teeth but your entire body! Diabetes continues to have ill effects on much more than previously understood. Please read!

A new study led by University of Pennsylvania researchers has found that the oral microbiome is affected by diabetes, causing a shift to increase its pathogenicity. The research, published in the journal Cell Host & Microbe, not only showed that the oral microbiome of mice with diabetes shifted but that the change was associated with increased inflammation and bone loss.

“Up until now, there had been no concrete evidence that diabetes affects the oral microbiome,” said Dana Graves, senior author on the new study and vice dean of scholarship and research at Penn’s School of Dental Medicine. “But the studies that had been done were not rigorous.”

Just four years ago, the European Federation of Periodontology and the American Academy of Periodontology issued a report stating there is no compelling evidence that diabetes is directly linked to changes in the oral microbiome. But Graves and colleagues were skeptical and decided to pursue the question, using a mouse model that mimics Type 2 diabetes.

“My argument was that the appropriate studies just hadn’t been done, so I decided, We’ll do the appropriate study,” Graves said.

Graves co-authored the study with Kyle Bittinger of the Children’s Hospital of Philadelphia, who assisted with microbiome analysis, along with E Xiao from Peking University, who was the first author, and co-authors from the University of São Paulo, Sichuan University, the Federal University of Minas Gerais and the University of Capinas. The authors consulted with Daniel Beiting of Penn Vet’s Center for Host-Microbial Interactions and did the bone-loss measurements at the Penn Center for Musculoskeletal Diseases.

Graves co-authored the study with Kyle Bittinger of the Children’s Hospital of Philadelphia, who assisted with microbiome analysis, along with E Xiao from Peking University, who was the first author, and co-authors from the University of São Paulo, Sichuan University, the Federal University of Minas Gerais and the University of Capinas. The authors consulted with Daniel Beiting of Penn Vet’s Center for Host-Microbial Interactions and did the bone-loss measurements at the Penn Center for Musculoskeletal Diseases.

“We were able to induce the rapid bone loss characteristic of the diabetic group into a normal group of animals simply by transferring the oral microbiome,” said Graves.

With the microbiome now implicated in causing the periodontitis, Graves and colleagues wanted to know how. Suspecting that inflammatory cytokines, and specifically IL-17, played a role, the researchers repeated the microbiome transfer experiments, this time injecting the diabetic donors with an anti-IL-17 antibody prior to the transfer. Mice that received microbiomes from the treated diabetic mice had much less severe bone loss compared to mice that received a microbiome transfer from untreated mice.

The findings “demonstrate unequivocally” that diabetes-induced changes in the oral microbiome drive inflammatory changes that enhance bone loss in periodontitis, the authors wrote.

Though IL-17 treatment was effective at reducing bone loss in the mice, it is unlikely to be a reasonable therapeutic strategy in humans due to its key role in immune protection. But Graves noted that the study highlights the importance for people with diabetes of controlling blood sugar and practicing good oral hygiene.

“Diabetes is one of the systemic disease that is most closely linked to periodontal disease, but the risk is substantially ameliorated by good glycemic control,” he said. “And good oral hygiene can take the risk even further down.”

The study was supported by grants from the National Institute of Dental and Craniofacial Research (DE017732 and DE021921) with assistance from Penn Vet’s Center for Host-Microbioal Interactions and the Penn Center for Musculoskeletal Disorders.

Article: Diabetes Enhances IL-17 Expression and Alters the Oral Microbiome to Increase Its Pathogenicity, Dana T. Graves et al., Cell Host & Microbe, doi: 10.1016/j.chom.2017.06.014, published 12 July 2017.

Jaw pain: Causes, symptoms, and treatment

Jaw and facial pain is a common problem affecting millions of people worldwide. It causes many treatment challenges in the healthcare community when it comes to diagnosis and treatment.

As there are so many potential causes to jaw pain, correct diagnosis is vital. Doctors need to identify the exact cause in order to provide the best course of pain-relieving treatments.

Contents of this article:

  1. Causes
  2. Symptoms
  3. Diagnosis
  4. Treatments

Causes

TMJ - Close-up

TMJ – Detail

Teeth grinding and arthritis may be causes of jaw pain but the most commonly reported is temporomandibular joint disorder (TMJ).

There are several possible causes of jaw pain and these may be related to physical injury, nerve problems, or blood vessel problems.

The most commonly reported cause of jaw pain is temporomandibular joint disorder (TMJ). The condition affects up to 12 percent of people. Nearly 5 percent seek medical treatment due to the severity of the problem. Women of childbearing age are most commonly affected by TMJ.

TMJ collectively describes disorders of the temporomandibular joints, and the muscles responsible for jaw movement. These muscles are known as the masticatory muscles.

Other known causes of jaw or facial pain include conditions, such as:

  • Teeth grinding, clenching, or opening the mouth too wide: Most often, teeth grinding and clenching is experienced during sleep and can lead to tooth damage and jaw pain. It can also occur during periods of increased emotional stress.
  • Osteomyelitis: This is a condition where an infection in the body affects the bones and associated tissues.
  • Arthritis: Arthritic conditions, such as osteoarthritis and osteoarthrosis, which lead to the surface of bones wearing away.
  • Synovitis or capsulitis: These are conditions in which the lining of the joint or a connecting ligament becomes inflamed.
  • Dental conditions: These can include gum disease, cavities, tooth gaps, damaged teeth, or abscesses.
  • Sinus problems: These affect the nasal cavities.
  • Tension type headaches: Tension headaches are typically caused by stress and may lead to facial pain.
  • Neuropathic pain: This type of long-term pain occurs when nerves become damaged and send pain signals to the brain. This pain can be continuous or occur from time to time.
  • Vascular pain: This type of pain occurs when the supply of blood to part of the body is disrupted. It is caused by conditions that include giant cell arteritis and carotid artery dissection.
  • Neurovascular pain: This type of pain is caused by conditions that affect both the nerves and the blood vessels, such as migraine and cluster headaches.

Pain can also be caused by lifestyle-related factors, including emotional stress, sleep disturbances, a lack of certain nutrients, or tiredness.

Other conditions that may cause jaw and facial pain include rheumatoid arthritis, hypothyroidism, Lyme disease, multiple sclerosis, lupus, fibromyalgia, and some mental health conditions.

Symptoms

woman holds jaw
Jaw pain symptoms may include facial pain, earache, jaw locking, toothache, and facial swelling.

The presenting symptoms of jaw pain vary depending on the cause. They may include:

  • facial pain that worsens when the jaw is used
  • joint and muscle tenderness
  • limited range of motion
  • jaw alignment issues
  • clicking or popping sounds with opening or closing of the jaw
  • ringing in the ears
  • earaches
  • headaches with or without ear pain and pressure behind the eyes
  • dizziness
  • jaw locking
  • dull aching to sharp stabbing pain
  • becoming overly sensitive to pain
  • vertigo
  • toothache
  • tension headaches
  • nerve-type pain, such as burning
  • fever
  • facial swelling

Other symptoms may be present and these will depend on the root cause of the jaw pain.

It is important for people to seek prompt medical attention in order to work out the cause of their pain so that a treatment plan can be determined. Doing so swiftly can help prevent long-term complications from occurring. Dentists, oral surgeons, and doctors are able to evaluate jaw pain.

Complications

Complications vary based on the cause and other factors associated with your pain, including the treatments that are used. They may include:

  • dental complications
  • surgical complications
  • infection
  • chronic pain
  • emotional distress
  • changes in eating habits

Diagnosis

In order for a doctor to diagnose and treat the cause of jaw pain, they will need to perform certain tests.

The following tests may help them to find out more about the cause of jaw pain, including:

  • physical exam, including assessment of the nerves, neck bones, jaw, mouth, and muscles
  • complete medical and pain history
  • certain laboratory tests, such as an erythrocyte sedimentation rate blood test, used in the diagnosis of conditions involving pain
  • certain radiology imaging procedures, such as X-ray or MRI
  • psychological and psychiatric screening

Other tests may be needed if a clinician suspects that the jaw pain is caused by a particular disease. They will discuss what they recommend for diagnosing the cause of any jaw pain as necessary.

Treatments

drugs being poured into a hand
If the cause of jaw pain is an infection, antibiotics may be prescribed by a healthcare professional.

Treatment of jaw pain depends on what the cause is. Treatment methods are varied and may include the following:

  • antibiotics if the jaw pain is caused by an infection
  • surgery to remove damaged bone, treat an affected nerve, or to diagnose the problem
  • use of a mouth protector, such as a mouth guard
  • physical therapy
  • muscle relaxants or tranquilizers to aid in relaxing the affected muscles
  • antidepressants, which can sometimes help treat painful conditions
  • topical capsaicin, which is helpful in treating some nerve-related conditions
  • steroid injections to decrease inflammation or swelling
  • antiviral therapy to treat viral infections, such as herpes zoster
  • pain medication
  • oxygen therapy and some prescription medications to treat cluster headaches
  • certain blood pressure medications when migraines are being treated
  • root canal treatment, a procedure to treat infections within teeth
  • tooth extraction if the cause is from an abnormal or infected tooth
  • vapo-coolant spray to relieve painful areas of muscle, called trigger points
  • injections with local anesthetics
  • stretching to stretch and sooth the affected muscles
  • relaxation therapy
  • soft diet to avoid excessive jaw movement and crunching
  • moist heat application or cold therapy
  • massage or acupuncture
  • use of correct posture to avoid neck and back strain

Other treatments are available to treat jaw pain, and their use is determined by the cause of the pain. Doctors can discuss the best method for treating pain with each person, based on their unique situation.

Prevention

Knowing the trigger of any jaw pain is important to prevent the pain from returning.

Some basic preventive measures may be useful, and these include:

  • avoiding crunchy foods, gum, chewing fingernails, or other hard objects
  • eating soft or liquid foods, such as soup or pasta
  • taking smaller bites of food
  • avoiding caffeine
  • trying massage, meditation, and aerobic exercise
  • taking calcium and magnesium supplements, if appropriate
  • avoiding yawning
  • sleeping on the back or side, avoiding stomach sleeping
  • avoiding grinding teeth
  • avoiding carrying bags on the shoulders for too long, switching shoulders frequently
  • using correct posture
  • seeking regular dental care

People should always speak to their doctor to determine the safety of any preventive measure to ensure it is appropriate for their unique situation.

When to see the doctor

It may be necessary for people to seek medical care for jaw pain if they are experiencing symptoms, such as:

  • failure of home remedies to treat jaw pain
  • jaw pain that interferes with a daily routine
  • irregular jaw motion
  • jaw joints making sounds when moving
  • neck or upper back pain
  • eye pain
  • headaches
  • ringing in the ear
  • dental problems, such as broken or worn teeth

People should speak with a dentist or doctor about jaw pain in order for diagnosis and treatment of the underlying condition.

Last reviewed:

Dental implant with slow-release drug reservoir reduces infection risk!

At Doctor Krape Cosmetic & Specialized Dentistry we work hard to stay on top of all the latest technology and treatment procedures in order to offer you every option available for you and your family’s dental health.  After all “Your Smile means everything to us!”
When it comes to choosing the best dentist in the north palm beach county area, we would love the opportunity to meet you and show you around our warm and friendly office where you will feel like family.
  • We welcome patients looking for second opinions and best of all, they are free!
  • We are also open Saturdays and are available 24/7 for Emergency situations.
In the latest news, scientists have developed a dental implant containing a reservoir for the slow release of drugs. Laboratory tests in which the reservoir slowly released a strong antimicrobial agent showed that the new implant can prevent and eliminate bacterial biofilms – a major cause of infection associated with dental implants.

Lead author Dr. Kaat De Cremer, from the Centre of Microbial and Plant Genetics at KU Leuven, explains that the reservoir in the implant can be filled by removing the cover screw. She adds that:

“The implant is made of a porous composite material, so that the drugs gradually diffuse from the reservoir to the outside of the implant, which is in direct contact with the bone cells. As a result, the bacteria can no longer form a biofilm.”

In general, bacteria have two life-forms. In one, the planktonic state, they exist as single, independent cells, and in the other, they aggregate in a slime-enclosed mass called a biofilm.

Published:

Dental-sealant program could prevent most cavities, lower treatment costs in vulnerable children

There is much talk about in school programs that could have such a profound effect on cavity prevention and even long term dental health of children. Dr. Krape Cosmetic & Specialized Dentistry has always encouraged parents to consider dental sealants as a must for their children at such critical development ages. Please don’t put this off. Schedule an appointment for your children today! Call: 561-257-2580.

Dental Sealants prevent cavities

Close-up of little boy opening his mouth wide during inspection of oral cavity

Research shows dental sealants to shield the back teeth could prevent up to 80 percent of cavities in school-aged children. They are quick, easy, and painless to apply – yet according to a new CDC Vital Signs report, about 60 percent of school children ages 6-11 years don’t get dental sealants.

Dental sealants are a thin coating that is painted on teeth to protect them from cavities. One way to provide sealants to more children is by increasing their access to school-based sealant programs (SBSPs).

SBSPs are especially important for children from low-income families because such children are less likely to receive dental care. These programs target schools with a high percentage of children eligible for free or reduced-cost meal programs. As a result, SBSPs provide sealants to children who are at higher risk for cavities and less likely to receive preventive care.

“Many children with untreated cavities will have difficulty eating, speaking, and learning,” said CDC Director Tom Frieden, M.D., M.P.H. “Dental sealants can be an effective and inexpensive way to prevent cavities, yet only 1 in 3 low-income children currently receive them. School-based sealant programs are an effective way to get sealants to children.”

School-based dental sealant programs are high impact and low cost

Sealants provided in school settings are effective. Recent studies found that dental sealants prevent 80 percent of cavities for two years after application and continue to protect against 50 percent of cavities for up to 4 years after placement. They can be retained in the mouth for as long as nine years.

Key findings from the report include:

  • About 43 percent of 6- to 11-year-old children had a dental sealant. Low-income children were 20 percent less likely to have sealants than higher-income children.
  • School-age children without sealants have almost three times more cavities than children with sealants.
  • Applying sealants in school-based programs to the nearly 7 million low-income children who don’t have them could save up to $300 million in dental treatment costs.

CDC supporting states to start or increase school-based dental sealant programs

State officials play an important role in increasing children’s access to school-based dental sealant programs in their states. Officials can:

  • Target school-based sealant programs to the areas of greatest need in their state.
  • Track the number of schools and children participating in SBSPs.
  • Implement policies that deliver SBSPs in the most cost-effective manner.
  • Help connect schools with health departments, Medicaid and CHIP offices, community health centers, and dental professionals in the community.

CDC currently provides funding to 21 state public health departments to coordinate and implement school-based and school-linked sealant programs that target low-income children and those who live in rural settings.

The Vital Signs report can be viewed here.

For more information on SBSPs, dental sealants, and CDC’s work, visit: www.cdc.gov/oralhealth.

Source: Centers for Disease Control and Prevention (CDC)

Gingivitis, eventual Periodontitis will cost you your overall health and $…

Dr. Krape Cosmetic & Specialized Dentistry of North Palm Beach Florida, understands the seriousness of oral neglect. Over many years he has observed the long term ill-effects of poor oral hygiene and what it can do to the entire body when it comes to much more serious and life threatening concerns.

Gingivitis is one of the most common signs that eventually leads to a much more serious concern of Periodontitis. Note what the following article and study published by: Applied and Environmental Microbiology on August 12th reveals below.

The damage of advanced periodontal disease.

The damage of advanced periodontal disease.

Investigators chart microbial ecology of gingivitis, periodontitis

Gingivitis, a common and mild form of gum disease can progress to periodontitis, a more serious infection that damages the soft tissue of the gums and sometimes even destroys the bone supporting the teeth. An international team of researchers and clinicians has charted the microbial ecology of the mouth at all stages of this progression, in nearly 1,000 women in Malawi. This work is laying a foundation of knowledge that could lead to better oral health. The research is published in Applied and Environmental Microbiology, a journal of the American Society for Microbiology.

The investigators used high-throughput sequencing of the 16S ribosomal RNA (rRNA) gene to take the census of the oral microbiomes. Among much else, they found that a small number of species were associated with periodontitis, but not gingivitis, including members of the genera, Prevotella, Treponema, and Selemonas. “Our findings confirm that periodontitis cannot be considered simply an advanced stage of gingivitis, even when only considering supragingival plaque,” said first author Liam Shaw, a PhD student at University College London, United Kingdom.

Periodontitis is diagnosed by measuring the depth of the pockets in the gums next to the teeth. “But diagnosing periodontitis visually is impossible and it doesn’t usually give any symptoms until it has developed so far that teeth become mobile, which is very late for any treatment,” said coauthor Ulla Harjunmaa, a dentist with a master’s degree in international Health, who is a PhD student at the Center for Child Health Research, University of Tampere and Tampere University Hospital, Finland.

Diagnosis requires specially trained dental professionals and expensive equipment, which are seldom available in developing countries, said Harjunmaa. But among other things, in the future, this research may lead to an inexpensive and rapid point-of-care test, based on distinguishing the two conditions’ microbiomes. “The research made it possible to tell which differences in bacteria were linked specifically to the deepening of dental pockets – which causes loss of teeth – rather than just to bleeding gums,” explained Shaw.

“We’re not the first to do this sort of research into periodontal disease, but our study is the largest to be done in such a setting,” said Shaw. “There is a great need to find new solutions to prevent these problems everywhere, but especially in this kind of setting.” He added that oral infections are very common in Malawi, since there is little awareness about oral health and prevention, and little treatment available.

Some of the techniques used in the research may have wide applications, said Shaw. “Where diseases can have multiple severities and clinical features that are also found in non-disease (like bleeding gums in periodontitis), this kind of modeling will be increasingly important in microbiome research.”

Periodontal disease is a major public health problem associated with oral bacteria. In developed nations, approximately half of adults are thought to have moderate periodontal disease, with another 7-15 percent having advanced disease, according to the Centers for Disease Control and Prevention. Additionally, periodontal disease is thought to be a risk factor for cardiovascular disease, diabetes, and other chronic health conditions. Treating gum disease could reduce healthcare costs, as well as hospitalizations, according to a study published in the August, 2014 American Journal of Preventive Medicine.

“The best way to prevent periodontal disesases is by proper tooth brushing twice a day combined with flossing once a day,” said Harjunmaa. For smokers, quitting is also critically important to prevention, she said.

 

Article: Distinguishing the Signals of Gingivitis and Periodontitis in Supragingival Plaque: A Cross-Sectional Cohort Study in Malawi, Liam Shaw, Ulla Harjunmaa, Ronan Doyle, Simeon Mulewa, Davie Charlie, Ken Maleta, Robin Callard, A. Sarah Walker, Francois Balloux, Per Ashorn and Nigel Klein, Applied and Environmental Microbiology, doi: 10.1128/AEM.01756-16, published online 12 August 2016.

Distinguishing the Signals of Gingivitis and Periodontitis in Supragingival Plaque: A Cross-Sectional Cohort Study in Malawi

Periodontal disease ranges from gingival inflammation (gingivitis) to the inflammation and loss of tooth-supporting tissues (periodontitis). The bacterial composition of supragingival plaque across a range of periodontal severities has not previously been explored with high-throughput sequencing. Furthermore, quantitative modelling of bacterial abundances in supragingival plaque as a function of both gingivitis and periodontitis has not previously been attempted.

We assessed a cross-sectional cohort of 962 Malawian women for periodontal disease and used 16S rRNA gene amplicon sequencing (V5-V7 region) to characterise the bacterial composition of supragingival plaque samples. Associations between bacterial relative abundances and gingivitis/periodontitis were investigated by using negative binomial models, adjusting for epidemiological factors. We also examined bacterial co-occurrence networks to assess community structure.

The main differences in supragingival plaque composition were associated more with gingivitis than periodontitis, including higher bacterial diversity and greater abundance of particular species. However, even after controlling for gingivitis, the presence of subgingival periodontitis was associated with an altered supragingival plaque. A small number of species were associated with periodontitis but not gingivitis, including members ofPrevotella, Treponema, and Selemonas, supporting a more complex disease model than linear progression following on from gingivitis. Co-occurrence networks of periodontitis-associated taxa clustered according to periodontitis across all gingivitis severities. Species including Filifactor alocis and Fusobacterium nucleatum were central to this network, supporting their role in co-aggregation of periodontal biofilms during disease progression.

Our findings confirm that periodontitis cannot be considered simply an advanced stage of gingivitis, even when only considering supragingival plaque.

IMPORTANCE. Periodontal disease is a major public health problem associated with oral bacteria. While earlier studies focused on a small number of ‘periodontal pathogens’, it is now accepted that the whole bacterial community may be important. However, previous high-throughput marker gene sequencing studies of supragingival plaque have largely focused on high-income populations with good oral hygiene without including a range of periodontal disease severities. Our study includes a large number of low-income participants with poor oral hygiene and a wide range of severities. We are able to quantitatively model bacterial abundances as a function of both gingivitis and periodontitis, which has not previously been attempted. A signal associated with periodontitis remains after controlling for gingivitis severity, supporting the concept that even when only considering supragingival plaque, periodontitis is not simply an advanced stage of gingivitis. This suggests the future possibility of diagnosing periodontitis based on bacterial occurrences in supragingival plaque.

Don’t let piercings put a hole in your oral health

Lip Piercing Dental Dangers

Lip Piercing can be dangerous to the health of your mouth and teeth

A leading health charity is calling on people to understand the risks associated with oral piercings after uncovering their remarkable popularity.

Research1 carried out by the Oral Health Foundation found tongue piercings are particularly popular, with 43% of people with oral piercings opting for them. A third (33%) of people had a lip piercing, with cheek (3%) and gum (7%) piercings much less common.

The poll also found that 13% of people with oral piercings had more than one, highlighting the current popularity of the trend.

Type of piercing Vote
Tongue 43%
Lip 33%
Cheek 3%
Gum 7%
Multiple 13%


The charity wants everyone who has, or is considering getting, an oral piercing to understand the risks associated with them and take the necessary steps to avoid the health problems which they are related to.

CEO of the Oral Health Foundation, Dr Nigel Carter OBE, discussed the hazards which oral piercings can have on a person’s oral health.

Dr Carter said: “Our research has found that a sizeable amount of people are choosing to have oral piercings, they have become a very fashionable form of self-expression but not everybody realises the potential long and short term damages that they can have on our mouths.

“Oral piercings are a major cause of chipped or cracked teeth due to trauma when they come into contact with the teeth; many people even have a habit of biting or playing with their piercing which can be extremely dangerous and can often lead to extensive dental work.

“The mouth also contains a huge amount of bacteria and is an ideal place for infection to arise, this is especially the case with new piercings as it is an open wound and needs constant care and attention to prevent infection. An infection can quickly lead to other more serious conditions such as blood poisoning (septicaemia).

“The act of getting a piercing is itself very dangerous as if done incorrectly can cause issues such as permanent numbness of the tongue, blood loss, excessive swelling which affects breathing and swallowing and and in severe cases and increased risk of HIV and Hepatitis B.”

The Oral Health Foundation is encouraging people to fully research the health risks associated with oral piercings and if they still wish to have it done ensure that they do so with a trustworthy provider and confirm that it is done in a clean and safe environment.

Dr Carter added: “On a day to day basis oral piercings can interfere with such basic functions such as speech, chewing and swallowing, there is certainly a lot of things to think about before going out to get an oral piercing.

“But, as our research shows, many people already have oral piercings. Our advice to these people is to keep it as clean as possible, using an antiseptic mouthwash regularly can help to do this.

“Try to avoid playing or fiddling with it and having it come into contact with teeth, especially when speaking or eating as this leads to teeth wear which can lead to extensive dental intervention.

“If you are taking part in sports remove the jewellery to minimise the risk of any damage through trauma.

“Most importantly though ensure you visit your dentist regularly, as often as they recommend, to look after the overall health of your mouth and prevent any long term problems from developing.”

Never floss? You’re not alone … and that’s bad news!

Dentist North Palm Beach - Gum Disease Prevention

Gum Disease is no laughing matter!

If you never floss your teeth, you’re in good company among a third of US adults. CDC researchers looked at data on more than 9,000 Americans aged 30 and over about the number of days in which they flossed during the previous week.

In news that probably won’t shock most dentists, 32.4 percent said they didn’t floss their teeth at all, in contrast to the 30.3 percent who said they flossed daily and the 37.3 percent  who flossed less than once a day, reports CNN.

The study is called the most comprehensive national analysis to date on the habit, which can get rid of bacteria linked to gum disease and keep tartar from building up.

Some particulars, via US News & World Report:

  • Men were more likely than women to be in the never-floss camp, 39 to 27 percent.
  • In terms of race, 40 pecent of African-Americans say they never flossed, along with 38 percent of Hispanics and 31 percent of whites.
  • Nearly half (49 percent) of those in low-income brackets say they never flossed, versus 28 percent of those in higher brackets.
  • Those 75 and older (45 percent) were more likely to never floss than those ages 30 to 44 (31 percent).

“I think it’s one of those things people don’t know enough about,” says study author Dr.

Duong Nguyen, who suggests that doctors, not just dentists, should push flossing. “If you hear it more and hear it from different places, maybe it will stick a little more.” (Smoking pot might also be bad for your gums.)

This article originally appeared on Newser: Never Floss? You’re Not Alone

More From Newser

By Arden Dier

Dr. Jerry Krape – Specialized and Cosmetic Dentistry has continues to remind patients to…”ONLY FLOSS THE TEETH YOU WANT TO KEEP!”

We all understand that flossing teeth after brushing is very very important to your dental hygiene routine. Why is it so difficult to do regularly? Time! Yes it take a little more time, and after brushing many rationalize that brushing should do the job, more than not. However, it will always come back to haunt you on your routine dental cleaning and exams. Always remember, dentistry is not expensive, neglect is. Keep flossing folks and you will enjoy many full body health benefits as well!

At Dr. Jerry Krape – Specialized and Cosmetic Dentistry, your healthy smile means everything to us!

Call today for your dental cleaning and exam! 561-257-2580, or schedule here.

Fruit juices and smoothies have ‘unacceptably high’ sugar content

The next time you offer your children a healthy smoothie instead of a soda, you may want to remember that it could contain as much as 13 g/100 ml, equivalent to around 2.5 tsps in a 3.5-oz serving, or approximately two thirds to a half of a child’s recommended daily sugar intake.

High sugar smoothies

Some smoothies have exceptionally high sugar content that are bad for your teeth.

New research, published in the online journal BMJ Open, describes the sugar content of fruit drinks, natural juices and smoothies, in particular, as “unacceptably high.”

According to Yale Health, the average American consumes around 22 tsps of added sugar every day; for teens, the figure is closer to 34. One 12-oz can of soda contains 10 tsps of sugar.

The American Heart Association (AHA) recommend no more than 3-4 tsps of sugar a day for children, and 5 tsps for teens.

In the UK, guidelines recommend a maximum of 19 g, or just under 4 tsps for children aged 4-6 years, and 24 g at age 7-10 years, or just under 5 tsps, according to the UK’s National Health Service (NHS).

As awareness spreads about the impact of sweetened drinks on weight gain and tooth decay, many people are turning to fruit juices and smoothies as healthy alternatives to sodas, iced tea and other favorites.

Even 100% juice is not guilt-free

However, even 100% fruit juice is not as innocent as it seems. The American Academy of Pediatrics (AAP) recommend not giving juice to infants under 6 months, and children aged 1-6 should have no more than 4-6 oz, or one half to three quarters of a cup. The recommended amount for 7-18 year-olds is 8-12 oz, or 1-2 cups.

Researchers from the University of Liverpool and the University of London in the UK assessed the sugar content per 100 ml (approximately 3.5 oz) of fruit juice drinks, 100% natural juices, and smoothies aimed at children, using information from the pack label.

They checked the amount of “free” sugars in 203 standard portion sizes (200 ml, or around 7 oz) of UK-branded and store-brand products.

Free sugars include glucose, fructose, sucrose and table sugar, which are added by the producer, as well as naturally occurring sugars in honey, syrups, fruit juices and fruit juice concentrates. Although fructose occurs naturally in fruit, when consumed as a drink, it can cause dental caries – as can any other sugar.

There are other naturally occurring sugars in whole fruits and vegetables, which the body metabolizes differently, and they act to curb energy intake. These were not included.

Over 40% of drinks contain 4 tsps of sugar

The sugar content in the drinks surveyed ranged from 0-16 g/100 ml, and the average was 7 g/100 ml, or around 1.5 tsps. It was significantly higher in pure fruit juices and smoothies.

The average sugar content of the 21 pure fruit juices assessed in the survey was as high as 10.7 g/100 ml or just over 2 tsps, and in the 24 smoothies, it was up to 13 g/100 ml, or just over 2.5 tsps. Over 40% of all the products, contained 19 g, or around 4 tsps, of free sugars, the maximum daily amount recommended for children.

Around 78 products contained zero-calorie sweeteners, such as aspartame. While classed as safe, health experts say they are not helping children’s taste buds to get used to a less sweet diet.

Based on the findings, the team recommends:

  • Not counting fruit juices, juice drinks and smoothies with a high free sugar content as one of the “5 a day”
  • Consuming fruit whole, not as juice
  • Diluting fruit juice with water or opting for unsweetened juices, and allowing these only during meals
  • Limiting intake to 150 ml/day, or just over 5 oz
  • Requiring manufacturers to stop adding unnecessary sugars to fruit drinks, juices and smoothies, if necessary, through government intervention.

Medical News Today asked Dr. Simon Capewell, who led the research, whether, in the light of these findings, we should reduce our fruit intake, too.

He told us:

“No. Fruit is very good for the health. Vegetables likewise. Indeed, we would recommend unlimited fruit and vegetables.”

Whole fruit has a higher fiber content than juice, it takes longer to consume, it is more satisfying, and there is evidence that the body metabolizes whole fruit in a different way, adjusting its energy intake more appropriately than it does after drinking juice.

A limitation of the study was that researchers only looked at products that are available in supermarkets, and there may be alternatives with a lower sugar content.

MNT recently reported on research suggesting that health warnings on sugary drinks could encourage parents to think twice about getting them for their children.

In summary, “ALL SMOOTHIES ARE NOT CREATED EQUAL”. As a concerned parents, wanting your children to have healthy bodies and teeth, the key here is quite simple. Smoothies can be incredibly healthy and delicious, but carefully choosing the ingredients without added sugar such as fruit juices, and sticking to fresh all natural fruit can have a profound effect in healthy teeth development.
Dr. Krape Cosmetic and Specialized Dentistry wants to see all their young patients have a bright smile for years to come.
Schedule your family’s routine dental cleaning and check-ups can save you much expense and grief in the long run.
Call today: 561-257-2580

Do You Have These 5 Bad Dental Habits? Cosmetic Dentist – Jupiter

Sometimes you just do not realize what can affect your teeth. You believe you practice good dental care: You brush your teeth, floss fairly regularly, and see your dentist twice a year for checkups and cleanings. Good for you! But you’re probably also engaging in one or more bad habits that can undermine the good ones and compromise your dental health. Here’s our list of five of the worst dental habits, why they’re harmful, and what you can do to stop them.

cosmetic dentist jupiter florida

Girl with beautiful white teeth on reception at the doctor dentist.

DENTAL CARE PROBLEM 1: CRUNCHING, SUCKING, AND SIPPING
You slurp down an ice-cold soda or iced tea and then crunch, crunch, crunch the leftover ice. What’s the harm? The brittleness and cold temperature of ice cubes can actually cause teeth to fracture. They can cause microscopic cracks in the surface of the enamel, which could lead to bigger dental problems over time. Crushed ice is less harmful than bigger cubes, but it still doesn’t get the blessing of most dentists.

Right up there with ice cubes are popcorn kernels, which can also put undue stress on a tooth and cause it to fracture. Some people keep the pits of fruit such as peaches, apricots, and plums in their mouth to suck on and then crunch on.
Sipping sugary soda throughout the day is another bad habit, research suggests. The constant exposure to sweet and acidic beverages can foster tooth decay.

Be mindful of these practices when you eat or drink. Switch to crushed ice in drinks and when eating snacks eat something that’s healthier to chew, such as baby carrots. Sip soda through a straw to minimize soda exposure to your teeth. Be sure the straw is positioned toward the back of the mouth, not resting against your teeth.

DENTAL CARE PROBLEM 2: USING TEETH AS TOOLS

Dentists report that patients rely on their teeth for a number of odd jobs: to tear open a bag of potato chips, uncap a bottle of nail polish, pull out a watch stem, straighten a bent fork tine, or rip a price tag off a piece of clothing. This can be hard on your teeth, traumatizing them or causing the edge of a weakened tooth to chip off or even fracture.

Think about what you’re putting in your mouth before you use your teeth as tools. And keep simple real tools such as a scissors and pliers handy to do the dirty work and let you maintain good dental health.

Dental Care Problem 3: Grinding Your Teeth

Whether you grind your teeth during the day, at night, or both day and night, it wears them down. Although teeth grinding can be caused by stress and anxiety, it is more likely caused by an abnormal bite or missing or crooked teeth.

Your dentist may suggest wearing a mouth guard for teeth grinding at night. Custom models made by your dentist cost more than over-the-counter ones, but they generally fit better and work better, too. Sometimes, it helps simply to be aware that you are grinding your teeth. If it is caused by stress, consider an exercise program or counseling.

You may also want to try cutting back on foods and drinks that contain caffeine; reduce or avoid alcohol consumption; don’t chew on pencils or anything else that isn’t food; if you notice that you clench or grind your teeth during the day, position the tip of your tongue between your teeth to train your jaw muscles to relax; and, relax your jaw muscles at night by holding a warm washcloth against your cheek, in front of the earlobe.

Dental Care Problem 4: Using a Hard-Bristled Toothbrush

Some people think the firmer the toothbrush, the better. This isn’t so, especially for older adults. With age, the gums push back and the roots of the teeth become exposed, often increasing sensitivity. The root is covered with cementum, which is worn away more easily than enamel. A brush with too-firm bristles may irritate the gums and lead to sensitive teeth.

Ask your dentist or hygienist what toothbrush might be best to maintain your dental health.

Dental Care Problem 5: Not Brushing, Flossing, or Rinsing Properly

Some people brush, floss, and rinse their teeth regularly, but not often enough. You should aim to brush twice a day, and be sure to replace your manual toothbrush or electric toothbrush head every three or four months.

Flossing teeth should be done daily, too. If you aren’t sure if you floss properly — and dentists say many people aren’t — ask your dentist or your hygienist for a demonstration on your next visit.

Antiseptic rinses help get rid of bacteria that cause gum disease and bad breath. Fluoride rinses help prevent tooth decay. Dentists recommend rinsing once or twice a day.

You may find a powered toothbrush better, especially if you have hand, arm, or shoulder problems that make manual brushing difficult. If you have children, be sure to buy them child-sized brushes so they fit their hands and mouth, and are easier to use.

Dr. Krape Cosmetic and Specialized Dentistry of Jupiter can determine and may suggest additional remedies that can protect your teeth and gums from further damage. Always be sure to schedule routine cleaning and exams that can prevent conditions that may become irreversible.

Serving: Jupiter, Tequesta, Palm Beach Gardens, Juno Beach, North Palm Beach, Florida and surrounding areas.

Published by: http://www.webmd.com/oral-health/do-you-have-these-5-bad-dental-habits