Our Blog

In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. Michelle Slezewski and Dr. Paul Engibous suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our Anchorage, AK office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

Creating good dental hygiene habits early in your child’s life is essential to the health of his or her teeth, even when your infant doesn’t have any. By starting now, you can set the foundation for your son or daughter’s oral health later on in life.

When do I start?

The best time to begin brushing your baby’s teeth is before that first tooth ever comes in. Wipe your little one’s gums gently with a soft washcloth soaked in warm water every day. Not only will this help to get rid of bacteria in the mouth, but it will also familiarize your child with a daily brushing routine.

What do I use?

When your child’s teeth begin to emerge, it’s time to switch to a baby toothbrush. Select one with a big grip for your hand and a small head that’s easy to maneuver in your baby’s mouth.

Your little one won’t need toothpaste until he or she is about a year old; and even then, only a small amount is necessary. Apply an amount the size of a grain of rice and move to a pea-sized amount when your infant is about two years old.

By around six years, your child will probably rinse and spit without your help. At this time, you may introduce a child-friendly fluoride mouthwash.

How do I do it?

Until about age five or six, it’s likely your child will still need your help with brushing teeth. Gently scrub over all the teeth and gums, even where teeth have yet to come in. It may be helpful to explain what you are doing and how you are doing it, so your toddler can learn to brush her or his teeth alone.

Paired with regular visits with Dr. Michelle Slezewski and Dr. Paul Engibous at our Anchorage, AK office, proper hygiene habits instilled in your child early on will set up a good foundation for a healthy mouth in the future.

When working out, studying late, or any time we feel like a bit of a boost would come in handy, energy drinks are a common go-to for many teens and adults. Energy drinks promise more focus and vitality, all wrapped up in clever names and eye-catching graphic designs. What they can’t promise, though, is a drink that’s good for your dental health.

Why? Because most energy drinks come with a high concentration of caffeine, acids, and/or sugar.

• Caffeine Consequences

Before we talk about your dental health, a word about caffeine. Too much caffeine in a short period can leave us jittery, anxious, irritable, and sleepless. A cup of coffee has about 100 mg of caffeine, and some energy drinks have three to four times that much.

While the recommended daily limit for adults who aren’t pregnant is 400 mg of caffeine, doctors suggest a much lower limit for children and teenagers. Among other reasons, sleep is especially important for developing brains and bodies, and caffeine interferes with healthy sleep.

You might have to go online to find out how various energy drinks measure up and compare in terms of caffeine, but taking the time to check them out is well worth it. Now, back to your dental health!

• Acid Attacks

Many energy drinks are very acidic. The tart flavors of energy drinks might please your palate, but they attack your enamel.

Our mouths are their healthiest when our saliva is neutral, balanced between acidic and basic on the pH scale. That’s somewhere around a 7 on a scale of 0-14, where lower numbers mean more acidic conditions. That burning feeling we get from acid reflux when stomach acids back up? That’s because stomach acid is a 1-2 on the pH scale.  Many energy drinks rate an eye-opening (and not in an energetic way!) 1.5-3.5 on the pH scale, which means your teeth are bathing in acids.

Even tooth enamel, the strongest substance in the body, can’t stand up to these acids, because acids break down the mineral structure of your enamel. If your teeth are more sensitive to heat and cold, if they appear darker as the white outer layer of enamel thins, if your dentist has discovered weak spots in your enamel—you might be experiencing demineralization. Once enamel is gone, it can’t be replaced.

• Surplus Sugar

A well-known source of quick energy is sugar. A little more biology and chemistry here—sugar is a food which our bodies can break down quickly. And when sugar molecules break down, this breakdown releases energy—energy which we use to fuel essential bodily functions. This quick burst of sugar energy is why many energy drinks contain lots of added sugar. Some brands have more than 60 grams of sugar per serving—and 60 grams is almost 5 tablespoons!

We get all the sugar we require for our daily energy needs from the natural sugars found in fruits, dairy, even some vegetables and grains. With added sugars, we’re just adding empty calories, affecting the balance of our blood sugar and hormones, and increasing the risk of chronic health conditions—all while providing a convenient food source for the bacteria in plaque.

Because, just like our bodies find it easy to convert sugar to energy, the oral bacteria which cause cavities find it easy to convert sugar to acids. And just like the acids in foods, these acids attack the tooth’s mineral structure and break down its strength. Eventually, the weak spots in enamel grow larger and deeper and become cavities.

While most labels don’t let you know how much caffeine you’re getting, or the pH of the liquid inside, you can see how much sugar is being added to your diet with every can or bottle. Do look for added sugars before you choose your beverages.

If you have several energy drinks a day, a soft drink or two, plus the occasional sports drink—you’re bathing your teeth in acids and sugar all day long. With any beverage high in sugars and acids, limit your consumption. Rinse with water afterward, and don’t brush for about an hour to give your enamel time to remineralize after being exposed to the acids in your drink.

Better yet, choose healthier alternatives. Water is still the best way to hydrate. Try adding protein and carbs to your diet for more energy. Make sure you’re getting the vitamins you need with a balanced diet. If you see signs of enamel erosion, talk to Dr. Michelle Slezewski and Dr. Paul Engibous. The temporary boost you get from a bottle of caffeine, acids, and sugar might seem tempting, but it can have long-lasting consequences for your dental health!

Over the past decade, most people have been ingesting less and less fluoride. This is not such a great trend, since fluoride has a history of successfully reducing tooth decay and promoting good dental health. Most of us drink bottled water now, so many children and adults are not getting the optimum amount of fluoride they need. Of course, dental needs vary, depending on such factors as age, tooth sensitivity, medical conditions, and risk for cavities, but there are several ways to make sure you get the proper amount of fluoride.

Fluoride can be applied in the form of foam, varnish, or mouthwash. For children, topical fluoride can be useful in the early stages of development to ensure the future strength of enamel. For people who have a dry mouth as the result of medication to treat anxiety, diabetes, high blood pressure, depression, or high cholesterol, a daily fluoride rinse is recommended, as well as a varnish treatment. 

If you’ve received or are receiving any form of cancer treatment, that could be affecting your dental health. If such is the case, fluoride varnish treatments are recommended prior to, during, and after chemotherapy. Getting an oral infection during cancer treatment can be especially harmful, so it’s worthwhile to do as much as you can to prevent that.

If you suspect you might be in need of a fluoride treatment or have any questions about the treatments Pediatric Dental Associates offers, please feel free to give our Anchorage, AK office a call!