Posts for category: Oral Health

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
December 09, 2018
Category: Oral Health
Tags: osteoporosis  
ManageYourOsteoporosisMedicationtoAvoidJawboneProblems

Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.

Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.

Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax™, and denosumab or Prolia™. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.

In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.

The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.

Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.

Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.

If you would like more information on the effect of osteoporosis treatment on dental 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 article “Osteoporosis Drugs & Dental Treatment.”

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
November 19, 2018
Category: Oral Health
BeyonceMakesFlossingaFamilyAffair

As is the case with most celebs today, Beyonce is no stranger to sharing on social media… but she really got our attention with a video she recently posted on instagram. The clip shows the superstar songstress — along with her adorable three-year old daughter Blue Ivy — flossing their teeth! In the background, a vocalist (sounding remarkably like her husband Jay-Z) repeats the phrase “flossin’…flossin’…” as mom and daughter appear to take care of their dental hygiene in time with the beat: https://instagram.com/p/073CF1vw07/?taken-by=beyonce

We’re happy that this clip highlights the importance of helping kids get an early start on good oral hygiene. And, according to authorities like the American Dental Association and the American Academy of Pediatric Dentistry, age 3 is about the right time for kids to begin getting involved in the care of their own teeth.

Of course, parents should start paying attention to their kids’ oral hygiene long before age three. In fact, as soon as baby’s tiny teeth make their first appearance, the teeth and gums can be cleaned with a soft brush or cloth and a smear of fluoride toothpaste, about the size of a grain of rice. Around age 3, kids will develop the ability to spit out toothpaste. That’s when you can increase the amount of toothpaste a little, and start explaining to them how you clean all around the teeth on the top and bottom of the mouth. Depending on your child’s dexterity, age 3 might be a good time to let them have a try at brushing by themselves.

Ready to help your kids take the first steps to a lifetime of good dental checkups? Place a pea-sized dab of fluoride toothpaste on a soft-bristled brush, and gently guide them as they clean in front, in back, on all surfaces of each tooth. At first, it’s a good idea to take turns brushing. That way, you can be sure they’re learning the right techniques and keeping their teeth plaque-free, while making the experience challenging and fun.

Most kids will need parental supervision and help with brushing until around age 6. As they develop better hand-eye coordination and the ability to follow through with the cleaning regimen, they can be left on their own more. But even the best may need some “brushing up” on their tooth-cleaning techniques from time to time.

What about flossing? While it’s an essential part of good oral hygiene, it does take a little more dexterity to do it properly. Flossing the gaps between teeth should be started when the teeth begin growing close to one another. Depending on how a child’s teeth are spaced, perhaps only the back ones will need to be flossed at first. Even after they learn to brush, kids may still need help flossing — but a floss holder (like the one Beyonce is using in the clip) can make the job a lot easier.

If you would like more information about maintaining your children’s oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
November 09, 2018
Category: Oral Health
Tags: tmj disorders  
TMDandFibromyalgiaCouldShareLinksinChronicPain

Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.

To understand why this is, let’s take a closer look at these two conditions.

Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.

Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.

Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.

Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.

In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.

If you would like more information on managing TMD or fibromyalgia, 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 “Fibromyalgia and Temporomandibular Disorders.”

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
October 30, 2018
Category: Oral Health
Tags: oral hygiene  
WhatYouCanDotoSupportYourChildsDentalDevelopment

Your child’s teeth and gum development is truly a wonder. In just a little more than two decades they’ll gain and lose one set of teeth, while the subsequent permanent set will grow in coordination with other facial and oral structures. All of these structures will finally reach maturity sometime in early adulthood.

Sometimes, though, obstacles can arise: disease, trauma or even genetics can derail normal development and endanger future health. So although nature does most of the heavy lifting, there are things you should do to keep your child’s dental development on track.

For instance, begin oral hygiene practices before their first teeth come in. By wiping their gums after feeding with a clean damp cloth, you can help reduce the numbers of disease-causing bacteria in the mouth. Once teeth appear switch to brushing.

There are also habits to avoid. Don’t kiss your baby directly on the lips—you may transfer to them your own mouth bacteria, which their young immune system can’t yet adequately handle. Also, avoid putting them to bed with a sleep-time bottle filled with sugary fluids (including milk or formula) because the constant contact between the sugar and their teeth could increase their risk for tooth decay, the number one dental disease in young children.

Of course, not all prevention efforts depend on you alone—we’re your partner in helping to keep your child’s dental development progressing normally. We can provide preventive treatments like sealants or topical fluoride to reduce the risk of tooth decay, while continually monitoring for signs of the disease that may require treatment. We also look for signs of emerging bite problems that may require intervention before their effects worsen.

This is all part of regular dental visits, usually at six-month intervals, which are best begun around your child’s first birthday. Not only does this enable us to stay ahead of dental problems, it also helps your child become more comfortable with dental visits and increase the likelihood they’ll continue the habit in adulthood.

As we said, nature is responsible for most of this amazing development without any help from us. But we can assist development and hopefully prevent issues that could diminish their dental health in years to come.

If you would like more information on supporting your child’s dental development, please contact us or schedule an appointment for a consultation.

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
October 20, 2018
Category: Oral Health
Tags: oral health   pregnancy  
KeepupRegularDentalCareWhileYourePregnant

During pregnancy, your body isn’t the only part of your life that changes. Instead of “me,” you’re now thinking about “us”—you and the new person growing inside you. Because of this change in focus you may be re-examining your current habits to see if any could adversely affect your baby.

If you’re concerned your regular dental visits might be one of these, don’t be. Both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) recommend continuing regular dental exams and cleanings even during pregnancy.

In fact, professional dental care is often more important during pregnancy. Because of hormonal changes, you may develop food cravings for more carbohydrates like sugar. Unfortunately, eating more sugar could increase your risk for dental diseases like tooth decay and periodontal (gum) disease.

These same hormonal changes can also make you more prone to gum disease. There’s even a specific form of it known as pregnancy gingivitis that often occurs in expectant mothers. You may also experience “pregnancy tumors,” large, reddened areas of swelling on the gums.

To decrease your risk of pregnancy-related dental disease, you should certainly keep up your regular dental visits—and more if you begin to notice signs like swollen or bleeding gums. And although it’s usually best to postpone elective procedures like cosmetic dental work, you should be able to safely undergo any essential treatment for disease even if it requires local anesthesia. But do discuss any proposed dental work with both your dentist and obstetrician to be sure.

There are also things you can do for yourself during pregnancy that support your dental health. Be sure you’re practicing good oral hygiene habits like daily brushing and flossing. And by all means eat a well-balanced diet and restrict your sugar intake if at all possible. Taking care of these things will help you avoid dental problems and help make this memorable time in your life as joyous as possible.

If you would like more information on caring for your teeth during pregnancy, 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 “Dental Care During Pregnancy.”



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To contact us, please call our office at (973) 835-3900.

Dr David Kahn, DMD & Dr John Pergolizzi, DMD

(973) 835-3900
Dentist in Ringwood, NJ
Dr. David Kahn, DMD & Dr. John Pergolizzi, DMD
10 Greenwood Lake Tpke
Ringwood, NJ 07456
(973) 835-3900
(973) 835-4631 Fax

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