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Old 09-15-2020, 09:12 AM
 
Location: Coastal Georgia
41,377 posts, read 51,214,306 times
Reputation: 71660

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Quote:
Originally Posted by Sand&Salt View Post
How nice to offer advice, Doc!

I have joint replacements. At the time of the surgery, the dentist said to let every dentist/doctor know I have artificial joints, due to the risk of infection heading straight to the joint.

Is this forever, or just for a limited time?
I have 2 knee replacements and my ortho doc said after two years I can stop the antibiotics.
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Old 09-15-2020, 09:36 AM
 
44 posts, read 33,871 times
Reputation: 126
Quote:
Originally Posted by brava4 View Post
I keep going back and forth about going to have my teeth cleaned. I was due in March. With the WHO saying not to go for non-emergency issues, I am wondering if they still holds. I'd really like to get my teeth cleaned but not interested in getting sick from such close proximity to others.

Go or not go? Thanks, and thanks for offering your expertise.

There is no straightforward answer to this as there are different things to consider. For one, your age and comorbidities such as diabetes and hypertension all play a factor. I would even go as far as saying your at home oral care is also important because if you haven't been taking care of your own teeth at home for months, then a stronger case could be made that you should go to the dentist. The office that you visit is also important. In my office, we have the highest infection control protocols. We all wear a KN95 mask, face shield, hair net, shoe shields, and 2 gowns. We also follow CDC guidelines and sanitize the office every 30 minutes and we use air purifiers with HEPA filters and only use operatories/rooms with doors for treatment. Most offices cannot or do not want to go through all this trouble. Finally, the area that you live in may have already stabilized in Covid new cases and deaths. For example, in New York, they are averaging around 5 deaths a day for several months now (which is horrible but relatively low), while in California we were averaging around 100 deaths a day but it is coming down now.

So to answer your question, it depends on your health, at home care, the office that you visit, and where you live. Personal comfort is also important. For emergency/pain reasons, I would definitely tell you to visit the dentist. For cleanings, that's more up to you.
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Old 09-15-2020, 09:56 AM
 
44 posts, read 33,871 times
Reputation: 126
Quote:
Originally Posted by Forever Blue View Post
Hi Dr. S & thanks a lot for helping. Yes, trying my best to stay home more due to COVID. If you can please answer these questions, I'd greatly appreciate it:

1) What can a person do at home themselves if they know they have a cavity? My 82-yr old mother has one, but it's not bothering her yet. She's been trying to chew her food on the opposite side from the cavity so as not to aggravate it. She rinses her mouth w/ water to cut down on build-up, etc.

2) I bought a little "dental cleaning kit" that they sell at Target w/ the picks & round mirror because I'm sure a teeth cleaning's needed by now, but it's not bad. I'm trying to do the tedious work of scraping out the built-on tarter between certain teeth. Is there something (preferably all-natural) I can use/buy that dissolves or at least softens tarter? Anything else I can do so the build-up doesn't get so severe?

3) Re: upper implants, if a person needs it for the entire upper, is it in a U-shape OR does there have to be that plate part that covers the whole roof of the mouth too? (Hopefully, it's not the latter since it's snap-on procedure.)

Hello

1) There aren't many thing that can be done at home for a large cavity that has already been formed besides doing a filling. A visit with a dentist is important, particularly if she is in pain. In the mean time, rinsing with water helps, but rinsing with a mouthwash that contains fluoride would be better. If there is a hole in the tooth and for some reason a visit to the dentist is out of the question, then getting an over the counter temporary filling material may help her out. It's not perfect, but it could buy her some time.

2) Tartar or calculus build up is a tough cookie. To my knowledge, there is nothing that really "dissolves or softens" tartar. One product that comes to mind though is the Perio Restore or Perio Daily Defense. With this, your dentist would make a tray that fits your specific mouth. Then you would place a thin amount of a hydrogen peroxide gel inside the tray. When you wear the tray, the gel is supposed to go underneath your gums and essentially kill the bacteria that typically become tartar.

With that said, your best bet is to get a good cleaning, ideally by a dentist or a hygienist, then buy yourself a good electric toothbrush (oral-b and sonicare make great ones). You would want one that doesn't use AA or AAA batteries but ones you plug in to the wall. After a good cleaning, it's much easier to prevent tartar from building up if you brush every day.

3) If i'm understanding you correctly I think you are talking about implant overdentures. For implant overdentures, one big benefit is that it is U-shaped and it doesn't cover your palate/roof of your mouth.

Hope that helps!

-Dr. S
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Old 09-15-2020, 10:09 AM
 
44 posts, read 33,871 times
Reputation: 126
Quote:
Originally Posted by BijouBaby View Post
I have a question about dental procedures following a joint replacement. I hear differing opinions from orthopedic surgeons. One I talked to said antibiotics were only required for a dental procedure for the first 2 years following a joint replacement, while another told me he recommends taking antibiotics prior to any dental procedure (esp. a cleaning) for the rest of my life. While my Orthodontist said that he thinks antibiotics prior to dental work isn't necessary, and my dentist said he'd do it if I asked for it, but was also on the fence about it. My research revealed that the ADA's most recent stance is that antibiotics are not necessary for dental work following a joint replacement, whereas the AOA still recommends the use of prophylactic antibiotics. This is very confusing for the patient.

What is your stance on prophylactic antibiotics for dental work for patients with joint replacements?

This is a great question, and you are definitely not alone in your confusion. To add to the confusion, many years ago, the ADA was recommending antibiotics for almost all joint replacements. You are correct that the ADA currently does not recommend prophylactic antibiotic for most patients with joint replacements. I'm sure you have read this but below is what the ADA says.

"The new CSA guideline clearly states that for most patients, prophylactic antibiotics are not indicated before dental procedures to prevent [prosthetic joint infections]. The new guideline also takes into consideration that patients who have previous medical conditions or complications associated with their joint replacement surgery may have specific needs calling for premedication. In medically compromised patients who are undergoing dental procedures that include gingival manipulation or mucosal inclusion, prophylactic antibiotics should be considered only after consultation with the patient and orthopedic surgeon. For patients with serious health conditions, such as immunocompromising diseases, it may be appropriate for the orthopedic surgeon to recommend an antibiotic regimen when medically indicated, as footnoted in the new chair-side guide."

The way I personally work is that if my patient had more significant joint replacements and other serious health conditions, I typically ask for a medical release to be filled out by the patient's orthopedic surgeon. If the patient already knows that they need to be taking prophylactic antibiotics, I explain to them the ADA stance on it, but certainly comply with their request or orthopedic surgeon request. Dentists and orthopedic surgeons need to have mutual respect and it ends up working out nicely for the patient.
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Old 09-15-2020, 10:12 AM
 
44 posts, read 33,871 times
Reputation: 126
Quote:
Originally Posted by Sand&Salt View Post
How nice to offer advice, Doc!

I have joint replacements. At the time of the surgery, the dentist said to let every dentist/doctor know I have artificial joints, due to the risk of infection heading straight to the joint.

Is this forever, or just for a limited time?
Hello,

You can read my previous answer. Based of trends over the past few decades, I foresee that eventually dentists will not recommend prophylactic antibiotics for any joint replacement patients. Time will tell.

-Dr. S
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Old 09-15-2020, 10:16 AM
 
44 posts, read 33,871 times
Reputation: 126
Quote:
Originally Posted by somil34 View Post
I lost my four tooth in accedent and i feel very bad for that can you suugest me what i do ,i feel my dispoint

Hello.

There are many things that can be done these days. I would definitely recommend that you see a dentist. You could get implants, you can get a partial, or you can get a stayplate. These are just a few options that you can talk to your dentist about. I very often see patients who have been in accidents and were too embarrassed to even smile. They feel much better after they replace their teeth. If money is a problem, then you can go to a dental school or a community health clinic. I hope you go and take care of yourself.

- Dr. S
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Old 09-21-2020, 06:43 AM
 
764 posts, read 251,973 times
Reputation: 1219
OK, here's one. Age 70, still has most natural teeth, no particular issues. Is it good or bad to give teeth an occasional workout, like with hard crusty bread, pork rinds. Is it better to give old teeth plenty of exercise, or rest them with softer food?
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Old 09-21-2020, 06:51 AM
 
Location: Southern California
9,096 posts, read 10,261,174 times
Reputation: 10178
Quote:
Originally Posted by Forever Blue View Post
Hi Dr. S & thanks a lot for helping. Yes, trying my best to stay home more due to COVID. If you can please answer these questions, I'd greatly appreciate it:

1) What can a person do at home themselves if they know they have a cavity? My 82-yr old mother has one, but it's not bothering her yet. She's been trying to chew her food on the opposite side from the cavity so as not to aggravate it. She rinses her mouth w/ water to cut down on build-up, etc.

2) I bought a little "dental cleaning kit" that they sell at Target w/ the picks & round mirror because I'm sure a teeth cleaning's needed by now, but it's not bad. I'm trying to do the tedious work of scraping out the built-on tarter between certain teeth. Is there something (preferably all-natural) I can use/buy that dissolves or at least softens tarter? Anything else I can do so the build-up doesn't get so severe?

3) Re: upper implants, if a person needs it for the entire upper, is it in a U-shape OR does there have to be that plate part that covers the whole roof of the mouth too? (Hopefully, it's not the latter since it's snap-on procedure.)
Quote:
Originally Posted by stresslessdds View Post
Hello

1) There aren't many thing that can be done at home for a large cavity that has already been formed besides doing a filling. A visit with a dentist is important, particularly if she is in pain. In the mean time, rinsing with water helps, but rinsing with a mouthwash that contains fluoride would be better. If there is a hole in the tooth and for some reason a visit to the dentist is out of the question, then getting an over the counter temporary filling material may help her out. It's not perfect, but it could buy her some time.

2) Tartar or calculus build up is a tough cookie. To my knowledge, there is nothing that really "dissolves or softens" tartar. One product that comes to mind though is the Perio Restore or Perio Daily Defense. With this, your dentist would make a tray that fits your specific mouth. Then you would place a thin amount of a hydrogen peroxide gel inside the tray. When you wear the tray, the gel is supposed to go underneath your gums and essentially kill the bacteria that typically become tartar.

With that said, your best bet is to get a good cleaning, ideally by a dentist or a hygienist, then buy yourself a good electric toothbrush (oral-b and sonicare make great ones). You would want one that doesn't use AA or AAA batteries but ones you plug in to the wall. After a good cleaning, it's much easier to prevent tartar from building up if you brush every day.

3) If i'm understanding you correctly I think you are talking about implant overdentures. For implant overdentures, one big benefit is that it is U-shaped and it doesn't cover your palate/roof of your mouth.

Hope that helps!

-Dr. S

Thanks a lot, Dr. S for answering! So regarding what you said for answer #2, sounds like I'd have to go see a dentist for that , which is the main thing I'm trying to avoid.

If I have any more questions, I'll let you know.
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Old 09-21-2020, 11:23 PM
 
1,583 posts, read 2,151,038 times
Reputation: 2471
Quote:
Originally Posted by SanyBelle View Post
The code was D7210, zip code 32935. I paid $319. I had to pay an additional $138 for D0180.

The crows only say Porcelain Bridge Abutment 06740 and Porcelain Bridge Pontic 06245.

It's crowns. Kinda like HIPAA.
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Old 09-23-2020, 12:09 PM
 
2,291 posts, read 1,150,142 times
Reputation: 4126
Quote:
Originally Posted by toofache32 View Post
It's crowns. Kinda like HIPAA.
haha I must have been watching an Alfred Hitchcock movie when I was posting!
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