Tag: dental health

Dental care procedures, such as teeth cleanings, inserting a crown, or performing a root canal, can occasionally result in bleeding of the gums. While bleeding is always minimized, some bleeding is unavoidable in dental procedures. There are typically no long-term effects nor high risks associated with slight gum bleeding. 

However, in general, a person can bleed more while taking blood-thinning medications. Therefore, patients who are on blood thinners should inform our dental team prior to undergoing any dental care. 

What Are Blood Thinners? Anticoagulants and Antiplatelets Explained. 

Antiplatelet and anticoagulant medications, colloquially referred to as blood thinners, are important medications that can help reduce the chance of blood clots in a high-risk patient. Anticoagulant medications act upon blood cells by slowing down or preventing the process of blood cells forming clots, known as coagulation. This “thins” out the blood, making it flow more easily through the veins, and subsequently, making it flow more quickly and easily out of an open wound. 

These blood thinners can often be prescribed to someone who has coronary artery disease (CAD), a congenital heart defect (CHD), a history of clots, a history of deep vein thrombosis (DVT), a history of pulmonary embolism (PE), or a history of cerebrovascular accident (CVA), also known as stroke.

Occasionally, blood thinners are prescribed after surgery to prevent post-surgical clots. Blood thinners are typically halted or discontinued prior to surgery to prevent bleeds during surgery. 

Because these are serious medical conditions, most patients who are prescribed blood thinners are aware of the reason for their medications. Some patients who deal with polypharmacy are not aware of every medication function, and therefore, should get a list of current medications from their healthcare provider before seeking dental care.

Antiplatelet medications work specifically to stop platelet blood cells, which do most of the binding together in coagulation, from clumping together. 

Anticoagulants:

• Warfarin (Coumadin)
• Heparin (Hep-Lock)
• Enoxaparin (Lovenox)
• Dabigatran (Pradaxa)
• Rivaroxaban (Xarelto)
• Apixaban (Eliquis)
• Edoxaban (Savaysa)

Antiplatelets: 

• Aspirin 
• Clopidogrel (Plavix)
• Ticlopidine (Ticlid)
• Prasugrel (Effient)
• Ticagrelor (Brilinta)
• Dipyridamole (Persantine) 

Non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil or ibuprofen can also cause blood thinning, although not always. Furthermore, NSAIDs are typically not taken on a daily basis, like anticoagulants and antiplatelets.

What to Know About Dental Care on Blood Thinners

If you are only taking blood thinners (anticoagulants, antiplatelets, NSAIDs) for a temporary condition or finite amount of time, such as use for one week after surgery, then the smartest decision usually is to postpone dental care if possible until after the cessation of using blood thinners. 

However, dental care can be done safely when on blood thinners. If you are taking blood thinners daily or indefinitely,  stopping the use of blood thinners is generally not feasible. In fact, there can be more risk in stopping the use of blood thinners for patients who need them (which can lead to the aforementioned medical conditions, like clots, stroke, or heart attacks in at-risk patients) than with dental care with blood thinners.

Dental prophylaxis, or teeth cleaning, is a common dental procedure that dentists can most likely provide while a patient is on blood thinners. While bleeding can occur, there are many techniques in dental care to staunch or slow bleeding. One example is the use of gauze to staunch bleeds. Furthermore, the practice of minimally invasive dental techniques, suctioning and hemostatic devices, and even simply biting down during certain parts of a procedure, can reduce bleeding.

As long as our dental team is fully informed about your medication use, they can come up with a safe dental care plan that specifically caters to your use of blood thinners. 

A thorough examination of medical history should include any current medications, medication or food allergies, medical conditions, genetic conditions, surgical history, major cardiac event history, dental history, dental surgery history, pregnancy status, alcohol or smoking or drug use, level of hydration, and labs such as clotting factor presence and Internalized Normal Ratio (INR) or Partial Thromboplastin Time (PTT). 

By assessing these factors, you can be most prepared and knowledgeable about your own health. If you do not know this medical history information, you can contact any prior physician’s office or your primary care physician to obtain a medical record. Labs can be obtained at standard lab testing facilities or at an urgent care, emergency room, or physician’s office, depending on the situation. 

Other dental procedures can often incorporate more bleeding than simple dental prophylaxis. 

Some examples of these dental procedures are:

• Root canals
• Scaling and deep teeth cleaning
• Dental crown placement
• Tooth extraction or removal
• Gum surgery
• Biopsies of teeth or gum tissue
• Wisdom teeth removal  

If you’re taking blood thinners on a long-term basis, then you should inform our dental team, physician, and any specialists to identify the best course of action for upcoming dental procedures. This will be a unique decision from patient to patient. 

Sometimes, the best way to protect oneself is through thorough communication and support from professionals. That is why it is important to consult with our dental team and your prescribing physicians about blood thinners prior to dental care.

Moving Forward: Care for Oral Bleeding 

So what if you are on blood thinners and have oral bleeding after dental care?

Oral bleeding after dental care may occur after a procedure, but it is usually well-controlled and short-lived. Some simple bleeding might last for around 30 minutes after surgery, but it can be controlled through the use of gauze. Drinking cold or room-temperature fluids from a cup is recommended. 

Some behaviors to avoid limiting oral bleeding after dental care:

• Excessive spitting or rinsing out the mouth
• Smoking
• Drinking hot beverages
• Eating sharp foods like chips, popcorn, or nuts
• Using a straw, which might irritate or poke gums (unless a straw is needed to prevent choking)

If you have bleeding from your gums or mouth for several hours in a row, and it is constant and non-staunchable with gauze, you should call your doctor. Alternatively, if you feel worried about the amount of blood loss you’ve experienced, you can go to an emergency care facility. Although this is highly unlikely in a patient who is on blood thinners, if you are experiencing large blood clots coming from the mouth, you should seek emergency care as well. 

Most people can obtain safe, healthy, and beneficial dental care while on blood thinners. Dental health is connected to heart health and happiness, so it’s important not to neglect dental care because of mild worry. This information is intended to help educate, empower, and inform all patients on blood thinners. 

For further questions about blood thinners and dental care, contact our dental team here at Lifetime Dental Health.

Most of us do it twice a day. Many of us do it at least once. You guessed it! Brush our teeth. And maybe floss. We all know how to do it, and that’s a good thing. But there’s more to a good oral hygiene regimen, regardless of how often you do it.

What is a Good Oral Hygiene Regimen?

There are four fundamental tasks for basic oral health, and you may already do them. Still, we can all use a refresher course on how to do those tasks as well as we can.

Step #1: Brushing
When? Preferably twice a day – when you wake up and when you go to bed. If you can’t do this, brush at least once every 24 hours. If you have breakfast prior to your first-of-the-day brush, wait to brush for 45-60 minutes, particularly if breakfast included orange juice or grapefruit. Acidic foods like these can loosen tooth enamel and brushing may damage your teeth.

Why? The #1 reason is to prevent cavities. Brushing removes plaque (a coating of bacteria) on your teeth which, if left to settle in, causes tooth decay. Just as important is that brushing also stimulates your gums. Gum disease does more than ruin your teeth. It can lead to major health problems, including stroke, heart disease, and diabetes.

How? Position your brush at a 45-degree angle to your teeth and gums and brush up and down on the front and back, and back and forth across the top. Brush for a minimum of two minutes. (You can buy electric toothbrushes that beep every 30 seconds, so you can brush each quarter of your teeth for the same length of time.) The American Dental Association recommends using a soft-bristled brush and an ADA-approved toothpaste.

Step #2: Flossing
When? Before you brush. And at least once a day. Whatever is in your mouth when you fall asleep has all night to do its damage, so flossing just before bedtime is the optimal time.

Why? Flossing loosens up the bits of food that are too small to see. The ones stuck between your teeth and under your gums. Flossing loosens plaque as well, and that will help your brushing do a better job.

How? You can use dental floss wrapped around your fingers or one of the easy-to-use floss picks (a plastic holder with a piece of floss attached). Slip the floss between your teeth and guide it gently up and down along the side of each tooth and down into the space between tooth and gum. Don’t forget those molars in the back!

Step #3: Rinsing
When? Every time you do Steps #1 and #2, also rinse with mouthwash. Pick a flavor you like (brand doesn’t matter) so you’ll be more likely to do it regularly.

Why? For the same reason you usually drink something after eating. Flossing and brushing are most important, but even done well, they can miss some things. Rinsing flushes out the last few bits of toothpaste and food. Not to mention that mouthwash makes your mouth feel – and taste – totally refreshed!

How? It’s simple! Fill the cap of the bottle with mouthwash and move the liquid around in your mouth for 30 seconds, then spit it out. Be sure to keep your lips closed while rinsing, so the mouthwash can do its job.

Step #4: Scraping
When? You needn’t do this after every time you floss, brush, and rinse, but it’s a good idea to make scraping your tongue a regular part of your routine. And it only takes a minute!

Why? Food, bacteria, and dead cells collect on your tongue when you eat or drink. And all that debris can dull your taste buds and lead to tooth decay. While it may seem that brushing would be effective for your tongue as well as your teeth, it isn’t. In fact, one study found that using a tongue scraper can significantly reduce the number of bacteria known to cause bad breath and tooth decay.

How? Use a tongue scraper. They’re designed specifically to clean the tongue. After flossing, brushing, and rinsing, look in the mirror and stick out your tongue. Lay the rounded edge of the scraper across the back of your tongue (or start in the middle if the back activates your gag reflex). Pull the scraper gently along your tongue from the back to the tip. Never push the scraper from the tip to the back! One or two scrapes should do the job.

How Can I Tell If my Hygiene Routine Is Working?
The first indication will be almost immediate – your mouth will feel fresh, clean, and healthy. Over time, you’ll notice other conditions – and the lack of some – that demonstrate your success.

• Your breath will smell fresh and your teeth will feel clean even when you first wake up
• Your gums will look pink and healthy, and they won’t bleed when you floss and brush
• Your mouth will flinch less when you eat or drink something hot or cold

What Else Do I Need to Know?
Here are a few extra guidelines for taking the best care of your mouth:

• Eat plenty of crunchy vegetables and fruit
• Limit food and drinks that are sugary or acidic
• Drink plenty of water, and never chew ice
• Keep your toothbrush clean and get a new one often
• Don’t use tobacco

Of course, some problems and conditions can’t be seen in your bathroom mirror. So, it’s important to see us at least twice a year for a checkup and a thorough cleaning. We encourage you to contact us or make an appointment online. Your mouth will thank you!

Many of today’s adults share common memories from childhood. Sunday drives, visits to grandma and grandpa, trips to the local playground or the city zoo, and hearing the iconic phrase – do as I say, not as I do – over and over again. Why? Because children are natural mimics and will do exactly what Mom and Dad do, no matter what it is. Of course, some of the things children mimic are things they shouldn’t do. But there is one daily habit parents can be proud of modeling for their children: Good oral hygiene.

Is Good Oral Hygiene Different for Children?

While many healthful habits are different for children than for adults, taking care of teeth is almost exactly the same: floss and brush daily, avoid certain foods and drinks, see your dentist regularly. Simple, right? Right. And easy to follow. For adults and motivated teenagers.

But for younger children, especially babies and toddlers, it’s a hard act to mimic. Nearly one in every five children between the ages of 5 and 11 has untreated tooth decay. Even baby teeth (now called primary teeth) can get cavities! And if cavities in primary teeth aren’t treated, permanent teeth could be negatively affected. Untreated tooth decay, even in early childhood, can lead to other dental and medical problems in adult life. Of course, all of those primary teeth will disappear eventually, but by the time that starts – when your child is around six years old — the damage from tooth decay will have already happened.

My Child Is Still a Baby. How Soon Should I Start?

Caring for your child’s teeth should start as soon as they come home from the hospital. It’s up to you to teach good oral hygiene habits, and here’s how to start:

• Until your baby is about a year old, simply wipe their teeth with a soft, damp washcloth after the morning feeding and right before bedtime. This washes away bacteria and sugars that can cause tooth decay.
• Never, ever let your baby fall asleep with a bottle. (As harmless as it may seem, this simple activity often generates tooth decay.) When teeth start coming in, usually around a child’s first birthday, begin using a soft child-size toothbrush and plain water.
• When your child reaches toddler age, you can add a small dab of a non-fluoride toothpaste (non-fluoride toothpaste is safe to swallow).
• As soon as your child is old enough to spit out the toothpaste, switch to one that has fluoride in order to give your child the extra protection fluoride provides.
• You should introduce flossing — and demonstrate it — when your child starts brushing their teeth on the own. (Hint: the floss that comes on a plastic holder is easier for children.)
• According to the Centers for Disease Control and Prevention, your child’s first visit to a dentist should take place before his or her first birthday.

How Can I Make Good Oral Hygiene Habits Appealing?

Children get bored easily, we know, and caring for their teeth may not be as exciting as other things they could do. But children will understand caring for their teeth if you tell them (as one 5-year-old declared): “Plaque makes your teeth dirty, and you have to wash them.” It’s up to you, as a parent, to help make it interesting enough — even fun! — that they will establish a solid habit. Good oral hygiene habits will serve them well throughout their life. And they will look to Mom and Dad to learn what to do.

One of the most successful ways to instill oral health habits in your children is to make establishing those habits as much fun as the other things they enjoy. You know your children best, so you probably already have an idea of what will work. But just in case you’d like some fresh ideas:

• Let your child choose their own toothbrush – their favorite color or a cartoon character they love. Just make sure the one they choose is a good size for their hand and has soft bristles.
• If they want to, let them choose their own toothpaste, as well. They may not want the mint you like, but some companies have toothpaste with flavors like strawberry or watermelon.
• Set up a system to reward your child for good oral care with something they’ll appreciate, such as staying up a little longer, watching a favorite movie, or being read a special story.
• Avoid sugary treats or drinks as rewards, though. (This kind of defeats the purpose.)
• Find a song your child likes and record exactly two minutes of it. Then play that two minutes when it’s time to brush. The American Dental Association advocates two minutes of brushing twice a day for both children and adults.
• Best of all, let your child see you brushing your teeth correctly…and enjoying it. When children are young, anything Mom and Dad does is something they want to do, too, including brushing their teeth.

What if I Need a Bit of Help?

Come on in, and bring your child! At Lifetime Dental Health, we’ll be happy to discuss how best to handle your child’s at-home dental hygiene. We’ll explain ways to maintain your children’s teeth that are similar to how you take care of your own and explain anything you need to know based on the specific condition of your child’s teeth. In addition to setting the stage for healthy adult teeth, introducing children to dental care as early as possible can go a long way toward eliminating the fear some children experience when their first time in a dental chair includes lots of uncomfortable scraping and the scary sound of a dental drill.

To talk to one of our dental professionals or to make your first appointment, contact us. We’ll be happy to serve you and your little ones.