Posts for: November, 2014

By Rockdale Dental Associates
November 19, 2014
Category: Oral Health
Tags: medication  
NewGuidelinesIssuedforAdministeringAntibioticsBeforeaDentalProcedure

One of the possible side effects of dental work is the introduction of oral bacteria into the bloodstream, a condition known as bacteremia. Although not unusual — it can also occur when you eat or brush your teeth — bacteremia could trigger a dangerous infection for some patients.

For many years, we in the dental profession have taken extra precautions with two such categories of patients: those with congenital (“at birth”) heart conditions who are more susceptible to infective endocarditis, a life-threatening infection of the heart lining or heart valves; and patients who’ve undergone joint replacements and are at a higher risk of developing blood-borne infections at the replacement site. It’s been a standard practice for many years to administer antibiotics to patients in these two categories sometime before they undergo a dental procedure as a way of curtailing the effects of any resulting bacteremia.

Recently, however, the guidelines for antibiotic pretreatment for dental work have changed as two major medical associations have revised their recommendations on the procedure. The American Heart Association (AHA) now recommends dentists administer antibiotic pretreatment only to heart patients with a history of endocarditis, artificial valves or repairs with artificial material, heart transplants with abnormal heart valve function and other similar conditions.

Likewise after a series of joint studies with the American Dental Association on infections in dental patients with orthopedic implants, the American Academy of Orthopedic Surgeons no longer recommends pretreatment for artificial joint patients. It’s now left to the dentist and patient to determine whether antibiotics before a procedure is appropriate based on the patient’s medical history. For example, premedication may still be prudent for joint replacement patients with compromised immune systems caused by systemic illnesses like cancer or diabetes.

Although the guidelines have narrowed, it’s still important for you tell us about any heart condition you may have, or if you’ve undergone any type of joint replacement therapy. It’s also advisable for you to discuss with your primary doctor how your condition might be impacted by any proposed or scheduled dental procedure. Our aim is to always minimize any risk to your overall health as we treat your dental needs.

If you would like more information on antibiotic treatment before dental procedures, please contact us or schedule an appointment for a consultation.


By Rockdale Dental Associates
November 03, 2014
Category: Oral Health
KristinCavallariandtheMysteryoftheBathroomSink

While she was pregnant with her son Camden Jack Cutler, 25-year-old Kristin Cavallari noticed an odd occurrence in her bathroom sink: “Every time I floss, my sink looks like I murdered somebody!” the actress and reality-TV personality exclaimed. Should we be concerned that something wicked is going on with the star of Laguna Beach and The Hills?

Before you call in the authorities, ask a periodontist: He or she will tell you that there's actually no mystery here. What Cavallari noticed is, in fact, a fairly common symptom of “pregnancy gingivitis,” a condition that affects many expectant moms in the second to eighth month of pregnancy. But why does it occur at this time?

First — just the facts: You may already know that gingivitis is the medical name for an early stage of gum disease. Its symptoms may include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. Fundamentally, gum disease is caused by the buildup of harmful bacteria, or plaque, on the teeth at the gum line — but it's important to remember that, while hundreds of types of bacteria live in the mouth, only a few are harmful. A change in the environment inside the mouth — like inadequate oral hygiene, to use one example — can cause the harmful types to flourish.

But in this case, the culprit isn't necessarily poor hygiene — instead, blame it on the natural hormonal changes that take place in expectant moms. As levels of some female hormones (estrogen and/or progesterone) rise during pregnancy, changes occur in the blood vessels in the gums, which cause them to be more susceptible to the effects of bacterial toxins. The bacteria produce toxic chemicals, which in turn bring on the symptoms of gingivitis — including painful and inflamed gums that may bleed heavily when flossed.

Is pregnancy gingivits a cause for concern? Perhaps — but the condition is generally quite treatable. If you've noticed symptoms like Kristen's, the first thing you should do it consult our office. We can advise you on a variety of treatments designed to relieve the inflammation in your gums and prevent the harmful bacteria from proliferating. Of course, your oral health (and your overall health) are prime concerns during pregnancy — so don't hesitate to seek medical help if it's needed!

How did things work out with Kristen? She maintained an effective oral hygiene routine, delivered a healthy baby — and recently appeared on the cover of Dear Doctor magazine, as the winner of the “Best Celebrity Smile” contest for 2012. And looking at her smile, it's no mystery why she won.

If you would like more information about pregnancy gingivitis, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Expectant Mothers” and “Kristen Cavallari.”




Rockdale Dental Associates
Lisa M. Carvalho, DMD
499 Rockdale Ave
New Bedford, MA 02740
(508) 992-4608

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