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Dentist in Orlando, FL
Marcia Martinez, D.M.D.
5180 Curry Ford Road
Orlando, FL 32812
(407) 273-6620
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Posts for: October, 2015

By Marcia Martinez, D.M.D.
October 26, 2015
Category: Oral Health
Tags: oral health   medications  
DoYouNeedAntibioticsBeforeHavingaDentalProcedure

Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.

First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.

At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:

  • An artificial heart valve, or a heart valve repaired with artificial material
  • A history of endocarditis
  • A heart transplant with abnormal heart valve function
  • Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
  • A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
  • Repaired congenital heart disease with residual defects, such as leakage or abnormal flow

In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.

The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.

If you have questions about premedication before dental treatment, please contact us or schedule an appointment for a consultation.


By Marcia Martinez, D.M.D.
October 25, 2015
Category: Dental Procedures
Tags: dental implants  
KnowtheRisksandBenefitsforSame-DayToothReplacement

While there’s usually a period of months between implant placement and the permanent crown, a new technique known as same-day tooth replacement installs both the implant and a temporary crown during the same visit. But be advised — it does have its risks and isn’t for everyone.

Successful same-day replacements require special attention during the three phases for implants: the removal (extraction) of the existing tooth; placement of the implant in the bone; and attachment of the crown, the visible tooth, to the implant. The tooth extraction lays the foundation for the entire process; the extraction procedure must be performed carefully to avoid undue damage to the socket. In addition, if infection or disease has compromised the site, an implant may not be possible immediately.

The implant must then be placed in the bone so that it’s stable and immovable. All implants stabilize with time as the bone grows and adheres to them, but we need greater stability for a same-day tooth replacement when an extraction is performed.

Our last consideration is positioning the implant so that the attached crown blends in naturally with the surrounding gum tissue and adjacent teeth. We must place it at the proper depth below the gum tissues so that the crown appears to emerge from them in the proper tooth length.

Taking extra care during all these phases, including the angle of crown attachment, will increase our chances of success. We still run a risk of implant damage or failure, however, from biting forces before the implant fully integrates with the bone. This means avoiding chewy foods and other situations that might increase the force on the implant. We may also use a temporary crown that’s slightly shorter than adjacent teeth so it won’t make full contact with the opposing tooth.

If you’d like to know if you’re a good candidate for a same-day tooth replacement, see us for a detailed examination. After reviewing your needs, we’ll be able to discuss with you the risks and benefits for a new look in one day.

If you would like more information on same-day tooth replacement, 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 “Same-Day Tooth Replacement with Dental Implants.”


By Marcia Martinez, D.M.D.
October 17, 2015
Category: Dental Procedures
Tags: root canal  
SurveySaysTheydRatherHaveaRootCanal

Which would you rather have — the flu or a root canal procedure? Nearly 80 percent of people recently surveyed by the American Association of Endodontists wisely chose the root canal. If this takes you by surprise, then let us bring you up to date on root canal treatment today. It’s nothing like the experience that once made it the butt of jokes and a benchmark against which other “undesirable” experiences were measured.

The term “root canal” actually has two meanings. It is part of the pulp-filled chamber at the center of every tooth containing nerves and blood vessels that keeps teeth vital (alive). It’s also the endodontic (endo  = inside; dont = tooth) procedure that treats inflammation and infection in this tissue. Common causes of pulp problems are traumatic damage (for example a crack, chip, or root fracture), deep decay, or gum disease.

The first sign of a problem is typically pain — ranging from acute and intense pangs when biting down, to lingering discomfort after consuming hot or cold foods, to a chronic dull ache and pressure, or tenderness and swelling in nearby gums. The primary pain may abate as the nerves in the pulp die, but the infection will continue, compromising the affected tooth, jeopardizing the health of the surrounding tissues, and often triggering secondary pain.

Pain-Relieving, Tooth-Saving Treatment
Endodontic treatment, by contrast, is no more uncomfortable than having a cavity filled. The tooth and surrounding area are numbed with a local anesthetic before the procedure begins. In order to access the diseased pulp, a small opening is made in the biting surface of the tooth. Tiny instruments are used to remove the pulp, clean and disinfect the root canal(s) and pulp chamber, and prepare the empty tooth interior to receive a biocompatible filling material to prevent bacteria from returning. A permanent crown may be placed over the tooth at that time, or a second visit may be needed. A crown (cap) is important to the tooth's long-term strength and functionality.

For a day or two following treatment you may experience temporary sensitivity, which often responds to an over-the-counter medication like ibuprofen. Occasionally, prescription medications, including antibiotics, may be needed.

All in all, doesn’t saving a tooth sound easier and more constructive than coming down with the flu?

If you would like more information about root canal treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “A Step-By-Step Guide To Root Canal Treatment.”


By Marcia Martinez, D.M.D.
October 09, 2015
Category: Oral Health
Tags: oral health   sleep apnea   snoring  
YourDentistcanHelpGuideyouintheBestTreatmentOptionforSleepApnea

Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.

Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.

One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.

As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.

Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.

Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.

Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.

Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.

If you would like more information on treating sleep apnea, 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 “Sleep Disorders & Dentistry.”


By Marcia Martinez, D.M.D.
October 01, 2015
Category: Dental Procedures
Tags: veneers  
YourVeneersHaveStayingPower-ifCaredforProperly

Porcelain veneers are excellent for restoring otherwise sound teeth that are stained, chipped or slightly misaligned. But the question for many is, are they long-lasting?

Just as the term is used in building construction, a dental veneer is a thin covering of material that’s bonded to the outside of a tooth to conceal blemishes. Very thin layers of dental porcelain (a form of hardened glass colored to match a patient’s natural teeth) are created by a dental lab technician to achieve the preferred shape and size of the patient’s tooth. Unlike crowns or other restorations, veneers require very little tooth preparation to accommodate them.

As to their longevity: if cared for properly, a veneer could last for twenty years or more. While the veneer itself isn’t subject to the effects of dental disease, the tooth and the gums that support it are. Shrinking gum tissues as a result of periodontal (gum) disease, for example, could have a negative effect on the veneered tooth and subsequently the veneer. It’s important, then, that you properly practice daily brushing and flossing, along with keeping up regular office cleanings and checkups.

There’s one other important consideration: while porcelain veneers can withstand normal biting forces, if they’re subjected beyond their tolerance they could shatter. You should be careful not to subject your veneered teeth to an abnormal biting force, such as biting down on an extremely hard object. If you tend to grind your teeth at night, wearing a night guard can minimize the force created from the grinding.

It’s possible to repair and re-bond a loose or slightly chipped veneer. In some cases, though, severe damage may require a replacement. Still, by using common sense about what you bite down on and taking proper care of your teeth and gums, you can minimize the chances of damage and enjoy many years of a more attractive smile.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: How Long will Your Porcelain Veneers Last?.”