Patients on Blood Thinners Require Precautions Before and During Oral Surgery

By Drs Lawitts and Yeates

April 22, 2015

Category: Oral Health

Tags: blood thinners oral surgery

PatientsonBloodThinnersRequirePrecautionsBeforeandDuringOralSurgery

The proliferation of drugs to treat all manner of diseases and conditions has heightened concerns not only about general side effects, but also how a particular drug may affect treatments for other conditions. There are indications, for example, that drugs classified as blood thinners could cause complications for patients undergoing oral surgery.

Blood thinners like Warfarin are typically prescribed to patients with artificial heart valves or who are at significant risk for stroke, heart attack, or the formation of clots that could potentially damage the heart and lungs. The drug reduces the coagulation (clotting) mechanism in blood; aspirin taken regularly should also be considered a blood thinner.

As with any invasive procedure, blood thinners can complicate oral surgery. Blood doesn’t clot normally and so bleeding during a procedure is more difficult to stop. This doesn’t necessarily mean the surgery can’t be performed. For one thing, many oral procedures like tooth removal involve little trauma to tissues and bleeding in the hands of a careful and experienced surgeon. The surgeon can also use hemostatic agents during surgery that will stabilize blood clotting, as well as suturing the incision in such a way as to reduce bleeding from surface capillaries. In the case of a tooth extraction, a bone graft placed within the empty socket not only reduces bone loss from a missing tooth, but can also enhance bleeding control.

In consultation with your medical doctor, it’s also possible to temporarily stop or reduce your medication dosage in anticipation of a pending oral surgery. While it may not be safe to stop the drug altogether, a reduced dosage can ease the anti-coagulant effect and reduce any complications from bleeding that might occur during the surgery. You can then resume normal dosage soon after the procedure.

During your pre-op examination, it’s important to let your surgeon know about any drugs you are currently taking, including over-the-counter drugs like aspirin. The oral surgeon will then be able to take the necessary steps, including working with your medical doctor, to ensure your surgical procedure is safe and uneventful.

If you would like more information on oral surgery precautions while taking blood thinners and other medication, 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 “Oral Surgery & Blood Thinners.”

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Know the Facts to Reduce Your Child's Teething Discomfort

By Drs Lawitts and Yeates

April 14, 2015

Category: Oral Health

Tags: pediatric dentistry teething

KnowtheFactstoReduceYourChildsTeethingDiscomfort

The arrival of your child’s first set of teeth is a natural and expected process. But that doesn’t mean this period of development, commonly known as teething, is an easy time: your baby will endure a fair amount of discomfort, and you, perhaps, a bit of anxiety.

Knowing the facts about teething can help you reduce your child’s discomfort — as well as your own concern — to a minimum. Here are a few things you need to know.

Teething duration varies from child to child. Most children’s teeth begin to erupt (appear in the mouth) between six and nine months of age — however, some children may begin at three months and some as late as a year. The full eruption sequence is usually complete by age 3.

Symptoms and their intensity may also vary. As teeth gradually break through the gum line, your baby will exhibit some or all normal teething symptoms like gum swelling, drooling and chin rash (from increased saliva flow), biting or gnawing, ear rubbing, or irritability. You may also notice behavior changes like decreased appetite or disrupted sleep. These symptoms may be a minimal bother during some teething episodes, while at other times the pain and discomfort may seem intense. Symptoms tend to increase about four days before a tooth emerges through the gums and about three days afterward.

Diarrhea, rashes or fever aren’t normal. These symptoms indicate some other sickness or condition, which can easily be masked during a teething episode. If your child exhibits any of these symptoms you should call us for an exam to rule out a more serious issue.

Keep things cool to reduce discomfort. There are a few things you can do to reduce your child’s discomfort during a teething episode. Let your child chew on chilled (but not frozen) soft items like teething rings, wet washcloths or pacifiers to reduce swelling and pain. Gum massage with your clean finger may help counteract the pressure from the erupting tooth. And, if your doctor advises it, pain relievers in the proper dosage may also help alleviate discomfort. On the other hand, don’t use rubbing alcohol to soothe painful gums, or products with the numbing agent Benzocaine in children younger than two unless advised by a healthcare professional.

If you would like more information on dealing with teething issues, 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 “Teething Troubles.”

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Other Factors Besides Hygiene Could Contribute to Gum Disease

By Drs Lawitts and Yeates

April 06, 2015

Category: Oral Health

Tags: gum disease

OtherFactorsBesidesHygieneCouldContributetoGumDisease

Periodontal (gum) disease is an infectious condition that if left untreated could lead to tooth loss. While gum disease is primarily caused by a thin layer of bacterial plaque and calculus left on the teeth due to poor hygiene, you may also have extenuating factors that may make you more susceptible to the disease.

Gum disease is actually a group of infectious diseases in which some forms are more difficult to control than others. All these forms arise from interactions between the bacteria in the dental plaque and your body’s immune system. Depending on both your body’s individual response and the disease form, your resistance to the resulting bacterial infection may be low.

That low resistance to certain strains of bacteria may be genetic — something you’ve inherited from your parents. Your stress level, particularly when it’s high, can also diminish your body’s ability to resist disease. There are also numerous strains of bacteria that could lead to gum disease — your body may not be able to effectively resist the particular “mix” of strains contained in your dental plaque.

Aside from lifestyle issues like stress or oral hygiene, we can at least test and verify any susceptibility you may have due to uncontrollable factors like genetics or the particular bacterial makeup within your plaque. Unfortunately, a minority of people will continue to deal with gum disease even after treatment and adopting a more effective hygiene regimen. Although we can’t cure the disease, we can certainly control it with regular monitoring and treatment when necessary.

The key is to adopt a long-term strategy that will seek to preserve the teeth for as long as possible. In some cases, the best treatment approach is to prolong the life of the affected teeth for as long as possible to give you time to prepare emotionally and financially for eventual tooth replacement.

Indeed, any patient experiencing some form of gum disease should seek professional treatment, followed by a daily oral hygiene program and regular checkups and office cleanings. Taking the right steps in consultation with your dentist will assure you’ll preserve your teeth for as long as possible.

If you would like more information on treatment for periodontal disease, 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 “Periodontal (Gum) Treatment and Expectations.”

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Five Things You Should Know About Oral Cancer

By Drs Lawitts and Yeates

April 03, 2015

Category: Oral Health

Tags: oral cancer

Like a shadowy figure hovering at the edge of the movie frame, cancer may be scariest when you can't see it clearly. That's why, instead of looking away, many people have chosen to take a proactive attitude toward the disease. They're learning about the benefits of prevention, early detection and treatment — and so can you. How much do you know about oral cancer? Here are five fast facts.

Oral cancer isn't just an older person's disease.

In the past, people over 40 years of age were the main population group in which oral cancer was found. But in recent years, a growing number of young people have also been diagnosed with the disease. The sexually transmitted Human Papilloma Virus (HPV16) is thought to be responsible for the increase in oral cancer among younger people.

Oral cancer can de deadly.

While it accounts for just 2-3% of all cancers, its survival rate is far lower than lots of cancers you've heard more about. Why? Because its symptoms can be hard to tell from more benign mouth sores, and isn't caught in the early stage often enough. When discovered in its later stages, the 5-year survival rate for this disease is just 58%.

There are several risk factors for oral cancer.

Moderate to heavy drinkers and users of tobacco products — whether smoked or smokeless — are at far greater risk than non-users. Chronic exposure to the sun, besides leading to skin cancer, is also clearly associated with cancers of the lip. And, because of HPV, the same risk factors for other sexually transmitted diseases apply to oral cancer as well. Genetic predisposition also plays a role, as it does in many other diseases.

Lifestyle choices can decrease the odds of getting oral cancer.

Obviously, giving up tobacco, moderating alcohol consumption and avoiding risky sexual behavior will mitigate these risk factors. But you can also lessen your chances of getting the disease by eating a healthy diet. Studies have shown that a high intake of fruits and vegetables is protective against oral cancer — and other cancers as well.

Early detection boosts the survival rate for oral cancer above 80%.

Yet the earliest symptoms of oral cancer are hard for many people to distinguish from common maladies like cold sores. What's the best way to detect it? Do something you should be doing anyway — get regular dental checkups! We're trained to find the signs of a potential problem via a quick, painless screening that can be done at your routine checkup. We can also schedule biopsies or other diagnostic tests if they're needed.

If you have concerns about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”

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	Dr. Karen Lawitts	Dr. Nancy Yeates
	Dr. Lawitts was born and raised in Syracuse, NY. She received her Bachelor of Science and D.D.S degree from Northwestern University in Chicago.	Dr. Nancy Yeates graduated from Canisius College with a B.A. in Biology. She then attended Georgetown University School of Dentistry.

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Posts for: April, 2015

Patients on Blood Thinners Require Precautions Before and During Oral Surgery

Know the Facts to Reduce Your Child's Teething Discomfort

Other Factors Besides Hygiene Could Contribute to Gum Disease

Five Things You Should Know About Oral Cancer

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