Posts for: July, 2016
The development of antibiotic drugs is widely considered one of the greatest medical achievements of the last century. Their widespread use has turned life-threatening diseases like cholera, strep throat or bacterial meningitis into manageable, treatable ones. It’s no exaggeration to say antibiotics changed the face of healthcare, including dentistry.
But this gleaming sword for fighting dangerous diseases has a double edge because our biological “enemies” can adapt to the microscopic attacks against them.Â This has created an ironic conundrum: as antibiotics have proliferated in both the amount and frequency used they’ve become less effective against ever-resistant organisms.
This unfortunate situation has been helped along by a widespread, misguided practice in the medical profession, created by a “better safe than sorry” philosophy, to use them to treat any illness. This has morphed in recent decades into using antibiotics as a preventive measure in those not even exhibiting signs of disease, which then evolved into using antibiotics as a feed additive for livestock. As a result, antibiotic drugs have made their way into the food chain to accelerate, in many people’s opinion, bacterial and viral resistance.
What can we do then as “super-bugs” are on the rise, like Methicillin-Resistant Staphylococcus Aureus (MRSA) which is resistant to the most common antibiotics?
Certainly, continuing research into creating new antibiotics that address resistance is vital. But it won’t be enough: we — both healthcare providers and patients — must also change our approach and attitude toward antibiotics. This means putting in place better prescription guidelines that reduce the application of antibiotics for only those conditions where it’s absolutely necessary. And, we must restrict their use as a preventive measure, particularly in regard to their use in livestock feed.
This will take a change in everyone’s mindset, our professional standards and guidelines, and perhaps our laws. Thankfully, many are seeing the looming danger, and change is already happening. But time is of the essence, and the future depends on it — not just for people today but also for tomorrow’s generations.
If you would like more information on prudent antibiotic use, 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 “Antibiotics: Use and Abuse.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
Recurring episodes of severe pain along your face could mean you have trigeminal neuralgia (TN). Although not always curable, TN can be managed effectively with the right strategy.
TN affects a specific pair of nerves called the trigeminal that signal pain in the face or jaws. They originate from the brain stem through the skull on either side of the face, with each nerve having upper, middle and lower branches. TN can affect one or more of these branches and cause anywhere from a mild twinge to excruciating pain.
Causes for TN differ in individual patients. Though it could be linked to a tumor, lesion or cold sore, it most often seems to arise from a blood vessel impinging on the nerve and damaging its outer coating. This causes it to be hypersensitive: chewing, speaking or even lightly touching the face can set it off. The damaged nerve may also fail to "shut off" when the triggering stimulation stops.
If you have these types of symptoms, your first step is to obtain an accurate diagnosis. You'll need a thorough examination to rule out other possibilities like jaw joint problems or a tooth abscess. Once we've determined it's definitely TN, we can then devise a treatment strategy.
We usually begin with conservative measures like medication to block pain transmission to the brain or anticonvulsants that stabilize the nerve and decrease abnormal firing. If medication isn't enough, we may then consider an invasive procedure to control symptoms.
Percutaneous treatment — often recommended for older patients or those in poor health — involves inserting a thin needle into the nerve to selectively damage certain fibers that will prevent the nerve from signaling pain. We might be able to move an impinging blood vessel aside from the nerve with a microsurgical procedure. As an alternative to surgery, high-dose radiation could also be aimed precisely at the pain site with a controlled beam to alter the nerve's ability to transmit pain.
TN can be a source of great discomfort that lowers your quality of life. But employing treatment techniques that best suit your situation, we can greatly reduce the misery it inflicts.
If you would like more information on facial pain caused by trigeminal neuralgia, 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 “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”