Antibiotic Prophylaxis: Prosthetic Joints and Orthopedic Implants

If you have had a joint replacement and taken antibiotics before dental work in the past, you may not need to make a trip to the pharmacy before your next procedure. The American Dental Association has found it is no longer necessary for most dental patients with orthopedic implants to have antibiotic prophylaxis to prevent infection.

What Is Antibiotic Prophylaxis?

Antibiotic prophylaxis (or premedication) is simply the taking of antibiotics before some dental procedures such as teeth cleaning, tooth extractions, root canals, and deep cleaning between the tooth root and gums to prevent infection. We all have bacteria in our mouths, and a number of dental treatments—and even daily routines like chewing, brushing or flossing—can allow bacteria to enter the bloodstream (bacteremia). For most of us, this isn’t a problem. A healthy immune system prevents these bacteria from causing any harm. There is concern, however, that bacteria in the bloodstream could cause infection elsewhere in the body.

Prior to 2012, premedication prior to dental procedures was common for joint replacement patients, even though there was little evidence to support the practice and experts recommended against its practice for most dental patients. In 2012, the American Dental Association and American Association of Orthopedic Surgeons published updated guidelines, stating that dentists “might consider discontinuing the practice of routinely prescribing prophylactic antibiotics”. In January 2015, the ADA’s Council on Scientific Affairs issued another guideline, which continued to discourage prophylactic antibiotic use for most patients with prosthetic joint implants. Guidelines are re-evaluated every few years to make sure that they are based on the best scientific evidence.

Why Don’t I Need Antibiotic Prophylaxis? 

Based on careful review of the scientific literature, the ADA found that dental procedures are not associated with prosthetic joint implant infections, and that antibiotics given before dental procedures do not prevent such infections.

In fact, for most people, the known risks of taking antibiotics may outweigh the uncertain benefits. Risks related to antibiotic use include nausea, upset stomach and allergic reactions, including anaphylactic shock (a severe allergic reaction that can be life threatening). Other risks include developing antibiotic resistance in bacteria, which can complicate treatment of infections such as strep throat, pink eye and meningitis; as well as increasing the risk of C. difficile infection, which causes diarrhea and other intestinal problems. Patients over 70 years old are also at increased risk of experiencing adverse  reactions to some antibiotics. 

Who Can Antibiotic Prophylaxis Help?

Depending on your personal medical history, you may still be a candidate for premedication. For example, antibiotic prophylaxis might be useful for patients undergoing dental procedures who also have compromised immune systems (due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk of orthopedic implant infection. It may also benefit others with heart conditions. Always talk with your dentist or physician about whether antibiotic prophylaxis before dental treatment is right for you.

The above article is from mouthhealthy.org

Ivan K. Salmons, DDS  
1855 Indian Hills Drive   
Sioux City, IA 51104   
(712) 239-5900   
SiouxCityDentist.com

Ketosis Breath: When Your Diet Affects Your Oral Health

The ketogenic diet has created buzz in the health community and for good reason. Many have found success in restricting their carb intake so that the body burns fat instead of glucose to lose weight. If you're following a keto diet, you might notice some unpleasant side effects that accompany the positive changes on the scale. For example, so-called ketosis breath is a common complaint. Understanding keto breath is the first step to ensuring your diet doesn't impair your oral health.

Ketosis and Your Breath

If a lower-carb lifestyle is supposedly healthy, then why does it result in foul-smelling breath? The answer is in how your body breaks down fats. After swapping a typical carb-heavy diet for one that promotes fats and protein, your body goes into ketosis. As the University of California, San Francisco explains, ketosis is a process wherein your body begins to burn fat for energy, since glucose stores (your body's preferred source of energy) aren't readily available. While in ketosis, your body converts fat cells into three types of ketones, which are fat byproducts. One of these ketones, called acetone, is essentially unusable for your body's energy stores. 

Therefore, your body releases it via your urine and lungs, notes Medscape. It's acetone that gives your breath that distinctive "ketosis" smell, which, according to Medline Plus, can be compared to an overly sweet, fruity scent.

Keto Diet and Oral Health

When swapping carbs for healthy fats and proteins, your body undergoes several changes. While ketosis breath is often associated with a low-carb lifestyle, the diet may also have a positive effect on your oral health. After all, in avoiding carbs, you're also avoiding processed sugars, which the American Dental Association counts among the worst foods for oral health. Because oral bacteria thrive on sugar, reducing your sugar intake may reduce cavities.

A low-carb diet may also help reduce inflammation. A study in BMC Oral Health found that a diet low in carbohydrates and high in omega-3 fatty acids resulted in lower rates of gingivitis and inflammation in patients. So while going low-carb may make your breath smell, it may actually help improve your overall oral health.

Freshening Up

If you've noticed that you have keto breath and you still want to continue your keto diet, consider some of these methods to deal with the smell:

• Chew sugar-free gum to help stimulate saliva and freshen your breath.
• Adjust your intake of complex carbohydrates, such as leafy green vegetables and whole grains, while continuing to avoid refined carbs.
• Fill a water bottle and sip throughout the day.
• Continue good oral health habits. A keto lifestyle, while beneficial for oral health, is not a substitute for daily brushing and flossing.
• Add fresh herbs to water and tea. Herbs such as clove, cinnamon, mint and fennel are natural breath fresheners.

Starting and continuing a ketogenic lifestyle should only ever be done with the supervision and approval of a qualified health care professional. While it's true that a keto diet may offer benefits for oral health, it has a few drawbacks as well. By addressing some of the roadblocks, you can make sure that your keto diet is as healthy as it is successful. To keep you on track, lessen the smelly side effects by brushing with Colgate Total Fresh Mint Stripe Gel toothpaste. It has a minty blend of gel and paste that leaves your mouth clean and fresh. 

The above article is from colgate.com

Ivan K. Salmons, DDS  
1855 Indian Hills Drive   
Sioux City, IA 51104   
(712) 239-5900   
SiouxCityDentist.com

Wine Tasters, Beware

Wine tasters may be at high risk for enamel stain and erosion.

Why? Sipping wine many times a day -- and swishing it in the mouth -- increases the enamel's exposure to damaging acids.

That is why it's better to drink a glass of wine, soda, or sweet tea with a meal instead of sipping it over several hours.

Above article from: Webmd.com/oral-health

Ivan K. Salmons, DDS  
1855 Indian Hills Drive   
Sioux City, IA 51104   
(712) 239-5900   
SiouxCityDentist.com