Robert A. Klement, DDS
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Wisconsin Rapids, WI 54494
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Posts for: October, 2020

Dental implants are considered today’s premier method for restoring missing teeth. Obtaining an implant, though, is often a long process and the implants themselves must be surgically placed within the jaw bone. Nothing to worry about, though: implant surgery is a minor to moderate procedure akin to a surgical tooth extraction.
Still like any surgery, this procedure does involve cutting into the soft tissues of the gums and could allow oral bacteria to enter the bloodstream. While most bacteria in the mouth are harmless (and even beneficial) a few strains can cause disease. For some people, especially those with certain heart conditions or joint replacements, this could potentially cause serious issues in other parts of their body that might be highly susceptible to infection.
To guard against this, it’s been a long-standing practice in dentistry to prescribe antibiotics to certain high risk patients before a procedure. Although this departs from the normal use of antibiotics for already occurring infections, due to the circumstances this has been deemed an acceptable measure to prevent disease.
In the past, the categories of patients for which preventive antibiotics were appropriate had been more extensive. In recent years, though, both the American Dental Association and the American Heart Association have adjusted their recommendations. Today, your dental provider may recommend antibiotic pre-treatment if you have a prosthetic (artificial) heart valve, a history of infective endocarditis (inflammation of the inner linings of the heart), a heart transplant or certain congenital heart conditions.
While physicians may still recommend premedication with antibiotics for patients with joint replacements, it’s not as blanket a standard as it might once have been. It’s now only recommended for certain cases, such as patients who’ve received a prosthetic joint within the last two years.
There’s still an ongoing debate about the effectiveness of antibiotic pre-medication. However, there’s evidence medicating before procedures with antibiotics can be beneficial in avoiding infection. If you fall into one of the categories just mentioned or are concerned about infection, feel free to discuss with your dentist if using antibiotics before your implant surgery is wise move for you.
If you would like more information on antibiotic treatment before oral surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”

There's ample evidence tobacco smoking increases your risk for tooth decay and periodontal (gum) disease. But the same may be true for electronic cigarettes (E-cigs): Although millions have turned to “vaping” believing it's a safer alternative to smoking, there are growing signs it might also be harmful to oral health.
An E-cig is a device with a chamber that holds a liquid solution. An attached heater turns the liquid into a vapor the user inhales, containing nicotine, flavorings and other substances. Because it doesn't contain tar and other toxic substances found in tobacco, many see vaping as a safer way to get a nicotine hit.
But a number of recent research studies seem to show vaping isn't without harmful oral effects. A study from Ohio State University produced evidence that E-cig vapor interferes with the mouth's bacterial environment, or oral microbiome, by disrupting the balance between harmful and beneficial bacteria in favor of the former. Such a disruption can increase the risk for gum disease.
Other studies from the University of Rochester, New York and Universit? Laval in Quebec, Canada also found evidence for vaping's negative effects on oral cells. The Rochester study found astringent flavorings and other substances in vaping solutions can damage cells. The Quebec study found a staggering increase in the normal oral cell death rate from 2% to 53% in three days after exposure to E-cig vapor.
Nicotine, E-cig's common link with tobacco, is itself problematic for oral health. This addictive chemical constricts blood vessels and reduces blood flow to the mouth's tissues. This not only impedes the delivery of nutrients to individual cells, but also reduces available antibodies necessary to fight bacterial infections. Regardless of how nicotine enters the body—whether through smoking or vaping—it can increase the risk of gum disease.
These are the first studies of their kind, with many more needed to fully understand the effects of vaping on the mouth. But the preliminary evidence they do show should cause anyone using or considering E-cigs as an alternative to smoking to think twice. Your oral health may be hanging in the balance.
If you would like more information on the effects of vaping on oral health, please contact us or schedule an appointment for a consultation.

We’ve all experienced eating or drinking something hot enough to scald the inside of our mouths. But what if you regularly have a burning sensation but haven’t consumed anything hot to cause it? You may have a condition called burning mouth syndrome, or BMS.
In addition to the sensation of feeling scalded or burnt, BMS can also cause dryness, tingling and numbness, as well as a change or reduction in your sense of taste. You can feel these sensations generally in the mouth or from just a few areas: the lips, tongue, inside of the cheeks, gums, throat or the roof of the mouth.
The root cause of BMS isn’t always easy to pinpoint, but it seems related to systemic conditions like diabetes, nutrition or vitamin deficiencies and acid reflux; it’s also been known to accompany the use of irradiation or chemotherapy for cancer treatment or psychological problems. It seems to occur most often in women around the age of menopause and may be linked to hormonal changes.
To determine the best treatment course, we must first eliminate the possibility that another condition besides BMS may be causing your symptoms. Some medications (both prescription and over-the-counter) cause mouth dryness, which can irritate the inner linings of the mouth or contribute to yeast infection, either of which could result in similar symptoms to BMS. Allergic reactions to dental materials in dentures or toothpastes that contain sodium lauryl sulfate, whiteners or cinnamon flavor can cause irritation and skin peeling within the mouth.
If we’ve determined you have BMS, there are a number of strategies we can try to bring relief, like stopping or cutting back on habits that worsen dry mouth like smoking, alcohol or coffee consumption, or frequently eating hot or spicy foods. You should also drink water more frequently to keep your mouth moist, or use biotene or products containing the sweetener xylitol to promote saliva production. If mouth dryness is related to medication, you should speak with your physician or our office about alternatives.
In some cases, BMS resolves over time. In the mean time, though, promoting good saliva flow and reducing stress will go a long way toward diminishing this irritating condition.
If you would like more information on the causes and treatment of burning mouth syndrome, 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 “Burning Mouth Syndrome.”