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The standard of care for professional dental cleanings has long been every 6 months. This still holds true today for most patients. Studies have repeatedly shown that those who goto regular dental visits are less likely to have the need for a dental restoration or to have a tooth removed.

Are Teeth Cleanings Necessary?

While for many at home care can be a breeze for many others it is a constant struggle. Our daily lives can get in the way of even the simplest tasks including our oral hygiene. Regular professional teeth cleaning removes plaque, the soft yellowish build-up, and calculus (hardened plaque) that we are just not able to get to. This soft build-up is made up of billions of different types of bacteria that live and reproduce in our mouth by feeding on the food we eat releasing acids that if left alone will damage our teeth and periodontal tissues.

Most bacteria co exist in our bodies without causing too much trouble to our health and well being. But certain bacteria in dental plaque, when they grow in numbers, can lead to tooth decay or periodontal disease.

A professional dental cleaning will reduce your chances of developing tooth decay or periodontal disease by significantly reducing the amount of plaque, calculus, and bacteria in your mouth.

How Often Is Acceptable?

As a dentist, my patients often ask me how regularly they should come in to get their teeth cleaned. My response is usually: “That depends”. For most of the population every 6 months is the right number. But there are those who just cannot maintain dental hygiene on their own or they develop calculus faster than others. So for those patients I will recommend a schedule of every 3 months. 2 extra visits a year to maintain your dental health should not feel like a lot. This will reduce chances of tooth decay and periodontal disease development in these patients over the long haul.

Factors Affecting Dental Hygiene

We know certain lifestyle choices can affect a person’s risk of developing tooth decay and periodontal disease. Following are some questions you may ask yourself to understand whether you are at an increased risk:

-Does your drinking water contain Fluoride? Is this your main source of drinking water?

-Do you frequently snack, including on sweets?

-Are you a regular flosser?

-Do you brush your teeth at least twice a day?

-Do you visit your dentist for toothaches rather than routine examinations?

-Have you had multiple teeth with tooth decay at your last few dental visits?

-Is your dentist “watching” a lot of teeth with early tooth decay?

-Do you have to wear a denture or undergoing orthodontic treatment?

-Do you develop excessive amounts of calculus quickly?

-Do you suffer from a chronic long-term health condition such as diabetes?

-Do you suffer from a xerostomia (dry mouth)?

If you were able to answer “yes” to most of the questions above, you are likely to need to see your dentist or hygienist at least every six months, if not more often based on your dentist’s recommendations. Following a professional cleaning, people prone to tooth decay can benefit from the fluoride treatment following removal of plaque and calculus. Studies have shown that professional fluoride treatment every six months can lead to about a 30% reduction in the development of tooth decay.

Dental Health = Overall Health

Some patients with chronic health issues such as cardiovascular disease or diabetes will need to see their dentists more frequently. This is because they are much more susceptible to periodontal disease.

Patients taking blood thinners and other medications, such as for osteoporosis, may need to visit the dentist more regularly as well. These medications can complicate the process of an tooth extraction or other dental work, so regular checks and cleanings are best to help detect problems before they become serious.

Financial Concerns?

The cost of seeing your dentist and dental hygienist 2-4 times per year will be far less than restoring your teeth over the long run. Routine dental health maintenance is the best insurance you have to maintain a healthy smile.

Protecting your smile

Parents often wish to set a good example for their children by making regular check and cleaning appointments for the whole family. In the end, only you can choose what you feel is right for you. Maintaining a healthy smile that will last a lifetime is important to most people.



Teeth whitening is a popular dental treatment but many want to know if it can be done at home? Hydrogen peroxide is a common product in most homes medicine cabinets as well as first aid kits. It has a range of uses. Hydrogen peroxide is also an active ingredient in many teeth whitening treatments. This has lead many people to wonder whether store bought hydrogen peroxide can work as a tooth whitener as well. While hydrogen peroxide may help whiten the teeth in certain situations it does not come without risks. There are some important safety issues to consider before using this product outside its intended form. Incorrectly used hydrogen peroxide can cause damage to the enamel of the teeth.

Effective For Teeth Whitening?

Hydrogen peroxide is a very common and highly effective active ingredient in many dental teeth whitening applications. Dental products containing peroxides (hydrogen peroxide and carbamide peroxide) act as bleaching agents to change the color of the teeth to lighter shades. Peroxide when used properly can partially penetrate the layers of the teeth, removing compounds that cause discoloration leaving teeth whiter than before.

Hydrogen peroxide can come in various concentrations depending on the product. Store bought teeth whitening kits generally are below 10% while kits purchased thru your dentist can be as high as 40%.

Many people assume that higher concentrations of peroxide may lead to more side effects (tooth sensitivity and enamel breakdown) but this is not always the case. However, it does appear that the length of time that these products are applied on the teeth is vitally important.

Studies as recently as 2016 have shown that lower concentration gels had more negative effects when left on teeth for longer period of times. Higher concentration gels require less application time which can reduce enamel damage and tooth sensitivity. A study in the American Journal of Dentistry found that a commercial mouthwash containing only 1.5% hydrogen peroxide caused a noticeable lightening in human tooth enamel after just four (4) weeks.

People who already have sensitive teeth may want to speak with their dentist before using hydrogen peroxide to whiten the teeth.

Risks?

There are some common risks to consider prior to using hydrogen peroxide for teeth whitening.

Most common side effects of teeth whitening include tooth and gum sensitivity, as well as irritated or inflamed gums. If you experiences these symptoms during teeth whitening treatment should stop using the product and contact your dentist to discuss other options that mat be gentler on your teeth and gums.

Some people may prefer to undergo hydrogen peroxide teeth whitening in a dental office setting. The dentist will ask the person to come in for a cleaning first. A professional dental cleaning will allow the hydrogen peroxide to penetrate the teeth evenly giving a bright smile.

Also during this appointment, the dentist will check for cracks, as cracks in the teeth can allow the peroxide to penetrate further into the tooth. This is important as it can become a problem if the peroxide comes into contact with the underlying dentin as it is likely to cause irritation or sensitivity.

Common At Home Remedies For Teeth Whitening

There are many other teeth whitening solutions that people can use at home. Many are not effective at achieving the proper teeth whitening a dentist can.

Most of these home remedies for tooth whitening should be relatively safe to try, though. They include:

-charcoal and salt

-baking soda

-lemon juice

-oil pulling with coconut oil

-apple cider vinegar

The American Dental Association does not recommend any of these methods for at home teeth whitening. Research also suggests that some of these methods are not effective and may actually harm the teeth or cause other adverse effects. So beware of the possible consequences. It is always best to speak to your dentist prior to attempting any of these treatments at home.

At Home Teeth Whitening Conclusion

Teeth whitening is a personal choice in many cases. It can also be quite dangerous to attempt on your own at home. Seek out professional care and advice form your dentist to ensure you achieve the results you want in a safe healthy manner.




Blood thinners are prescription medications taken by many dental patients. Blood thinners are used in medicine to prevent potentially fatal blood clots. Blood clots can lead to stroke, heart attack, deep vein thrombosis (DVT), or pulmonary embolism (PE). These blood thinners prevent clotting they cause a possible danger to dental procedures that may cause bleeding. The lifesaving benefits of these drugs very often outweigh the potential dangers they can have for you.

How Does Blood Clotting Work In The Body?

There are two main processes by which the body forms a blood clot normally. The first process involves platelets (small blood cells) which goto the site of a wound and clump together to form a plug which slows the flow of blood through the vessel and forms a covering to begin the healing process. The next phase of the process is called coagulation when proteins in the blood bind with each other to fill in the gaps between the platelets, stabilize the clot formation, and make it more solid until bleeding stops.

Medicines Used As Blood Thinners

There are 2 types of blood thinners. They are as follows:

-Antiplatelet – These blood thinners include aspirin, Ticlid (ticlopidine), and Plavix (clopidogrel). These medicines target the initial phase of the clot process by preventing platelets from binding to the blood vessel walls or to one another.  Aspirin is a good example of how these medicines act on the body. The mechanism by which Aspirin achieves this is by Aspirin Marielaina Perrone DDScreating permanent changes in the platelets which last throughout the lifetime of the platelet (approximately 7-10 days). This can only be reversed once the body produces new platelets that have not yet been exposed to Aspirin.

-Anticoagulant – These blood thinners include Coumadin (warfarin). Coumadin works by inhibiting the second phase of blood clotting by blocking production or the function of proteins that stabilize the clot (also called anticoagulation). For Coumadin it generally takes several days after the beginning the medication for it to reach its full anticoagulation effect,  and then again several days after the medication is stopped for the anticoagulation effect to cease.  Many foods and other medications can affect coumadin by either increasing or decreasing its effectiveness. Your physician will need to frequently monitor to check your level of anticoagulation activity. Newer anticoagulants have come to market and these include Pradaxa (dabigatran), Xarelto (rivaroxaban) and Eliquis (apixaban). These medications have an advantage over coumadin in that they do not need as long a time as coumadin to reach their full anticoagulation effect, and also to stop that effect when discontinued.  The downside is their anticoagulation activity cannot be monitored as easily as it is for coumadin. Another medication, Lovenox (enoxaparin)is used in prevention of pulmonary embolism (PE) and Deep vein Thrombosis (DVT). These blood thinners are given through self-injection.

Dentist Preparations For Blood Thinners

Generally, bleeding from dental procedures is fairly easy to control and bring to a stop, even in patients who are taking these blood thinner type medications. It is important to note that both the effect of these medicines on blood clotting and the potential for bleeding from dental procedures can vary quite a bit from individual to individual. So each patient must be considered individually based on their clotting factor and the dental procedure being performed. A consultation with the patient and their physician can lead to a change in dose prior to dental procedure or even stopping the medication altogether to complete the dental work.

It is very important for those on blood thinner medications to communicate with your dentist regarding medical history. Your dentist will ask you to provide a complete medical history including:

-All medical conditions (including heart disease, irregular heartbeat, stroke, liver disease, kidney disease, and/or history of blood clots)

-All medications currently being taken. Not just blood thinners but all medications. This is important because they could interact with what your dentist is using as well.

-Treating physician information

-Reason for taking blood thinners

-Anticipated time that you will be on blood thinners

-The results of your monitoring of the effects of these agents (blood test results)

-Any issues that have arisen with your blood thinners.

Your dentist may ask to run some tests prior to your dental treatment and call your physician before attempting to do the dental procedure(s). Your dentist may ask to do the dental procedure in one of 3 ways:

-Continue taking blood thinners as normal with no changes.

-Alter the dose or type of blood thinners for a short period of time

-Stop the blood thinners prior to the dental procedure.

Precautions may also be taken by your dentist before, during and after the dental procedure to reduce the chances of significant oral bleeding. It is important to not that you should never discontinue or change your blood thinners or dose without the advice of your physician and dentist. It is also important to be aware that over the counter medications such as Motrin, Advil and Aleve, can also increase the anti platelet effects. Additionally “non-traditional” medications can interfere with, or increase the effects of your anticoagulant medications.

Dental Procedures With Bleeding Risks

The following procedures are the ones most linked to increased bleeding.

-Professional teeth cleaning (also referred to as dental prophylaxis)
-Scaling and root planning (also referred to as a deep teeth cleaning)
Periodontal surgery
-Tooth extractions
Dental implant placement
-Biopsies

Blood Thinners Conclusion

Being on blood thinners comes with many benefits but also some risks. We can minimize these risks at least on the dental side by communicating properly to have your dental procedures completed safely and successfully. Remember, to maintain a regular dental hygiene and dental examination schedule for a healthy smile.



Dental Infections (also referred to as an abscess) generally develops as a result of untreated tooth decay and poor oral hygiene. However, a dental infection can also develop from other reasons previous dental work or traumatic injury. When a dental infection begins to develop, a pocket of pus forms in the mouth as a result of an overwhelming growth of bacteria. Symptoms of a dental infection often includes swelling, pain (often radiating away from area), and sensitivity in the area. It is vital to seek professional treatment as without proper and timely treatment, the dental infection may spread to other areas of the jaw or even the brain.

Tooth decay and cavities are very common. About 90% of adults ages 20–64 have had prior tooth decay. Also, almost 30% of people in the same age group have untreated tooth decay. Treating tooth decay early is important to prevent further complications such as dental infections which can often lead to tooth loss.

Anyone who experiences dental infections should see a dentist immediately to prevent the dental infections from spreading.

One of the initial options for a dentist is to recommend an antibiotic to kill dental infections. Some antibiotics will work better than others. This is due to the type of bacteria causing the actual infection., There may also be some over-the-counter pain medications to help relieve the dental infection symptoms temporarily.

Antibiotic Use For Dental Infections

Dentists generally only recommend antibiotics for dental infections. However, not all infected teeth will require antibiotics during treatment. In some instances, a dentist may be able to drain the infected area of pus, remove the infected tooth, or complete a root canal procedure to fix the issue. Antibiotics should not be used unless absolutely necessary to complete dental infections treatment.

Antibiotic Types And Dosages For Dental Infections

The type and dosage of antibiotic your dentist will recommend will vary depending on the type of bacteria that causes dental infections. Different antibiotics work in different ways to eliminate different strains of bacteria. There are over 150 different strains of bacteria that are present in the oral cavity. Many of these bacteria have the potential to grow and cause a dental infection. Treatment can change depending on the bacteria causing the dental infection, although, dentists simply recommend an antibiotic that works against many types. This gives them the best chance to handle the infection effectively and quickly.

Classes Of Penicillin For Dental Infections

Penicillin type drugs are common forms of antibiotics for dental infections. This includes penicillin and amoxicillin. Some dentists may also recommend amoxicillin with clavulanic acid, as that combination may help eliminate bacteria that are being unsuccessfully treated by previous drugs.

Typical dosages of amoxicillin for a dental infection are either 500 milligrams (mg) every 8 hours or 1,000 mg every 12 hours.

Typical dosages of amoxicillin with clavulanic acid are around 500–2,000 mg every 8 hours or 2,000 mg every 12 hours, depending on the minimum effective dosage.

However, some bacteria have been found to resist these drugs, making them less effective. In fact, many doctors now simply choose a different antibiotic as their 1st line of treatment.

Dentists must also be aware that some people are allergic to these drugs. Anyone who has had an allergic reaction to similar medications should tell their dentist immediately before receiving their treatment recommendation.

-Clindamycin

Clindamycin is highly effective against a wide range of infectious bacteria. Some researchers recommend clindamycin as the drug of choice to treat dental infections, as bacteria may be less likely to resist this drug than penicillin-class drugs.

A typical dosage of clindamycin is either 300 mg or 600 mg every 8 hours, depending on which dosage will be effective for the individual situation.

-Azithromycin

Azithromycin also is able to work against a wide variety of bacteria, working to halt their growth. It may be effective in treating some dental infections, though dentists may only recommend it to people who are allergic to penicillin-class drugs or who do not respond to them or other drugs such as clindamycin.

 The typical dosage of azithromycin is 500 mg every 24 hours for 3 consecutive days.

-Metronidazole

Metronidazole is an antibiotic uses to treat a number of infections by both doctors and dentists. This drug is typically not the 1st choice of treatment.

The dosage for metronidazole is around 500–750 mg every 8 hours.

Time To Begin Feeling Better?

The speed with which each antibiotic takes to work on the dental infection varies depending on many factors. These can include the severity of the infection and how effective the drug is at eliminating the infectious bacteria present.

It is imperative for people to complete a full round of antibiotics, taking all of the prescribed medication exactly how the dentist says to take it. A person may begin to notice their symptoms go away after a couple of doses, completing the full dosage of antibiotics helps prevent the infection from returning or getting stronger.

The majority of acute infections resolve in 3–7 days.

Side effects Of Antibiotics For Dental Infections

While antibiotics are very effective for dental infections they can have some possible side effects. These side effects will vary by antibiotic type and individual. It is important to speak with your dentist regarding possible side effects and what to expect.

Dental Infection Treatments Beyond Antibiotics

Antibiotics may help clear active dental infections, but the tooth will still need work to clear up the root of the dental  infection. Antibiotic treatment is just one part of the treatment.

Typical treatment for dental infection can include one or more of the following procedures:

-draining the abscess

-filling in any cavities

-performing a root canal

-extracting the infected tooth

Natural Remedies For Dental infections

Some over the counter remedies may also help “control” the symptoms of a dental infection. This can include over the counter pain relievers such as ibuprofen (Advil) and acetaminophen (Tylenol) and Sodium naproxen (Alleve).

Other things to try to relive symptoms at home:

-gently rinsing the mouth with warm salt water

-rinsing gently with baking soda and water

-avoiding very hot or very cold foods to prevent temperature sensitivity

-chewing with the opposite side of the mouth

-brushing with a very soft toothbrush around the sensitive area

-avoiding very sharp, hard-to-chew foods that may bump into the sensitive area or become stuck in the teeth

-sleeping with your head elevated to relive pressure

Dental Infections Summary

Antibiotics are not the sole answer to dental infections. They are a part of a larger dental infection treatment. Most if not all dental infections require further dental work by your dentist. This can include a root canal or a tooth extraction.

Prompt dental treatment is important to keep dental infections from spreading and making things more dangerous and painful. Some helpful home remedies mentioned above may help keep inflammation down or ease pain while taking antibiotics and preparing for the recommended dental procedure. maintaining a good oral hygiene regimen, such as brushing and flossing each day and seeing a dentist for regular checkups, may help prevent dental infections and their complications.