Farber Center for Periodontics & Dental Implants
You may wonder when is the right time to refer your patient to a periodontist. There are specific warning signs that indicate the presence of periodontal disease, or gum disease.
Non-invasive periodontal treatment may no longer be effective if bleeding occurs. Uncontrollable bleeding is the first sign to refer the patient to a periodontist.
How to Detect Periodontal Disease
The probe is the number one instrument used to monitor changes in periodontal health. An increase in probing depth often indicates that the disease cannot be controlled in office. That would be the second indication to refer a patient.
Radiographs are also used to determine when a periodontist is needed, but they are not taken as often, so changes there may not be seen for two to five years.
Standard probing depth reading is 3mm. When it hits 4mm this becomes a warning zone. When it increases to 5mm, to 7mm and higher, a patient needs an immediate referral. This is a sign that there is no longer health in the pocket of the gum tissue.
Evaluate the Patient
When you are thinking about referring your patient to a periodontist, how often you are seeing that patient is a contributing factor. If you are seeing the patient every three months, then you know that you can monitor the situation and reevaluate them again three months later. However, you are only seeing the patient once or twice a year, then that may be a time to be more assertive in your treatment plan. In the case of a patient who visits every three months – and there is no visible improvement – you should ask, “What is the next step?” If there is improvement, then we reevaluate the case at the next hygiene visit. If their condition stays the same, an ideal treatment plan is as simple as telling the patient to increase the frequency of their dental hygiene visits.
Heart Health Awareness Month and National Nutrition Month bring attention to lifestyle factors you should consider regarding heart disease, heart conditions. When we think about heart disease we should take the time to consider our nutrition. There are key fruits and vegetables that are especially good for your heart and teeth.
Nutrition for Heart Health
Many fruits and vegetables are very beneficial to your heart health.
- Berries are high in heart-healthy polyphenols, raspberries particularly have a lot of fiber (8 grams in a one-cup serving).
- Oranges are well known for their vitamin C content, but they also contain pectin, a kind of insoluble fiber that’s important for heart health.
- Tomatoes, like pomegranates, are a good source of potassium, and contain lycopene, a powerful antioxidant linked to heart health. Tip: Cooking tomatoes helps release their lycopene.
- Spinach is high in nitrates, which are linked to blood vessel health. It contains 181 percent of the daily value (DV) for vitamin K, which promotes heart health, in each one-cup serving.
Nutrition for Your Teeth
- Leafy greens such as kale and spinach also promote oral health. They’re high in calcium, which builds your teeth’s enamel. They also contain folic acid, a type of B vitamin that has numerous health benefits, including possibly treating gum disease in pregnant women, according to MedlinePlus.
- While the ADA recommends steering clear of most sweet foods, there are some exceptions. Fruits, such as apples, might be sweet, but they’re also high in fiber and water. The action of eating an apple produces saliva in your mouth, which rinses away bacteria and food particles. The fibrous texture of the fruit also stimulates the gums. Eating an apple isn’t the same as brushing your teeth with a toothpaste that contains fluoride, but it can tide you over until you have a chance to brush. Pack either a whole apple or apple slices in your lunch to give your mouth a good scrubbing at the end of the meal.
- Carrots are crunchy and full of fiber. Eating a handful of raw carrots at the end of the meal increases saliva production in your mouth, which reduces your risk of cavities. Celery acts a bit like a toothbrush, scraping food particles and bacteria away from your teeth. It’s also a good source of vitamins A and C, two antioxidants that give the health of your gums a boost.
Patients express their surprise by how comfortable they feel during and after the placement of dental implants. They often express the procedure was much easier than they expected.
Types of Sedation
Many patients have their implants placed with what we call local anesthetic. Once the patient is numb they do not feel any discomfort. They just feel a little pressure or a little vibration during the implant procedure.
Some patients, however, need more relaxation and we use what we call conscious sedation techniques using medications. I am currently certified in New York State for conscious sedation.
Often times patients come in and they say they just want to go to sleep and wake up when the procedure has been completed. We have a medical team of board certified anesthesiologists who come to our office quite regularly. A medical anesthesiologist uses intravenous sedation, also called IV sedation, and puts the patient to sleep and carefully monitors all vital signs during the procedure.
After the procedure, the patient wakes up and we conduct further assessments. The patient stays in our office for a period of time in order to fully recover from the anesthesia and receive post-op instructions. A driver who accompanied the patient to the office then drives them home.
When patients compare the procedure to having a tooth removed, they often tell me time and time again that the implant placement felt easier. They say afterwards that they hardly felt any discomfort.
Also after a dental implant procedure in one of our Long Island clinics, most patients report that they use a minimal amount of medication for discomfort. Often we recommend Motrin, Advil, Tylenol or similar medications if needed for a short time after a procedure.