Hi, folks! It’s been a busy couple of months of traveling and learning around here. I am two months into a ten-month course on what is probably the best dental implant education you could find — designed for dentists, of course, unless you’re really curious and care to commit the next year of your life learning about implant surgery. The classes are held in Puerto Rico, where the head surgeon lives, which means each month, for one week, I fly to Puerto Rico, learn about and work on implant surgeries, and come home for three weeks to repeat the routine. Like I said, we’re two months into this, and I’m already feeling the wear-and-tear of such frequent flying. This course is fabulous, and I’ll tell you why soon. But I think by the end of it I will be done signing up for classes out of state. That is, unless a particular course is especially intriguing. Sometimes I can’t resist.

I have a lot of great things to share about what we’ve done so far, so the next few posts will have some fun information and pictures. Stay tuned!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

P.S. I’ve been a little awed by how many internet users are looking for answers for solving pericoronitis issues. Soon I will try to help you out. For now, read this.

I am stating the obvious when I say that the Internet is the foremost consulted source of knowledge and answers to the world’s questions. We do it without thinking. Where was the transition, and why, in retrospect, does it feel like it happened without us noticing? Once upon a time, there was no cyberspace, no “online,”no instant mental gratification (unless you lived next-door to a library). What did we do all day? How did we work? As a dentist highly reliant on the latest technology available, the Internet has become a part of the skeleton of my practice. Without it, my practice would have fizzled out long ago in this fast-paced world.

But I do not mean to get all philosophical with you today. Today’s post just got me partly reminiscing about days gone by when society was more “awake” to the physical world around it, but also causing me to express gratitude in how much computers have transformed science and medicine and my own work.

In the online world of patients searching for solutions for their dental diseases and ails, oral irrigation has been quite a popular topic lately. I must say it’s for good reason. It is one of the best at-home dental hygiene routines you can maintain at home.

Pericoronitis, in particular, seems to be the central purpose for which people seek healing and relief through irrigation. Pericoronitis, if you remember, is an infection which develops under a gum flap of emerging teeth — usually the wisdom teeth of young adults. It is caused by the body defending itself from a foreign invader, which is usually an overabundance of bacteria feeding on a particle of uncleaned food. The pain is quite severe. The infection will remain swollen for up to several days or a few weeks. Even someone in good health has a tough time kicking this infection in less time, which is why it is so important to prevent it in the first place. Irrigation does just that, and it does it very well.

In those hard-to-reach areas around your teeth — and there are many — an oral irrigator shoots thin streams of water, ozone water, or diluted oral cleansing solutions, gently forcing out the debris that is not supposed to be there. Finely squirted liquid crawls into the places that floss can’t reach, effectively cleansing and leaving the mouth refreshed. How does this help healing and preventing infections? We’ll look into that tomorrow.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Sometimes, sadly, teeth that have suffered major trauma cannot be restored or the patient has let the injury go untreated for too long. In these cases, a full tooth extraction may be in order. A dental implant can replace the missing tooth later once the area is able to be prepared for an implant.

If you are ever presented with a situation where a tooth is knocked out, call the dentist immediately for an emergency appointment. The tooth must be handled professionally within the hour for the best chances of saving it. Some new advances in scientific technology have lengthened the time an ejected tooth can still be salvageable; however, most people are not equipped with the supplies when the accident happens. It is best to call a professional immediately and follow his instructions.

If the natural tooth was not able to be restored, the dentist will provide the opportunity to prepare for a dental implant to replace the missing tooth. Steps will be taken to properly let the injured area heal and set a foundation for a strong replacement. Every case is different, but with the aid of ozone, lasers, and strong ceramic zirconium restorations, we can assure you that around here the best work would be done to restore a strong, healthy smile.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

The method of treatment varies from injury to injury and depends on the severity of the damage done. Most injuries are caused by accidents that happen quickly. Major injuries are fairly noticeable because of the bleeding, pain, or visible cracks or chips in the tooth — or maybe it has been knocked out completely. Minor injuries may not be as noticeable at first, but are just as harmful to the tooth. For example, a small crack may occur nearer to the root than the crown and cause damage to the dentin, nerve, pulp, and blood flow to that tooth. Someone may choose to ignore the pain if it is minor enough. But when the tooth starts turning gray or black because it has “died,” then it is probably too late to salvage. If the person had had the tooth closely examined and x-rayed by a dentist, he probably would have been able to avoid the slow decay.

When there is damage to the tooth’s structure, besides preserving what natural structure we can, of equal priority is to protect it from further damage. Ozone gas, of course, works wonderfully for crawling into the microscopic cracks and crannies (whether old or new), completely sterilizing everything inside and out, halting any further decay or infection, and providing an ideal site for strong repairs and healing.

A dental laser is also a useful tool when repairing injured teeth. The laser can be used doubly for sterilization and cleaning out dead tissues that may have accumulated. Shaping soft tissues (gums) and speeding up healing are more of the laser’s useful benefits. To repair cracks and chips, laser- or light-cured composite may be used, and they are much stronger, far less risky, healthier, and better-looking than amalgam. For structure damage, whether caused by poor hygiene/diet or injury, laser-cured composite actually bonds to the tooth itself unlike the silver-mercury amalgam, which will likely crack and separate because of its non-biocompatibility and sensitivity to temperature changes.*

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

*In other words, don’t consume hot things and cold things simultaneously. That’s one fast way to spring cracks and leaks in your amalgam fillings. While you’re at it, make an appointment to just get them replaced completely. It’s bad to keep mercury in your body.

Holistic treatment is especially useful when treating dental injuries. Preserving as much of the natural structure of a tooth as possible is already priority; therefore, it becomes a matter similar to any other day’s objective: restore the tooth with minimal invasion, and allow clean healing so that the tooth’s natural strength and function is reinforced.

Dental injuries can happen in countless ways: car accidents, falls, sports accidents, work accidents, etc. Even rough-housing children commonly get their teeth whacked on, as I’m sure many frazzled mothers have dealt with. Hopefully those children haven’t had their adult teeth come in yet; if not, their baby teeth do not require the kind of work that adult teeth do because they will be falling out anyway. Of course, the area should be monitored over the years by the dentist. Always make sure you’ve got his stamp of approval. Their baby teeth are not as valuable as their adult teeth, but monitoring is definitely advised so any injuries do not impede or interfere with the adult tooth development and emergence.

Unfortunately, matters are usually more urgent and painful when dealing with an injury. It is also unfortunate that, when injured, a patient completely loses control over the condition of his teeth. Suddenly, serious damage has been done, and he needs an emergency appointment to determine the immediate fate of his dental health. It is a big difference from the day-to-day control he has (and probably takes for granted — take heed!) over his oral hygiene regimen that ultimately determines the general condition of his teeth.

The anticipation of injury, while not a very happy thought, is also a good reason to ensure that your dental and general physical health is good so the foundation for a healthy, strong recovery has already been set.

 

Since it’s likely that the mercury levels in your body will quickly spike as your amalgam fillings are removed, you should consider paying special attention to your health (nutrition and diet, in particular) in order to supply your body with the best ammo for serious detoxing. I have the ability to refer you to nutritionists and health specialists. Pregnant/nursing mothers should not get the procedure done until they are neither pregnant (or trying to be) nor nursing. Those with known sensitivities to mercury should consult a doctor knowledgeable about mercury and its effects on the human body before attempting the removal.

Take special care of your diet before and after the procedure to help your tissues detox. Also pay attention to your physical health and alert your physician and/or dentist about anything negatively out of the ordinary.

As you can see, this is serious stuff! Mercury poisoning is no frivolous matter. Here are a few helpful links with content directed towards patients about the whys and wherefores of mercury and removing it.

http://iaomt.org/patients/index.asp

http://dentalwellness4u.com/breaking/breaking.html

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Once you’ve decided to have the mercury in your mouth removed and replaced, some important precautions need to be taken:

  • Be aware that even when correctly removed, a mercury filling or crown releases astronomical amounts of mercury vapor and even visible debris. Sometimes, inevitably, there is a rise in mercury levels in the human body. However, now that the source of mercury is gone and the body will continue trying to detoxify itself, the amount will decrease over time.
  • It is important not to swallow while getting the amalgam replaced. This is probably the most uncomfortable aspect of the process, but should not be much of a bother considering the great service you’re doing for your health in the long run.
  • The time and effort involved in amalgam removal depend on how much mercury is in the mouth. Some may have one small filling; others, several crowns and fillings. It’s too bad that conventional dentists are not hesitant to pump mouths full of the stuff. Getting it back out is so much less convenient than putting in in.
  • I like to use the Isolite system for a hassle-free mercury removal procedure. An Isolite mouthpiece provides light, suction, and a tongue barrier all in one. An Isolite helps protect much of the oral cavity (your mouth) from flying mercury debris.
  • As an extra precaution, I use a powerful suctioning machine that stands nearby and safely “vacuums” up the mercury debris that may be released while the amalgam is removed. This machine is very important. When mercury is broken into pieces and removed, not only does the patient need to be careful of exposure, but the entire rest of the office does, too. Microscopic traces of mercury could very well go undetected, causing a toxic environment for everyone.

In the next post, I’ll go over what should happen after mercury is removed.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Irrigators are particularly useful for cleaning wisdom teeth. Wisdom teeth, because they are so far back in the mouth, are hard to see, let alone reach or clean well. The area surrounding them is especially prone to gum infections because, when wisdom teeth are emerging (or haven’t emerged properly), the gums are “in limbo” — not fully shrunken and tightened around the still-emerging third molars — and are usually full of loose pockets that trap all kinds of food and bacteria. When this area gets infected, pericoronitis develops.

Pericoronitis is somewhat similar to gingivitis, except it is specifically centered around one or more wisdom teeth. Unfortunately, it is quite common and is very painful. The symptoms of pericoronitis include redness and swelling in the area, pain, jaw stiffness, slight discharge, bad taste, and swollen lymph nodes in the neck. If left to itself, the infection will spread and become more serious.

Depending on the state of the wisdom tooth’s development and how well it is frequently cleaned, pericoronitis may or may not be a recurring infection. Those with unhealthy diets and poor hygienic habits will be more prone to the infection than those who stay on top of their physical health and daily thorough oral hygiene.

If you are one of many unfortunate battlers against pericoronitis, it is important to remember that cleanliness is priority. The two best recommendations I can make for healing would be frequent irrigation and rinsing. In my office, we could zap it out pretty quickly with ozone gas and a dental laser.

At home, as soon as you start feeling pain and swollenness in the area around the tooth, you need to immediately begin flushing it out with an oral irrigator several times a day (certainly after each meal). I can supply ozonated water to irrigate with, but hydrogen peroxide (don’t swallow!) and a bit of baking soda also work well. Be sure the tip of the irrigator reaches down under the gums in the swollen area. It will be uncomfortable, but if you nip it in the bud, you’ll save yourself far more severe pain down the road.

Along with frequent irrigation, you can also rinse your mouth during the day with a baking soda solution. You only need a pinch (1/8 tsp or less) per mouthful of warm water. This will provide some relief as the infection heals and help keep the rest of your mouth clean.

Brushing and flossing should be done after every meal — which should also consist of healthy foods — if it is not too painful to eat in the first place. Some find that temporarily resorting to liquid foods only (such as homemade smoothies and soups) causes less discomfort and keeps the mouth cleaner. Increasing superfoods to help your immune system along is a good idea.

Following these steps, the infection should resolve itself in a week or two. Yes, an entire week… or two! Keep your wisdom teeth sparkling — pericoronitis is not a pleasant experience that resolves itself overnight!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Inflammation, redness, and painful swelling of the gums are unfortunate complaints among the general public. Gingivitis — the name for this inflammation of the gums — is most often caused by teeth and gums that are not cleaned thoroughly. The bad bacteria get out of control and cause pain. One might experience just a little bleeding or sensitivity when flossing, or a mouth so swollen it becomes too painful to eat. It is a vicious cycle: a small infection produces pain, which begets difficulty to clean, which begets more infection, which begets more pain…

Yes, it is definitely something you want to avoid. If you have frequent “sore spots,” you may need to reevaluate how effective your at-home cleaning routine is. It is good to pay attention to how your gums are doing every day and to be very thorough about cleaning them out, even if it hurts a little. It is better to deal with a little pain now than unbearable pain in the future.

Sometimes, though, regular hygiene at home isn’t enough. In most cases, if gingivitis has developed into a more serious problem, patients on their own can heal from diligent care at home using an irrigator. Daily irrigation gently keeps the gums cleaned out and restores the proper environment for healing. Patients who suffer from mild to severe gum disease report that their gums gradually heal, shrink up against the teeth, return to a normal pink color, and are able to function normally again because the inflammation is greatly reduced. Not to mention, the need for chemicals and drugs is greatly reduced, if not eliminated. Oral irrigation is highly recommended for healing infections, particularly early gum disease or any inflammation around the teeth.

Whether or not you are prone to gum disease, if you do not have an oral irrigator, we recommend you look into investing in one. Not only will your teeth be so much healthier and low-maintenance, but you will save headaches and money for dental expenses in the long run.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Oral irrigators are one of the most valuable tools you could keep near the bathroom sink. An oral irrigator “flosses” your teeth with liquid, cleaning the deeper or more sensitive areas that floss can’t reach. It does not replace floss, but adds to its effectiveness. Cleaning out the pockets between your gums and teeth is the most important step you take to keep your mouth clean. Flossing catches the larger, stickier chunks of plaque that build up in your gums and around your teeth; irrigation deeply washes out anything that the floss misses — and you’d be surprised at how much debris is still rotting in your gums even after a “thorough” brushing/flossing!

Oral irrigators can be used with plain water — we use ozonated water — but special mouthwash-like liquid concentrates are also made for them that can be used at home. We have chosen a supplying company that makes 100% natural, chemical-free concentrates that taste great and do a great job of keeping bad bacteria at bay. Ask us about ordering some if you’d like to try it.

Irrigation should be done about once daily. A good time would be before you go to bed. You are done eating for the day and will want to clean your teeth before sleeping and leaving any food particles to sit in your mouth overnight. Like flossing, after a little while you’ll be able to see and feel a difference in your teeth after irrigating. Your gums become stronger and healthier and your teeth stay whiter. Irrigation is excellent, also, for healing from minor infections and early gum disease. But that post is for tomorrow.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com