Senior Dental Care: A Program Design Just for You

Dental care for those patients over the age of 65 involves unique considerations. Seniors are more likely to suffer from a host of issues resulting from the natural aging process, difficulty in receiving proper oral health care due to financial constraints (fixed income and lack of dental insurance) or their inability to provide adequate oral home care for themselves.

We know seniors are often:

-On softer diets (affecting the self-cleaning/natural food deflection action of the chewing process)

-On many medications (affecting the saliva production in the oral cavity leading to dry mouth)

-Having systemic diseases that affect the oral cavity such as diabetes and heart disease.

-Suffering from reduced manual dexterity (homecare efforts are not as effective as they once were)

-Not feeling well enough to properly take care of themselves

At the office of Guy Mangia DDS, we understand those unique problems and are willing to work with our patients to achieve positive oral health results.

Seniors are more prone to periodontal disease (gum disease) resulting from improper dental hygiene practices, poor diet, ill fitting partial dentures, diseases such as cancer, diabetes, heart disease or a predisposition due to genetics. In many cases, the supporting bone structure for the teeth, including the jaw, may shift, which can disrupt a patient’s occlusion (bite), which can contribute to tooth decay and further periodontal disease and/or jaw pain.

Seniors are also more prone to tooth decay and tooth sensitivity due to the loss of enamel or dentin, or root deterioration caused by gum recession. Old restorations may need to be replaced, medications may need to be applied directly to the tooth surfaces, products may be prescribed for homecare, and more frequent dental visits may be necessary to help stop the progression of any present dental disease.

Seniors are more likely to suffer from various symptoms including the following: inflammation of gum tissue, dry mouth syndrome (often caused by medications), or an oral fungal disease, which may cause ulcers and whitish spots. These may all be due to changes in the immune system that occur over a lifetime and should be checked and monitored on a regular basis.

Dental Tips for you:

-Brush, floss and rinse with mouthwash properly to maintain dental hygiene.

-Use special toothbrushes recommended by your dental hygienist to clean hard-to-reach areas of your mouth. Electric toothbrushes are highly recommended.
Chew sugarless gum twice a day for 20 minutes following meals to increase saliva flow and help clean the teeth of food debris.

-Know the warning signs that indicate your mouth, teeth or gums may be in jeopardy including: tooth sensitivity, teeth grinding, pain, mouth sores, bumps, swelling, loose teeth, jaw popping or clicking, difficulty quenching thirst and/or swallowing or chewing (these could be signs of dry mouth syndrome).

-Visit us as often as your dentist or hygienist recommends for regular dental hygiene check-ups.

-Properly maintain dental appliances such as dentures and removable dental bridges.

-Consider seeing your dentist before and after general surgery.

-Tell your dentist about any medications that you are taking or changes to medication.

-People suffering from arthritis or a similar medical condition that limits manual dexterity can try using a modified electric toothbrush. We may also recommend other such innovations designed to make regular oral hygiene simple and effective.

Whitening Forever

THAT’S RIGHT!
We are introducing a new Whitening Program that allows patients to maintain their brightened smile for life!

WHITENING...
With our program, you will receive $200.00 off our home bleaching system. For a one time fee of $99 you will receive one set of customized upper and lower whitening trays and a starter kit.

FOREVER!
Each time you commit to your regularly scheduled hygiene appointment, we will supply you with a Touch-Up Kit to maintain your brilliant smile.

ELIGIBILITY...
To be eligible for the program you must meet the following criteria:
* Be a new/or existing patient of record
* Have had a complete dental examination by Dr. Mangia, with recommended x-rays
* Be free of active, untreated periodontal/gum disease, tooth decay, root sensitivity, oral cancer, etc.
* Agree to, and sign whitening consent and commitment form
* Maintain your dental hygiene, by keeping your regularly scheduled cleaning appointments
* Your account must be current and in good standing.

PLEASE REMEMBER…
Whitening may not be for you. Whitening procedures may not be effective on some natural or synthetic teeth. (fillings/crowns)
Some medical or pre-dental conditions may hinder whitening effects. Your home care and professional cleanings are critical in maintaining brilliance.

DR. MANGIA HAS DONE IT AGAIN!

Once again, the readers of the Daily News voted Dr. Guy Maniga best dentist of Los Angeles for the Daily News Readers' Choice Awards. Thanks to all the voters out there. The Daily News will be visiting us soon and will be publishing an article about our office. So, keep a look-out for us in your morning paper.

Understanding Periodontal Disease

Did you know that more adults loose teeth due to periodontal disease that they do to tooth decay? Periodontal disease is a chronic inflammatory process of the gum tissue, bone and ligaments that surround the teeth. Millions of Americans have evidence of periodontal disease, leading to inflamed gum tissue, bone loss around the teeth and eventually the loss of the teeth. The good news is that affordable treatment is available to assist in bringing the tissues back to health and controlling the life long disease. You may have periodontal disease without noticing any symptoms. There are three main stages to the disease. Early detection and treatment can help periodontal disease from progressing. Gingivitis: Bacteria and plaque have caused the gums to become inflamed and bleed easily. Plaque gets in the space between the gums and the tooth, causing the tissue to swell and remain irritated. Good home care and a professional cleaning on a regular basis are normally enough to restore the healthy gums. Often medications or systemic disease can lead to gingivitis as well. This why it is so important to report any changes in your medications or to your health to your dental team so that your condition can be properly evaluated.

Periodontitis: High levels of bacteria initiate a release of tissue destroying enzymes. These enzymes start a process that results in deeper pockets and bone loss. Re-treatment is aimed at stopping further damage and reversing the progress of the disease. Advanced Periodontitis: Bacteria and enzymes have caused surrounding tissue and bone to degrade further. At this stage, tooth loss is possible. It is critical to avoid this outcome.

Adult Periodontal Treatments: With regular professional dental cleanings and proper home care, periodontal disease can be diagnosed early and treated.

Treatment includes scaling and root planing, enzyme suppression, antibacterial therapy, and sometimes surgery. For the best results, you may have a combination of these treatments Scaling and Root Planing: This is a special type of professional service provided under local anesthesia, by a dentist or dental hygienist. It is usually done in several appointments. The procedure is designed to meticulously remove plaque and calculus (tartar) and toxins imbedded in the root surfaces as well as the diseased root surface. The roots are smoothed to a glass like finish making it more difficult for plaque to attach in the future.

Enzyme Suppression: Suppression therapy is performed in conjunction with scaling and root planing, and includes oral medication that helps stop enzymes from attacking the gums and the surrounding bone.

Antibiotic Therapy: This treatment includes oral medication, topically applied antibiotics and rinses that can help fight the bacteria that caused periodontal disease. Surgery: Surgical treatment is used in the most advanced cases of periodontal disease. Surgery may be done on the soft tissue, the bone or on the roots of the teeth. The purpose of the surgery is to either correct defects or to make the area more cleansable for the patient . Thus reducing the bacteria in the effected area.

On-Going Periodontal Therapy: Following the initial periodontal treatment, it is most important that the patient receives a periodontal maintenance procedure from a dental hygienist every 12 –16 weeks. This procedure replaces the standard dental cleaning, with a more thorough session of periodontal scaling, and spot root planing where needed. Because periodontal disease is a chronic disease that can not be cured, the periodontal maintenance procedure will be necessary 3-4 times a year for the rest of the patients life. Timely on-going periodontal therapy and good oral home care are the only possible way of controlling this disease and preventing future tooth loss.

You and Your Bite

Isn’t it ironic how some of us sleep our recommended eight hours and still wake up in the morning fatigued, tired and with muscle strain? Do you ever feel neck, shoulder or back pain as soon as you sit up from bed? Most of us probably think it’s time for a new mattress; however, the answer to your restless sleep could be something you may not be aware is a problem. These pains could be symptoms of an uneven occlusion (bite) or of improperly aligned teeth. Occlusion problems cause clenching and grinding (bruxism), jaw clicking, headaches, ear aches and sore jaw muscles. Continuous grinding can also lead to a more severe problem, Temporomandibular Joint Disorder. This is a disorder that affects one or both of the joints in the jaw which work together to control chewing, speaking and swallowing. Repeated trauma to the joints will wear down the fibrocartilage, leaving your joint with no choice but to have bone on bone contact. As some of you know, this can be extremely painful and in severe cases surgery is the only treatment that can remedy it. But before reaching this point, there is a preventable tool that may aid in taking care of all these symptoms.

The solution may be splint therapy. A splint is made out of acrylic and provides a temporary perfect bite for the mouth. Splint therapy is implementing this device to correct your occlusion. Once your splint is constructed to your individual bite, there is a series of adjustments the dentist makes to the splint over a period of time until the bite is ideal and the symptoms once present are gone. The final step is to equilibrate the occlusion. In other words, now that the jaw has reached the perfect bite, adjustments will now be made to the teeth to achieve the same occlusion. The goal is to eliminate interferences in order to give that perfect bite once felt with the splint, but without the splint present and therefore, prevent any future problems.

Not addressing the issue can lead to more expensive treatment such as, repairing chipped teeth, replacing broken crowns, erosion and much of the bridgework adults encounter. You may not be aware of the clenching and grinding that goes on at night but your dentist will definitely see the evidence in your mouth. This is why not only regular hygiene visits are essential, but also comprehensive oral exams with the dentist. According to the Pankey Institute, a world renowned center for dental education, “your doctor knows that looking into the future means providing you with all the information about what’s happening today that will impact your teeth five, ten, twenty and more years from now.” This makes it possible for patients to be able to make informed decisions and therefore, have a healthier mouth, more restful sleep and fewer problems in the future.

Your Best Investmen in 2009: YOUR HEALTH

Grim news about the global financial crisis dominates headlines daily. Consumer confidence is at its lowest point in history. Even if your monthly income has not recently changed, you are probably looking at your household budget, trying to decide where you can cut back in personal expenses. It only makes sense to prioritize spending and cut back on the things that just are not necessary right now.

Personal Reflection: All of us have ongoing expenses that we can certainly reduce or perhaps go without. We want the item or service, but do we really need it? On the other hand, there are things that we need but we don’t really want. In these hard times, it is certainly easy to rationalize that you can’t afford something you actually need if it isn’t something that is high on your emotional priority list. Often, health care falls into that category. You need it but you don’t necessarily want it, and it is moved down the priority list when it comes to monthly spending.

Making Good Choices: Making the decision to reduce or eliminate health care in the short term during lean financial times can have long term repercussions. There are very few procedures in dentistry that are preventive (or elective) or that can be delayed. Often the public has considered regular hygiene visits (professional teeth cleaning), resin sealants, examinations and x rays as procedures that are preventive in nature and not totally necessary. Nothing could be further from the truth. Delaying any needed procedure, including a hygiene visit, will lead to more dental disease. A delay in needed therapy will result in dental treatment that is more extensive, more expensive, and with a poorer prognosis. Often, it leads to the loss of the tooth entirely. 90% of the dental diseases that we diagnose have no symptoms for the patient. The decision to not treat the disease until you feel it can be a costly mistake. Taking care of it now will be the most conservative treatment option, with the least expense and the best prognosis.

The doctor and your hygienist will make a recommendation for the frequency of your professional dental cleanings based on your level of periodontal disease and your ability to control the bacterial levels in your mouth, as well as your medical conditions. This is necessary to control or eliminate the dental disease process. Every patient is different; therefore, every patient’s frequency rate for professional cleaning and examination will vary.

The decision to spread out your regular dental visits for the sake of saving money in the monthly household budget may not be a wise choice. It would be the equivalent of a diabetic deciding to take insulin every other day, or a high blood pressure patient deciding to skip their medications twice a week for the sake of saving money. Could that decision create an unstable medical condition for the patient? You bet! The decision to delay or skip regular dental visits or needed treatment will create an unstable dental situation as well.

We Want To Help: We are dedicated to assisting our patients in achieving and maintaining excellent oral and systemic health. We know that means not only providing the services necessary but also the information and education necessary for our patients to make good decision about their care. We know that also means working with each patient individually to find a way to comfortably afford treatment. Let us help you with your questions and considerations during this unusual economy.
Invest In Yourself: The troubled financial times leave few places for an individual to securely invest their time and money. While Wall Street is seemingly in a state of disarray, the financial institutions are lacking credibility and real estate investments have become unpredictable, your continued good health becomes your best investment. We look forward to serving you in that endeavor.

Chewing Gum-the dental benefits

The benefits of chewing gum extend beyond oral gratification, fresh breath and a way to expel nervous energy. While people may chew for many reasons, scientific research has shown that chewing gum can make a positive contribution to oral health in general and the teeth specifically. Chewing gum stimulates one of the most powerful defense mechanisms from the body-saliva. The partnership between chewing gum and saliva stimulation creates a powerful force that contributes to good dental health for the following areas:

What are the oral benefits?

• Alleviates dry mouth discomfort


• Freshens breath


• Neutralizes acids formed from in the mouth by bacteria


• Re-mineralizes enamel to strengthen teeth


• Cleans the mouth of food debris


• Whitens teeth by reducing stains and preventing stains from accumulating


• Reduces plaque


• Helps fight cavities


• Reduces gingivitis to maintain healthy gums


• Kills the germs that cause bad breath

Perhaps future benefits? Healthy Mouth/Healthy Body

New Research suggests that inflammation from the body could be a factor associated with disease like heart disease and dieabetes. This inflammation may be realted to the bacteria you find in the mouth. Research is currently being conducted to explore the role chewing gum might play in reducing inflammation causing bacteria in the mouth and therefore its contribution to the overall health of the body.

What does chewing gum do?

The physical act of chewing increases the flow of saliva in your mouth. If you chew after eating, the increased salivary flow can help neutralize and wash away the acids that are produced when food is broken down by the bacteria in plaque on your teeth. Over time, the acid can break down tooth enamel, creating the conditions for decay. Increased saliva flow also carries with it more calcium and phosphate to help strengthen tooth enamel. Clinical studies have shown that chewing sugarless gum for 20 minutes following meals can help prevent tooth decay. Newly on the market are chewing gums also containing a variety of therapeutic agents (such as xylitol) that could also enhance the gum's ability to re-mineralize teeth and reduce decay, or enabel gum to reduce plaque and gingivitis.

Does chewing gum replace brushing and flossing?

Chewing gum is an adjunct to brushing and flossing, but not a substitute for either. We continue to recommend brushing twice a day with a flouridated toothpaste and cleaning plaque from between your teeth once a day with dental floss or other interproximinal dental cleaners.

The bottom line

Using chewing gum after meals to increase the flow of saliva in the mouth will aid in the reduction of acid concentration in the mouth helping to reduce cavity developement and periodontal disease.