Botox

Hi Readers,

Today I am here to talk with you about Botox and its counterpart Xeomin. Botox has been FDA approved since 2002 for the treatment of glabellar lines (or “11s” as people affectionately call the lines in between their eyebrows.) Since it’s development advancements in therapy have led to its use on forehead wrinkles, crow’s feet, water bottle lines, overactive sweat glands, gummy smiles, headaches, strabismus and uncontrolled bladders just to name a few.

Botox is an injectable medication that acts to reduce the strength of muscle. It does not work directly on the skin; rather it blocks the connection from nerve to muscle so your muscle cannot contract as forcefully. As time goes on and we make similar facial movements over and over again (think about the squinting face you make every time you step outside on a bright day) our skin begins to get etched with deeper lines in that area. These muscles become hyperactive as the result of our habit. When you block that muscle you block that pattern of etching and your skin is finally able to smooth out and relax over that area.

By relaxing the muscles we are effectively letting the skin “recover” giving patients a youthful more relaxed appearance. We relax only the muscles necessary to smooth your skin. By keeping the rest of the facial muscles active we avoid the “frozen” look that was very fashionable in the early 00’s (thank goodness that trend is over.)

Our goal here is to make patients look less mad, less tired and more happy, more refreshed. It's not for everyone, but it can certainly help the right candidate. To find out more information check out our frequently asked questions page.

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How to Get Your Kids to Brush Their Teeth

One of the questions I get asked most often by my mom friends is how I get my kids to brush their teeth. I have a 2 year old and a 10 month old, both girls. I wish I had a great and easy solution to offer my friends, and to offer all of you, but the sad truth is I don’t. My two year old is very strong willed. She is independent, determined, and self-sufficient. She is definitely taking the terrible twos by storm. The one thing I refuse to let her go without is clean teeth at bedtime. I may give up the fight about what clothes to wear, or if her shoes need to match, or whether or not paint brushes are allowed in the living room, but the tooth brush she knows I don’t give up on.  

For her consistency is really the key. We try for the morning, but whatever happens, without fail, every night they are brushed. I usually brush them while we are in the bath tub because she enjoys bath time and is slightly distracted. It took me a while, but my sister-in-law found a great toothbrush my daughter loves called The Firefly. Here is a link to the one she got at Target: http://www.target.com/p/firefly-lightup-timer-toothbrushes-2-pk-soft/-/A-14071887.

The toothbrush is nothing amazing, but it does light up when you push the button and keeps blinking until you are done brushing your teeth. More often than not my daughter also requests to bring it to bed with her so she can light it up in the dark. The “light toothbrush,” as she calls, it we reserve specifically for teeth brushing, but we also have lots of other toothbrushes around the house. Ones that she can play with, or brush her dolls teeth with, anything to just get her used to the idea in general. We had our fair share of fights (and I mean fights) in the beginning, and we still do on occasion, but I do not give up. Even if I can only brush when she opens her mouth to yell at me, but don’t worry. It does get better. Like most everything else about being a parent it takes incredible patience and repetition.

I know being a parent can be incredibly tough. And sometimes you feel like you just can’t take one more toddler tantrum. There are other ways to help reduce your child’s risk of cavities if they consistently refuse brushing. One of the most important would be to not let them have anything sugary immediately before bed time. (This includes juice and milk!) If they like to have milk before beds make sure they rinse out with water afterwards and they don’t take the bottle to bed with them. Cut down on any food throughout the day that is sticky (think gummies, raisins, jelly) this can coat their teeth and be difficult to get off without a brush. Discuss with your dentist if your child is getting enough fluoride for their habits (more on this in a future post.) And lastly take them to the dentist early and more often if you think they may be at risk for decay. You can do it! And your child will greatly benefit from all of your hard work.

Visit  www.omenedentistry.com for more information

Need a New Year's resolution...how about flossing?!

November 2015

Hi Readers,

Ok, I know that dentists and hygienists have a reputation for being obsessed with flossing. I remember going to the dentist as a child and wondering how they always knew that I didn’t floss every day and why they would harp on that every time. The reason for our infatuation is simple. As wonderful as brushing your teeth is, your toothbrush simply cannot reach every surface of your tooth. Where the teeth touch, or contact, the space is too tight for your toothbrush bristles to fit. This means up to 60% of the surface area of your teeth can be missed by brushing alone. Flossing does more that just clean food from in between your teeth. When done correctly flossing helps strengthen your gum tissue and removes plaque from in between the tooth and gum.

There are many different types of floss and that can make it overwhelming when you are in the dental aisle of the drugstore. First and foremost I would say as long as you are there actually  buying floss you are already ahead of the curve. From a dentist perspective the tried and true “rope” floss is still the gold standard. This type of floss is best because it is able to be manipulated to contour to the curvature of the tooth. The best way to use this floss is to take about a foot and a half piece between two fingers on opposite hands. Next gently push the floss through the contact of two teeth, wrap the floss in a C-shaped ‘hug’ around one tooth and move it up and down the length of the tooth into the gum. Then wrap the floss around the neighbor tooth and do the same. Afterwards pull the floss out and move to the next two teeth.

The floss-sticks or floss threaders have become very popular of late. You will find them in the same aisle. The tight hold on the piece of floss makes it harder to manipulate into that C-shaped pattern we were talking about above, but again it is better than nothing! Floss-sticks are a great way to get kids flossing, a great way to travel, or the perfect hygiene tool for someone with limited manual dexterity.

Floss picks, toothpicks, and waterpicks can also be a great addition to your oral hygiene arsenal. They are better at removing food from in between the teeth than they are an removing plaque from the contact or gumline. For that reason they should be used to supplement regular flossing, not  to take the place of flossing entirely.

Aim to floss at least once a day. I always suggest getting your technique down in front of the bathroom mirror, but once you get the hang of it you can floss anywhere. If it’s too boring for you, floss while you are watching tv. If you are too busy, floss while you are on a conference call. In no time your mouth will be feeling so healthy and clean, you will become just as obsessed as all of the dental professionals out there….and boy will we be impressed at your next cleaning!

To Have or Not to Have: Dental X-rays

October 2015

Hello Readers,

In this month’s blog we are going to touch upon another ‘hot button’ issue in dentistry: x-rays. It has been on our minds a lot as we get ready to make the big transition from old-fashioned, film x-rays to digital x-rays at Omene Family and Cosmetic Dentistry. In practice I have found that patients’ perceptions of dental x-rays run the gamut from intense scepticism to carefree enthusiasm. By that I mean it is just as common for a patient to say to me, “Hey these x-rays are nothing but a scam right?” as it is for them to say, “I want x-rays as often as my insurance will allow.”

To the skeptics I would like to address exactly what we look for on x-rays. X-rays fall into three common categories; the check-up bitewings, the full mouth series, and the panorex. Our visual exam of your mouth only gives us a limited amount of information. We can not ‘see’ the inside of your tooth or your bone levels with our eyes.The bite-wing x-rays help us spot decay in between your teeth. Your enamel (or the outer part of your tooth) is the hardest substance in the body. Breakdown of the enamel would not be visible until the cavity was so humongous that the tooth might not be able to be saved. Current bitewings help us detect and treat this decay before it compromises the whole tooth. A full-mouth series can help us identify bone loss from periodontal disease and infections in need of root canal treatment. Periodontal disease is the number one reason adults in America lose their teeth and has been linked to a whole host of other system wide conditions including diabetes and heart disease. Even the slightest changes from your last full mouth series of x-rays can alert us to shifts in your oral or overall health. Finally panorex x-rays are used to help visualize wisdom tooth position, your TMJ, abnormalities of the jaw, and your sinuses.

To the gung-ho patron I would have you address the best x-ray schedule with your dentist. X-rays should always be patient-centered and not just an insurance afterthought. As with most medical imaging, the patient is exposed to radiation during dental x-rays. But what most people don’t know is exactly how little that radiation is. According to the ADA “dental radiographs account for approximately 2.5 percent of the effective dose received from medical radiographs and fluoroscopies.”1 Or to phrase another way, dental x-rays have only 2.5% of the radiation exposure in a typical medical image. The Dana-Farber cancer research center says, “A full-mouth series of radiographs – which involves 18 separate pictures of the teeth – exposes an individual to roughly the same radiation risk as a plane passenger would absorb during a cross-country flight. At such levels, radiation is thought to have little or no effect on the risk for cancer.”2 On that note, there is also less radiation in dental x-rays than there is in the body scanner you are required to go through at the airport.

And for one final comparison again from the ADA, “The amount of radiation used to obtain dental radiographs is very small. For example, bitewing radiographs—two to four images of the back teeth—expose a patient to about 0.005 millisieverts (mSv) of radiation. By comparison, because radiation is part of our environment, people in the United States are exposed, on average, to 3.2 mSv every year from background sources of radiation.”3 So literally just by walking around outside every day we are exposed to more radiation than in the dental chair. That puts everything into a bit of a different perspective doesn’t it?

In our office we use the principle of ALARA when determining the need for dental x-rays. ALARA stands for As Low As Reasonably Allowable. This is one of the main reasons we are converting to digital x-rays which also minimize radiation exposure. Our goal is to educate you about your oral health. Often x-rays are needed to correctly diagnose and treat a problem. We look at the benefit of the x-ray versus the risk when doing our clinical exam. At the end of the day, x-rays help us to treat each patient effectively. I encourage you to have an open discussion with your dentist about your x-ray schedule and disease risk. You might both learn something new!

1.) Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure. Revised in 2012by the ADA and US Dept of Health and Human Services
2.) http://blog.dana-farber.org/insight/2014/01/can-dental-x-rays-increase-cancer-risk/
3.) Dental Radiographs Benefits and Safety. September 2011, JADA 142(9) 

Staff at Omene Family and Cosmetic Dentistry getting trained in the office's new digital x-ray system. Digital x-rays can reduce radiation exposure by 50%!



Read more at Ask Dr. K

What to Expect at the Dental Office When You Are Expecting

September 2015

Hello Readers,

Today I want to talk about what to expect, dental-wise, when you are expecting. This is a topic near and dear to my heart as I am happy to announce I am currently four months along with our second child.

Lots of rumors that fly around about your dental health when you are pregnant. I have heard everything from your teeth get soft, to you can’t have x-rays, to you need to have x-rays, to you should go to the dentist more often, to you should avoid it entirely. Phew! There is a lot of information out there. Today I want to get to the bottom of some of these myths. One thing I know for sure, is that you have enough things to worry about while pregnant rather than getting bogged down by dental fact and fiction.

First we will tackle, “what’s the deal with your teeth and gums while you are pregnant.” Many women report that their teeth bleed a lot and their teeth get soft during pregnancy. As you know, our hormones go on a roller coaster ride during gestation. The upflux of estrogen and progesterone can make your gums more sensitive and bleed more easily while brushing or flossing. (I, for one, look like a vampire when I am flossing while pregnant.) For this reason, some women may avoid their normal home-care routine. In addition, morning sickness can have a significant effect on your diet. Frequent meals are more common and I will be the first to admit carbs help me suppress those waves of nausea best. The combination of an increase in frequent carb intake and a simultaneous oral home-care decrease can lead to the phenomenon people describe as “soft teeth.” It is not uncommon for a woman with a great dental history and very few cavities in her life to all of a sudden have three or four while pregnant.

This debunks our second myth of the day, “you should avoid the dentist while pregnant.” Given what we learned in the last paragraph we can see how important it is to stay on top of our dental care so we don’t get into even more trouble with our teeth. And what’s worse (and what many women don’t know) is that bad oral hygiene in pregnancy has been associated with various adverse effects to the baby such as “premature delivery, intrauterine growth restriction, gestational diabetes and preclampsia.”1 Both the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics, recommend continuing your normal dental care while pregnant.

The third thing that can bring about a lot of confusion is what treatment is allowed during pregnancy. I would say the most frequently asked questions are: can I have x-rays, can I have novocaine, and can I have dental work completed? This month’s cover story in The Journal of the American Dental Association

covers just that topic. The major conclusion presented was “the use of dental local anesthetics, as well as dental treatment during pregnancy, do not present a major teratogenic [or birth defect] risk.”1 To state that another way: lidocaine, the most common modern day anesthetic used, and dental work, such as extractions, root canals, and fillings, did not increase the risk of birth or birthing abnormalities. There was also no negative findings with the use of x-rays on the women in the study. The exposure from one x-ray is so low that it is only 0.01 of a percent of what the U.S. Council on Radiation Protection and Measurements considers a safe dose for a mother.1  Of course no x-rays, anesthesia, or work need to be done unnecessarily, but it is nice to know that if you are in pain your dentist can help.

All in all the dentist’s office is your friend. We are here to lend a hand to you during your pregnancy and to make your life easier. Even if you just want to come in and complain about your gums (as I do most often these days.) We are here for that too! Pregnancy is complicated enough. Let us worry about your teeth and gums for you :)

Have a great day and a happy pregnancy,

Dr. Omene

1. Hagai A, Diav-Citrin O, Shechtman S, Ornoy A. The Journal of the American Dental Association. Dental Treatment Safety with Local Anesthetics During Pregnancy. 2015;146(8)572-580
2. Moore, P. The Journal of the American Dental Association. Selecting Drugs for the Pregnant Patient. 1998;129:1281-1286.
3. Sheth, B. Academy of General Dentistry Impact. Brushing for Two. 2009.
4. The Journal of the American Dental Association. For the dental patient: oral health during pregnancy. 2011;142(5):574

The Dos and Don'ts of Dry Mouth

July 2015

Good Morning Everyone,

I wanted to take some time today to talk to you all about a very important issue in dentistry: Xerostomia. Xerostomia is the scientific term for dry mouth. This happens when the salivary glands that produce the saliva in your mouth are not functioning at their optimal capacity. Unfortunately we see this a lot in our practice. You might ask, what causes this and more importantly, why do I care? Well those are great questions!

The reason this is such a problem is because saliva plays an important role in protecting your teeth and gums. Having less saliva increases your risk for cavities, tooth sensitivities, fungal infections and bad breath. It is not uncommon for someone to go from having excellent check ups many years in a row to all of a sudden having 3 or 4 cavities all due to the change in the climate of their mouth from xerostomia.

Xerostomia has been attributed to medication use, smoking, mouth breathing (especially at night,) dehydration, and some medical treatment such as cancer radiation and chemotherapy. It could also be the result of a systemic disease. It is no wonder we are seeing cases of xerostomia more and more. Oral dryness is listed as a side effect of over 500 different drugs. To phrase that a different way, about 80% of the medications commonly prescribed and used OTC can cause oral dryness.

That is a lot of information to absorb but I do not want you to feel helpless. There are many things we can do to try to combat this common problem. To start with, treatment has to be tailored to each individual patient. A good place to begin is with the source of the dry mouth. A consultation with your primary care physician can help you to come up with the best medication regime for you to follow; as well as, make sure there are no further systemic problems that need to be addressed. Regular hygiene appointments are also recommended to stabilize your oral health and to come up with a good daily oral hygiene routine.

In terms of the symptoms, there is no clear consensus on the most effective ingredient/product for dry mouth. There will be a bit of trial and error involved here. Some common solutions include: sipping water throughout the day, using a humidifier at night,  fluoride toothpastes and rinses, salivary stimulants, and sugar free gum that can help stimulate your own saliva production.

Xerostomia can be an uncomfortable condition, but it is something that can be managed with the help of your dentist and their team. Don’t hesitate to contact us with any questions or concerns you may have.

Have a great day,

Dr. Omene

What Really Happens at a Dental Cleaning?

June 2015

Hi Readers,

I want to welcome you to the first official blog post of Omene Family and Cosmetic Dentistry. Our goal is to use this blog to pass important health information on to our friends, family, patients, and perspective patients. There is a wealth of information out there, but it can be hard to sift through it all to find the education you need. We want to do that for you! We take oral health care and continuing education seriously over here and we love passing along what we've learned. Each month we will highlight specific articles we have read and bring out the most important points to benefit your oral and overall health.

Today I wanted to share an article from US News & World Report (5/20/15)
The article brings up the importance of maintaining a regular dental recall schedule with or without dental insurance. About 40% of American adults don't have dental insurance and are far less likely to see a dentist....until something goes wrong. Unfortunately, this might be the wrong move. As the article points out:

"minor cavities can turn into major problems, and what would have required a filling can eventually require a root canal or extraction [...] regular exams can uncover small problems before they grow in both size and cost."

The article goes on to consider how not caring for your oral hygiene can affect more than just your mouth. Studies have linked poor oral health to a variety of other overall health problems including diabetes and low-birth weight babies (look out for more on these topics in future blogs.)

Below we have created a fun video to let you know exactly what goes on during a cleaning at Omene Family and Cosmetic Dentistry. We hope you will come in for a visit and find out more for yourself. If nothing else, stop by for a free cup of coffee on us :)