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Posts for: April, 2014

PatientsonBloodThinnersRequirePrecautionsBeforeandDuringOralSurgery

The proliferation of drugs to treat all manner of diseases and conditions has heightened concerns not only about general side effects, but also how a particular drug may affect treatments for other conditions. There are indications, for example, that drugs classified as blood thinners could cause complications for patients undergoing oral surgery.

Blood thinners like Warfarin are typically prescribed to patients with artificial heart valves or who are at significant risk for stroke, heart attack, or the formation of clots that could potentially damage the heart and lungs. The drug reduces the coagulation (clotting) mechanism in blood; aspirin taken regularly should also be considered a blood thinner.

As with any invasive procedure, blood thinners can complicate oral surgery. Blood doesn’t clot normally and so bleeding during a procedure is more difficult to stop. This doesn’t necessarily mean the surgery can’t be performed. For one thing, many oral procedures like tooth removal involve little trauma to tissues and bleeding in the hands of a careful and experienced surgeon. The surgeon can also use hemostatic agents during surgery that will stabilize blood clotting, as well as suturing the incision in such a way as to reduce bleeding from surface capillaries. In the case of a tooth extraction, a bone graft placed within the empty socket not only reduces bone loss from a missing tooth, but can also enhance bleeding control.

In consultation with your medical doctor, it’s also possible to temporarily stop or reduce your medication dosage in anticipation of a pending oral surgery. While it may not be safe to stop the drug altogether, a reduced dosage can ease the anti-coagulant effect and reduce any complications from bleeding that might occur during the surgery. You can then resume normal dosage soon after the procedure.

During your pre-op examination, it’s important to let your surgeon know about any drugs you are currently taking, including over-the-counter drugs like aspirin. The oral surgeon will then be able to take the necessary steps, including working with your medical doctor, to ensure your surgical procedure is safe and uneventful.

If you would like more information on oral surgery precautions while taking blood thinners and other medication, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Surgery & Blood Thinners.”


By Preferred Dental
April 09, 2014
Category: Dental Procedures
HughJackmansShockingTeeth

Australian heartthrob Hugh Jackman has won international recognition for his work on stage, screen and television, including his long-running portrayal of Wolverine in the X-Men film series, and his Academy-Award-nominated starring role in Les Miserables. Oh, and did we mention he was named the “sexiest man alive” by People magazine in 2008? So when Jackman once said “I have shocking teeth”… what did he mean?

“[My dentist] looked at my teeth and went, ‘Oh, my God, you've got gray teeth,’” the actor stated. The proposed cure: tooth whitening. But what if the action hero's teeth were brightened too much — would his look still convey his trademark rugged charm? To see how that issue was resolved, let's look a little closer at various methods of tooth whitening.

All Whitening Isn't the Same
Everyone has seen the kind of over-the-counter tooth whitening strips advertised in magazines and sold in drug stores. Most dentists agree that, given enough time, they can work in many cases. But there may be problems, too.

One is that unless you know what's actually causing the darkening, you can't be sure if there is an underlying issue that needs treatment — a root-canal problem, for example. Bleaching a diseased tooth is like painting over a rusty car: it camouflages the problem, but doesn't fix it. That's one reason why, before any whitening treatment is attempted, it's important to have a complete dental examination, with x-rays.

Another is that without professional supervision, it's more difficult to control the degree of whitening you will end up with. For safety reasons, over-the-counter whitening products have the least concentrated bleaching agent, and will probably require weeks of use to produce noticeable results. The next step up — a custom-designed, at-home bleaching kit from our office — will likely produce results twice as fast.

The Professional Advantage
At-home bleaching done under our supervision uses stronger whitening agents with a flexible plastic tray that's custom-made to fit your teeth. It's a cost-effective way to achieve several shades of whitening in a relatively short time. Plus, with the advantage of our experience and guidance, you can get excellent results safely and efficiently.

If you want the fastest and most controllable whitening, however, in-office whitening treatments are the best way to go. According to one study, using the most concentrated whiteners in a safe clinical setting produced a six-shade improvement in just three office visits! This would have required a week or more of at-home bleaching, or upwards of 16 daily applications of the over-the-counter whitening products!

In-office whitening also offers the greatest degree of control over the outcome. That's why it was the method Hugh Jackman chose for his treatments. By adjusting the concentration of the bleaching solution and the treatment time, Jackman's dentist made sure his teeth were pleasingly light — but still looked completely natural. And in our office, we can do the same for you.

So whether you're looking for a dazzlingly bright smile or a more subtle enhancement, the best way to start is to call our office for a consultation. For more information, see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”