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In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr Karina Gregg suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our San Marcos, CA office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

Happily for all of us who like to celebrate with friends and family, there’s no need to be Irish to enjoy St. Patrick’s Day. Every March 17^th, many of us take the opportunity to display a bit of Gaelic spirit.

• Green Clothing (it’s tradition!)
• Green Hat (for a jaunty look)
• Green Shamrock (always the perfect accessory)
• Green Hair (for the adventurous among us)
• Green Grins?

Here’s where we draw the line. Emerald Isle? Delightful! Emerald smile? Not so beguiling.

That traditional St. Patrick’s party fare—green-frosted sweet treats and green-colored pastries and green-foamed beers—is full of green-tinted food dyes, which can leave us with teeth in subtle shamrock shades. Luckily, most of us will have only a very temporary tinge to remind us of our dietary shenanigans, and there are simple ways to rid yourself of the green sheen:

• Indulge sparingly in colorful cuisine, and drink water afterwards to rinse away green-dyed foods and beverages.
• Use a straw for green drinks.
• Brush your teeth. (Not only will you brush away the green, but you’ll brush away the sugars from sweet green desserts and the acids from sour green brews.)
• Try a whitening toothpaste.

One special note: if you’ve just whitened your smile, best to eliminate strong food dyes from your diet for a few days. Teeth are more sensitive to staining after whitening, because the whitening process temporarily makes them more porous. Give yourself a few days, and your enamel will be back to (stain)fighting strength.

So, celebrate on the 17^th and feel secure that on the 18^th, your smile won’t be “wearing the green” any longer. But if you find that you’re not happy with the appearance of your smile anytime during the year, if you have more permanent staining caused by natural darkening over time, or workdays fueled by black coffee, or a diet filled with tomato sauce, dark berries, red wine, and other tasty (but discoloring) food, you’re still in luck.

Ask Dr Karina Gregg about professional whitening procedures at our San Marcos, CA office for a brighter, more confident smile. And with a bright, confident smile, every day’s a reason to celebrate!

Do you have a space where a tooth used to be? Were you born with a missing tooth? Are you getting ready for dentures? You may be a good candidate for a dental implant. Metal dental implants were invented in 1965. Technology continues to advance with millions of implants placed in the United States and Canada. Placing implants has become mainstream and a common practice for offices like ours.

A dental implant is a small titanium post, which resembles a screw with threads. The post also has holes for bone to integrate. A dental implant is placed into the jawbone during a short dental procedure. It is relatively painless with very little post-operative pain. The threads on the implant post allow for the bone to fill in and integrate. To facilitate this process the implant is re-covered with gum tissue and allowed to heal and integrate for nearly three months. The implant acts as the root for the tooth to provide solid and stable support for the crown that’s yet to be placed.

The next step in the dental procedure is to uncover the implant and place a healing cap to allow the gum tissue to heal. After a short period of healing, an impression is taken to fabricate a crown to fully restore the missing tooth. The crown is then cemented on top of the post, at which point you can resume normal eating activities.

Dental implants do require some special care, but that is easily managed when you follow the directions outlined by Dr Karina Gregg. During your regularly scheduled cleaning, special instruments are used to clean implants. While a dental implant cannot get a cavity, a condition known as peri-implantitis can occur. This is very similar to periodontal disease as the end result is dental implant loss and loss of bone structure. Be sure to floss the dental implant daily and run the floss under the implant crown as far as it can go to remove food and plaque. If you use any picks or small brushes to go in between your teeth, make sure they are plastic. Metal will scratch the implant making it more susceptible to infection. Be sure to keep your regular dental visits and cleanings to monitor the implant and help preserve your investment.

Rumor has it that the Queen of England doesn’t allow garlic in the palace. And, even if you have no royal duties in the near future, it might be a good idea to avoid foods like garlic and onion before a big presentation or a first date. But if your diet is filled with mint, fresh apples, and parsley and you still worry about your breath, here are some common causes for bad breath that you might not have considered.

• A Slip of the Tongue

We brush and floss to remove food particles and bacteria. After all, bacteria that linger in the mouth produce acids that damage tooth enamel and cause bad breath. But there is one important brushing target you might be overlooking—your tongue.

Remove food particles and bacteria on the surface of the tongue with a gentle brushing after you have finished cleaning your teeth. With a dab of toothpaste, brush the top of your tongue gently from back to front. There are also tools called tongue scrapers available that are specifically designed to remove food particles and bacteria from the tongue’s surface. However you choose to clean your tongue, remember to move from the back to the front, and always clean gently.

• A Dry Spell

We spend the vast majority of our day not brushing our teeth. What helps keep breath fresh even during the hours between brushings? Saliva! As saliva bathes the teeth throughout the day, it not only washes away food particles and bacteria, but also neutralizes the enamel-damaging acids that are produced by bacteria. Yet another benefit? Saliva is not a friendly environment for the oral bacteria that produce volatile sulfur compounds (VSCs). It is these compounds that cause most of the unpleasant odors we know as bad breath.

If you are drinking the recommended amount of water each day, you are helping your body produce saliva and fight bad breath. Sometimes, a medical condition called dry mouth, or xerostomia, interferes with saliva production. Talk to Dr Karina Gregg about ways to deal with dry mouth. Solutions as simple as drinking more fluids or chewing sugarless gum can help, or we can suggest over-the-counter products or prescription medications if needed.

• A Bad Night’s Sleep

We’re all familiar with the concept of morning breath. As we sleep, our saliva production naturally decreases. It’s like a nightly version of dry mouth. Without normal levels of saliva, bacterial growth takes off, VSC’s are produced in greater quantities, and we wake up wondering what on earth happened to that fresh feeling we had after brushing the night before.

Unfortunately for snorers, nighttime brings more problems. Snoring leads to mouth breathing, and mouth breathing creates an even drier environment where oral bacteria increase more quickly. If you find you are consistently waking up with an especially unpleasant case of morning breath, you could be a chronic snorer without even realizing it. If you discover or suspect you have a snoring problem, talk to Dr Karina Gregg or your GP. Snoring can have serious health consequences, so let’s discuss possible solutions.

One important note to end on: if you have eliminated all the obvious causes of halitosis but still have persistent bad breath, give our San Marcos, CA office a call. Chronic bad breath can be a symptom of serious gum disease, oral infections, illnesses such as diabetes or kidney disease, and other medical conditions that should be treated as soon as possible. If the topic is bad breath, let’s make sure garlic is the only thing you have to worry about.