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MRSA and Your Mouth

Over the last few years there has been an increase or reported cases of MRSA infections. Many of my patients ask me about the risk of oral MRSA infections and how it can effect them. Our mouths are home to over 300 different types of bacteria. Fotolia_17801369_XS-200x300In a healthy mouth, these bacteria work together to create a healthy oral environment. But, as in any other system, if things go awry and the balance becomes upset then we find different types of bacteria take advantage of this and begin to thrive.

So does the average person have MRSA in their mouth?

Studies have shown that the population that has the highest incidence of MRSA colonization are elderly patients in nursing homes as well as patients with advanced malignant diseases  suffering from reduced salivary flow rate.

What can they do to reduce the amount of bad bacteria in our mouths?

MRSA tends to like to grow on the porous surfaces of dentures as well as being found in plaque in the mouth. Some studies have shown that a good way to clean MRSA infected dentures is with a chlorhexidine oral rinse as well as soaking the dentures in chlorhexidine for 10 minutes once a week. Dentures should be cleaned daily with a stiff brush and soap and water, not toothpaste. And even, if you wear dentures you should be cleaning your gums and remaining teeth as well. Some studies also suggest microwaving your dentures for 3 minutes. However, I don’t suggest this if you have any portion of your denture that is metal.

What kind of risks are there if you have MRSA in your mouth?

There are no studies that offer clear associations of MRSA colonization in the mouth causing systemic and dental problems. Although, the bacteria having been found in some orofacial abscesses as well as some infections located on the gingiva and corners of the mouth commonly associated with denture wear. So although there have been few instances of this type of bacteria found in oral infections the concern is for the potential for these strains to re-colonize at other body sites or become a source of cross-infection to other patients or hospital/nursing home staff.
The ecology of Staphylococcus species in the oral cavity; A. J. Smith, M. S. Jackson and J. Bagg Staphylococcus aureus in the oral cavity: a three-year retrospective analysis of clinical laboratory data; A.J. Smith, D. Robertson, M. K. Tang,  M. S. Jackson, D. MacKenzie & J. Bagg MRSA infection; K. Valand & P.M. McLoughlin
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Worst Home Remedies For Dental Problems

Fotolia_21448390_XS-199x300Okay, I understand getting to the dentist when you have an emergency can sometimes be hard. And, yes I realize that it’s awfully tempting to try and fix the problem yourself. But, there are just some things you should not do at home. This brings us to this weeks blog post. The WORST home remedies for dental problems. Putting garlic against a sore tooth…. Besides making you smell bad, garlic is very potent and can irritate or burn soft tissues around the tooth causing even more pain and sensitivity. Shaving down a sharp tooth with tools from around the house… Besides the fact that you are putting something that has seen more dirty surfaces than I’d care to mention directly into your mouth, you are putting yourself at risk for damaging the tooth more or slipping and causing damage to your cheeks and gums. Using crazy glue to fix a broken natural tooth... Yes, I know people say the same stuff that’s in super glue is the same stuff used to seal battlefield wounds, and they’d be correct. However, the stuff used to seal battlefield wounds are made specifically to seal battlefield wounds. Using superglue to fix a tooth most likely will result in 1: You super gluing your finger to your lip, cheek, tooth or some variation of the aforementioned. Or 2: Pain from a tooth with a freshly injured dental nerve being assaulted by a brand of material that was not meant to see the inside of your mouth or to fix broken teeth. Trust me, its not pretty…. Whitening your teeth with lemon juice and baking soda… This one, although its gotten a lot of popularity throughout the years, is just not healthy for your teeth. Mixing an abrasive and an acid together and then scrubbing it on your teeth can cause abrasion to your gums while also removing and/or damaging the enamel on your teeth. And lastly, searching through your medicine cabinet and finding a left over prescription from those wisdom teeth you (or someone you know) had extracted about ten years ago… Its not a mystery that taking old, expired or another persons prescription medications is a bad idea. Taking one or two remaining capsules of an antibiotic is not only ineffective, it can also help promote bacterial resistance to antibiotics. Also, taking prescription medications that were not prescribed to you can put you right in the middle of an adverse or even allergic reaction to a drug that no one knows you are taking. So if you are having a problem call your dentist or doctor first before resorting to whats left over in the medicine cabinet. Also, whenever you are prescribed medication once you have finished the prescription if there are any tablets remaining they should be disposed of. So, I’m not saying there are not some things that you can do at home in a pinch to get you by until you can see your dentist. But, in an emergency situation, first and foremost, call your dentist and see when they can see you for an appointment and tell them your emergency. Your dentist will suggest the best way to get you comfortable and safely treated!]]>

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Dental X-rays and Brain Tumors

Physicianeffort to keep our patients informed on the most recent dental information we assembled the facts about this study and its findings and our views on dental x-rays. The study suggests that dental x-rays, particularly when obtained frequently and at a young age, may be associated with an increased risk of an intracranial meningioma. The study compared dental and therapeutic radiation histories in 1433 patients against a control group of 1350 subjects. The study was conducted via telephone interviews with patients and information accrued via patients memory. Due to dental records being held at various offices, researchers were unable to validate the samples history due to time and financial considerations.

  • The study states that: “No studies have reported on the association between use of computed tomography (CT) and meningioma risk” as well as: ” The studies that report on dental x-ray exposure are suggestive but are limited by sample size and by the inclusion of cases from time periods with higher dosing regimes than the current era”
  • Meningioma’s are common benign brain tumors originating in the meninges. As reported by the Cancer Brain Tumor Registry of the United States, “Primary brain tumors represent only 2% of all cancers, with 35,000 new cases diagnosed each year in the United States,”  “Meningioma’s occur at a rate of 7.8 per 100,000 per year, but only 25% are believed to be symptomatic, with the others being found incidentally.” Because the overall prognosis for this type of tumor is good and the tumors are commonly asymptomatic, only being found incidentally, many doctors do not recommend treating them and opt to observe the tumors instead.
  • Dr. Elizabeth Claus, the lead author of the study reported is quoted as saying: “Our take home message is don’t panic. Don’t stop going to the dentist” and ” Our study refers to exposures in the past rather than exposures that people are receiving in this day and age”
  • The American Dental Association’s position on dental x-rays is that dentists should order dental x-rays for patients only when necessary for diagnosis and treatment.
So the take home message from this study, as we have interpreted it, is that this is a subject that is important and should be studied further. Because of how the study was conducted and the resulting opportunities for misinformation I can only take this study as a suggestion of a correlation. This study has brought to light  possibilities for increased risk of tumors that should be evaluated using current day risk factors, including exposure to other forms of ionizing radiation as well as solid dental histories in order to give us a better idea of the true potential or x-ray risk and meningioma’s. That being said, x-rays are a crucial part of dental diagnosis, not only for cavities but for lesions of the surrounding structures as well. We have always followed the ALARA principle, which stands for As Low as Reasonably Achievable. In our practice we utilize digital radiographs to lower exposure to radiation and recommend radiographs depending on each patients risks level for new decay. Typically we ask for a full set of  x-rays every 5-7 years and check up x-rays every 1-2 years depending on the individual.
Dental x-rays and risk of meningioma; Elizabeth B. Claus MD, PhD1,2,§,*, Lisa Calvocoressi PhD1, Melissa L. Bondy PhD3, Joellen M. Schildkraut PhD4, Joseph L. Wiemels PhD5, Margaret Wrensch PhD5,6
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Toothpaste Ingredients: How to Decode the Label

brushingteethEver look on the back of the toothpaste box and wonder, what exactly is xanthan gum and why the heck is it in my toothpaste? Well wonder no more, as we go through how to decode the toothpaste label… On every drug facts label you find a listing of active ingredients and inactive ingredients, as well as what its used for, any warnings for the product and directions for uses. Active Ingredients: This is the part of the toothpaste that makes its use effective. In the case of most toothpastes the active ingredient is usually for anti-plaque, anti-cavity, anti-gingivitis as well as including ingredients to help prevent tooth sensitivity. So in this portion you will normally see your fluorides such as sodium fluoride, stannous fluoride or sodium monofluorophosphate. You may also see potassium nitrate, triclosan, pyrophosphates or zinc salts as well as a myriad of other ingredients. Inactive Ingredients: This portion includes the ingredients that make the toothpaste standup to being on the shelf as well as completing the nuts and bolts function of general toothpaste use. So these ingredients stop the paste from drying out, keep it at a good pH, stop microbial growth, make them thick enough for use and help them become foamy when used. They also include flavoring agents, abrasives and whitening agents. So in this section, which in my opinion is the most confusing you’ll see these types of ingredients:

  • Propylene glycol, glycerol, and polyethylene glycol to help keep toothpaste moist
  • Carageenan, cellulose and xanthan gum to thicken and hold all the ingredients together
  • Sodium benzoate and methyl paraben to keep toothpaste from decaying and to prevent microbial growth
  • Sodium lauryl sulphate and cocoadmidopropyl betaine to make toothpaste foam thereby helping loosening and removing plaque from the tooth surface.
  • sodium saccharin, xylitol, sorbitol, sodium cyclamate to flavor the toothpaste.
  • Buffering agents to make it a pH favorable for the oral environment.
  • And, you may see silicas, dicalcium phosphate dihydrate or aluminum oxide which are abrasives which help remove plaque and bacteria as well.
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Dental Crowns, What Are They & Why Do I Need One?

Crown, dental crown, cap or bridge, are common dental terms used often in our practice.  If you’re not familar with these terms, this article should answer any questions you may have about what these procedures are and how they’re done, and why a patient would need them. A crown or cap is a restoration that covers a broken down, root canaled or esthetically unpleasing tooth. They’re made from a variety of materials such as porcelain, metal or zirconia. A bridge is a group of crowns linked together usually for the purpose of holding a fake tooth that will fill a space where a tooth is missing. During a crown or bridge appointment, the area will initially be anesthetized, and the tooth, or in the case of a bridge, the teeth surrounding the space, will be shaved down.
The tooth or teeth are shaved down into a cylindrical shape and and then an impression or mold is taken of the prepared area. The mold is sent to a dental lab and a bridge or a crown is fabricated. The lab generally returns the restoration in about 1.5 to 2 weeks so it can be tried in and cemented.]]>

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