Our Blog

At Water's Edge Dental, we know the human mouth contains a lot of bacteria. A bacterium can travel through your body with routine activities that are a normal part of daily living. You spread bacteria when you brush or floss your teeth, when you chew, and when you swallow.

For most people, bacteria don’t cause any problem. For some people, however, especially those who have chronic medical conditions, specific cardiac conditions, or whose immune systems are compromised, bacteria that spreads throughout the bloodstream can lead to much more serious bacterial infections.

The goal of pre-medication or antibiotic prophylaxis, Dr. Milillo, and Dr. Saldivar will tell you, is to prevent bacterial endocarditis, a serious infection of the endothelial heart surfaces or the heart valves. The condition is also called infective endocarditis. A small population of people with certain health problems has a high risk for contracting this potentially deadly bacterium.

The American Heart Association states that people at greatest risk for contracting bacterial or infective endocarditis are:

• Patients who underwent cardiac valve surgery in the past
• Those who have suffered past incidents of infective endocarditis
• Patients who have mitral valve prolapse, resulting in or causing valve leakage
• People who have had rheumatic fever or any degenerative cardiac condition that produces abnormalities in cardiac valves
• Patients who suffer from certain congenital heart diseases

For these patients, any dental procedure may cause bleeding, and prophylactic antibiotic administration is recommended as a preventive measure.

Other patients who require prophylactic antibiotics

The American Association of Endodontists extends recommendations to patients who have undergone joint replacement surgery within the past two years, suffer from type 1 diabetes, or have immune deficiencies from diseases such as lupus, rheumatoid arthritis, or HIV; cancer patients whose immune systems are suppressed because of radiation or chemotherapy; people who have had organ transplants; and hemophiliacs.

The American Academy of Pediatric Dentistry also includes people who suffer from sickle cell anemia, as well as patients who suffer from conditions that require chronic steroid therapy.

Typical endodontic procedures for which antibiotic prophylaxis is recommended include root canal therapy (when it involves going deeper than the root apex), surgical tooth extractions, and any other dental, endodontic, or periodontal procedure during which the doctor anticipates bleeding.

Although different medical societies and organizations offer these guidelines as a way of identifying patients for whom prophylactic pre-medication is essential prior to dental procedures, dentists will take each patient's medical history and personal risk factors into consideration. Some doctors may choose to administer antibiotics following a procedure, especially for patients who have previously suffered from oral infections either as a result of dental procedures or that necessitated oral surgery.

For more information about antibiotic prophylaxis, or to schedule an appointment with Dr. Milillo, and Dr. Saldivar, please give us a call at our convenient West Chester, Pennsylvania office!

We’re used to seeing athletes wearing mouthguards at practice or play, because dental trauma is one of the most common (and predictable) sports injuries. But it’s not just athletes who are at risk, and there are some events in our daily lives that we just can’t predict. Car accidents, falls, workplace injuries, even innocent playground structures can take their toll on our smiles.

A major chip or a crack in your tooth is upsetting enough, and should be seen by Dr. Milillo, and Dr. Saldivar as soon as possible. It’s even more unnerving when a tooth is knocked out completely. The technical term for a tooth which has been knocked out is an avulsed tooth, and it is a true dental emergency.

If you should suffer a partially or completely dislodged tooth, there is a possibility that your tooth can be reimplanted—if the damage isn’t too severe and if you get to our office immediately.

How can a lost tooth be saved? This is possible because of the complex biological engineering that anchors our teeth within the jaw. The root of a tooth is surrounded by the periodontal ligament. This connective tissue attaches the tooth to the alveolar bone of the jaw. When a tooth is knocked out, this ligament splits apart, leaving some tissue on the tooth root and some within the tooth’s socket.

To successfully reimplant a tooth, the connective tissue cells around the root of the tooth need to be vital, so that they can begin to reattach to the connective tissue left in the socket. Over time, this reattachment is complete, and the tooth becomes firmly anchored to the bone again.

It’s important to protect your tooth before you see Dr. Milillo, and Dr. Saldivar to make sure there will be enough healthy tissue for reattachment. First of all,

• Don’t panic! If you or a friend or family member lose a tooth, call your dentist or your emergency health care provider as soon as possible. You will get specific instructions for your specific situation.

If you are unable to reach a healthcare provider immediately, there are some general rules for taking care of an avulsed tooth:

• Find the lost tooth. Don’t touch the root—use the crown, or top part of the tooth, to pick it up. You are trying to preserve and protect the connective tissue on the root surface.

• If the tooth is dirty, gently rinse it in milk, saliva, or water. Don’t wipe it off, though. You could damage those connective tissue cells mentioned above.

• Place the tooth back in the socket, if possible. Gently hold it in place with your fingers or bite down (again, gently). You can also place the tooth in your mouth next to your cheek.

• If returning the tooth to the socket is not an option, or if you are worried about a child possibly swallowing the tooth, keep the tooth moist. Whole milk or solutions sold just for the purpose of preserving an avulsed tooth are better choices than water, which damage the tissue cells on the root. And never wrap the tooth tightly—this can also damage the connective tissue.

Above all,

• Don’t delay! The faster a tooth is reimplanted in its socket, the greater chance you have of keeping it. Really, every minute counts. Reimplantations are more successful if they take place within 30 minutes. After an hour out of the mouth, your tooth’s chances of successful reintegration are lower—but still worth pursuing!

What will Dr. Milillo, and Dr. Saldivar do?

• Evaluate the avulsed tooth.

There are variables which can affect whether or not a lost tooth is a good candidate for reimplantation. Trying to replace a baby tooth, for example, could interfere with the formation of the adult tooth. An adult tooth that is broken will probably require a different type of treatment.

• Prevent infection.

You might be given antibiotics and a referral to your medical doctor for a tetanus booster if needed.

• Clean the site.

The socket will be gently irrigated to clean the area and to remove any clots that may have formed which can interfere with the tooth’s placement.

• Recommend or perform a root canal.

Nerves and blood vessels within the tooth’s pulp generally don’t recover after a serious traumatic injury, so a root canal procedure could be necessary to preserve the health of your tooth. This procedure might be done immediately, or might be recommended for a later date.

• Stabilize your tooth.

The tooth must be stabilized after being reimplanted, so Dr. Milillo, and Dr. Saldivar will use a splint to anchor the tooth to the teeth next to it. The splint can be flexible or rigid, depending on the condition of the alveolar bone. Splinting generally takes from two to eight weeks, and you will be given detailed instructions for taking care of the area while you heal.

Losing a tooth is an alarming experience. But with prompt action, and a trip to our West Chester, Pennsylvania office, it might be possible to make that loss only a temporary one.

While you make sure your family is getting the best care possible, with regular dental checkups and cleanings at our West Chester, Pennsylvania office, there is one family member that might be hiding under the bed when it’s time for tooth care. Periodontal disease is the most common clinical condition affecting adult cats—and it is completely preventable!

Periodontal disease starts when the bacteria in your pet’s mouth form plaque. The plaque can harden into tartar, and, if plaque and tartar spread under the gum line, can be responsible for a number of serious problems. Tooth loss, tissue damage, bone loss, and infection can be the result of periodontal disease. Professional dental treatment is important if your cat is suffering from periodontal disease, and your vet can describe the options available to you.

But, like with humans, prevention is the best way to assure these problems never develop, and there are several methods for avoiding plaque and tartar build-up.

Brushing: Yes, there are toothbrushes and toothpastes specifically designed for your cat! If a toothbrush is not working for you or your pet, there are cat-sized finger brushes available as well. Daily brushing is most effective, but try for at least several times each week. The process of introducing brushing should be a slow and gentle one, and seafood and poultry flavored pastes make the process more palatable. (Human toothpaste is not good for your cat due to its abrasiveness, and swallowing the foam might pose a danger to your pet.)

Anti-plaque rinses and gels: If despite your gentle persistence your cat simply will not cooperate with brushing, there are other options! Rinses and gels containing Chlorhexidine are effective and do not usually pose a problem for pets—although they might not take to the flavor. Rinses can be squirted inside each cheek or gels can be applied to the teeth with a toothbrush or finger brush. Talk to your vet to find the safest and most effective products.

Diet: Whether they use a particular shape and texture to simulate brushing or an anti-tartar ingredient, several pet foods claim to reduce the accumulation of plaque and tartar. Your vet is the best resource for nutritional suggestions to make sure your cat’s dental and physical diet is as healthy as it can be.

Whether you try brushing, rinses, gels or a tooth-friendly diet, patience and a gentle touch are the best way to introduce dental hygiene. Talk to your vet at your cat’s next checkup, and find out what you can do to keep your feline friend healthy and happy. An ounce of prevention might be worth a pound of purr!

How better to spend the fall months than inside by the fireplace with a warm cup of cider and a book in hand? Dr. Milillo, and Dr. Saldivar and our team at Water's Edge Dental encourage you to warm up your mind this fall season with a few great books. Sure it may be easy to put off reading when balancing a hectic schedule, but reading is vital to brain development. Besides, reading is always a blast!

This week, we thought we’d ask what you or your child are reading this fall. Do you have any suggestions for must-read books this year? Out of ideas for great fall reads? Ask us for suggestions, and we would be happy to provide a few. You may also ask a local librarian here in West Chester, Pennsylvania for some ideas.

Happy reading! Be sure to share with us your fall picks or your all-time favorites below or on our Facebook page!