One of the top concerns in healthcare is the interactions and side effects of medications. Drugs taken for separate conditions can interact with each other or have an effect on some other aspect of health. It's important then that all your health providers know the various medications you are taking, along with other lifestyle habits. That includes your dental team.

Calcium channel blockers (CCBs) are one type of medication that can have an effect on your oral health. CCBs are used primarily to control hypertension (high blood pressure), and to treat other cardiovascular conditions like angina or abnormal heart rhythm. They work by dilating blood vessels, which makes it easier for the heart to pump.

CCBs are now recognized as a contributing factor in the development of a condition known as gingival hyperplasia in which the gum tissues “overgrow,” extending in some cases abnormally over the teeth. This abnormal growth can be painful and uncomfortable, and can make oral hygiene more difficult to perform. The overgrowth of tissue can also be socially embarrassing.

There's also a secondary factor that can increase the risk for tissue overgrowth in patients taking a CCB — poor oral hygiene. In the absence of a good hygiene routine, a layer of bacterial plaque known as biofilm can build up on tooth surfaces and lead to various forms of gum disease, including hyperplasia. The overgrown tissue contributes in turn to this disease process by inhibiting effective oral hygiene.

If you've already developed gingival hyperplasia or some other form of gum disease, it's important for you to receive periodontal treatment for the disease as soon as possible. Once we have the condition under control, it's then a matter of regular dental checkups and cleanings to reduce the risk of disease, including gingival hyperplasia. We can also help you develop effective hygiene practices that inhibit this condition while you are taking a CCB.

If you would like more information on the effects of medication on oral health, 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 “Blood Pressure Medications.”

Prior to his first appearance on the Oprah Winfrey show, interior designer Nate Berkus knew immediately that he was not there to pick sofa colors and paint chips. Instead, he was there to lift people up through the way they live. And boy, did he do just that. Over the next eight years, Berkus completed 127 makeovers and became one of America's most beloved go-to guys for inspiration on the latest design trends.

During a recent interview with Dear Doctor magazine, Nate discussed his career as well as his oral healthcare. He credits his dazzling all-natural smile — no cosmetic dentistry here — to the treatments he received as a child from his dentist. “I'm grateful for having been given fluoride treatments and sealants as a child.” He then added that, “healthy habits should start at a young age.” Nate is still in the habit of brushing his teeth two or three times a day. As for flossing his teeth, he credits his dentist with the advice he still follows: “Floss the ones you want to keep.”

Many parents and caregivers may not be aware of the important role fluoride treatments play in protecting children's teeth. Fluoride has the unique ability to strengthen tooth enamel, the hardest substance found in nature. Depending on where you live, you may have fluoridated tap water. You may also have fluoride in your toothpaste, depending on the brand you use. Both of these are beneficial, but sometimes we recommend additional fluoride treatments based on the specific needs of your children. Why? The concentrations of the topical fluorides we typically apply are much higher than what is found in toothpastes, and we apply them for a longer period of time. For example, we often apply them for four minutes per treatment session.

To learn more about fluoride treatments, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you or your child. Or to learn more about fluoride treatments now, you can continue reading the Dear Doctor magazine article “Topical Fluoride.” And to read the entire interview with Nate Berkus, please see the Dear Doctor magazine article “Nate Berkus.”

Root canal treatments are an important method for stopping the disease process within an infected tooth and ultimately saving it. However, one of the few side effects could have an aesthetic impact on your smile. Leftover blood pigments or the filling materials themselves can cause a darkening of the tooth — the tooth could eventually stand out in an unsightly way from surrounding teeth.

There is, however, one possible solution: a whitening technique known as internal or non-vital bleaching can lighten a darkened, non-vital tooth. For this procedure, we would insert a bleaching mix (usually sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a short period of time. The chemical reaction of the mix whitens the tooth from within.

Our first step is to make sure by x-rays that the root canal filling in the tooth is still intact and still has a good seal. We then create a small opening in the rear of the tooth just above the root canal filling, irrigate it with water to remove any debris, and then add a special cement at the point where the root canal filling begins to seal it from any leakage of the bleaching solution into the root canal filling.

We then insert the bleaching solution into the empty pulp chamber. This is covered with a cotton pellet, which is then sealed in with a temporary filling. We repeat this application over a number of days until we see a noticeable change in the tooth color (normally after one to four visits). At this point, we would remove any residual solution and apply a permanent filling to seal the tooth.

This procedure can be performed instead of more extensive procedures such as veneers and crowns as a cover for the discolored tooth, or as a way to lighten teeth before applying a veneer or crown to help prevent discoloration from showing through. Either way, non-vital bleaching can help remove unsightly discoloration and restore vibrancy to your smile.

If you would like more information on internal or non-vital bleaching, 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 “Whitening Traumatized Teeth.”