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Posts for: May, 2020

By Donald M Jackson, DDS, PA
May 21, 2020
Category: Oral Health
Tags: nerve pain  
FacialNervePainCanbeControlled

Every year 150,000 people, mostly women over age 50, find out they have a painful condition called trigeminal neuralgia. For many it begins as an occasional twinge along the face that steadily worsens until the simple act of chewing or speaking, or even a light touch, sets off excruciating pain.

The source of the pain is the pair of trigeminal nerves that course along each side of the face. Each nerve has three separate branches that provide sensation to the upper, middle and lower areas of the face and jaw.

The problem arises when areas of the myelin sheath, a fatty, insulating covering on nerves, becomes damaged, often because of an artery or vein pressing against it. As a result, the nerve can become hypersensitive to stimuli and transmit pain at even the slightest trigger. It may also fail to stop transmitting even after the stimulation that caused it is over.

Although the condition may not always be curable, there are various ways to effectively manage it. The most conservative way is with medications that block the nerve from transmitting pain signals to the brain, coupled with drugs that help stabilize the nerve and decrease abnormal firing.

If medication isn't enough to relieve symptoms, there may be some benefit from more invasive treatments. One technique is to insert a thin needle into the nerve to selectively damage nerve fibers to prevent them from firing. Another microsurgical procedure attempts to relocate the nerve away from a blood vessel that may be compressing it.

The latter procedure has some higher risks such as facial numbness or decreased hearing, and is often better suited for younger patients. Older patients may benefit more from the needle insertion procedure previously mentioned or a directed beam of high-dose radiation to alter the nerve.

To learn the best options for you, you should first undergo a neurological exam to verify you have trigeminal neuralgia and to rule out other causes. From there, you and your doctor can decide the best course of treatment for your age and individual condition.

Trigeminal neuralgia can be an unpleasant experience. But there are tried and true ways to minimize its effect on your life.

If you would like more information on trigeminal neuralgia, 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 “Trigeminal Neuralgia.”


By Donald M Jackson, DDS, PA
May 11, 2020
Category: Dental Procedures
Tags: dental implants   diabetes  
DiabetesCanMakeGettinganImplantDifficultButNotImpossible

Over 26 million Americans have diabetes, a systemic condition that interferes with maintaining safe levels of blood sugar in the bloodstream. Over time, diabetes can begin to interfere with other bodily processes, including wound healing—which could affect dental care, and dental implants in particular.

Diabetes affects how the body regulates glucose, a basic sugar derived from food digestion that's the primary source of energy for cell development and function. Our bodies, though, must maintain glucose levels within a certain range — too high or too low could have adverse effects on our health. The body does this with the help of a hormone called insulin that's produced as needed by the pancreas to constantly regulate blood glucose levels.

There are two types of diabetes that interfere with the function of insulin in different ways. With Type I diabetes the pancreas stops producing insulin, forcing the patient to obtain the hormone externally through daily injections or medication. With Type II diabetes, the most common form among diabetics, the body doesn't produce enough insulin or doesn't respond adequately to the insulin that's present.

As mentioned, one of the consequences of diabetes is slow wound healing. This can have a profound effect on the body in general, but it can also potentially cause problems with dental implants. That's because implants once placed need time to integrate with the bone to achieve a strong hold. Slow wound healing caused by diabetes can slow this integration process between implant and bone, which can affect the entire implantation process.

The potential for those kinds of problems is greater if a patient's diabetes isn't under control. Patients who are effectively managing their diabetes with proper diet, exercise and medication have less trouble with wound healing, and so less chance of healing problems with implants.

All in all, though, it appears diabetics as a group have as much success with implants as the general population (above 95 percent). But it can be a smoother process if you're doing everything you can to keep your diabetes under control.

If you would like more information on managing dental care with diabetes, please contact us or schedule an appointment for a consultation.


WhatYouShouldKnowAboutAntibioticTherapyBeforeImplantSurgery

Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.

To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.

While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.

But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.

But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.

Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.

If you would like more information on antibiotics before implant surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”