Dr. Marvin Clothier, DDS 
611 North Broadway Suite B
Pittsburg, KS 66762
(620)231-4140

CertainOsteoporosisDrugsCouldPoseaFutureRisktoYourDentalHealth

Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.

Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax™) and RANKL inhibitors (Prolia™). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.

By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.

This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.

For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.

If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.

Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.

If you would like more information on osteoporosis and dental care, 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 “Osteoporosis Drugs & Dental Treatment.”

By Smile Solutions
January 02, 2020
Category: Dental Procedures
Tags: cosmetic dentistry  
4WaysYouCanImproveYourSmileintheNewYear

Although we begin our New Year's resolutions with high hopes, many of them fall by the wayside by the end of January. It simply takes tremendous willpower to lose weight or exercise more. So to improve your resolution success rate, why not throw in some with a little more zing, like trying every item on the menu at your favorite restaurant or learning a new magic trick every month? Or how about this one: Resolve to do four things this year to change your smile.

Okay, it doesn't have to be exactly four. But we just happen to have four suggestions—one for each quarter of the new year—that can make your smile the best it can be in 2020.

Brighten up your smile. A professional whitening procedure can improve a stained, dingy smile. Our advanced bleaching techniques give your teeth that brighter look that could last for years with proper care and regular touchups. We can also control the level of whiteness to give your teeth a softer natural look or one that's dazzling bright.

Fix a chipped tooth with bonding. You may have a great smile, except for that one tooth that's missing a little piece. We can repair minor chips and other defects with composite resin material bonded directly to the tooth. Composite resin can be color-matched and shaped to fit the tooth being repaired so that it looks completely natural. Best of all, we can transform your tooth's appearance in just one visit.

Gain a new look with veneers. If you have one or more teeth with mild to moderate chipping, staining or misalignment, dental veneers could change their appearance altogether. These thin wafers of dental porcelain are bonded to the front of teeth to permanently mask imperfections. They're so lifelike, others will have a hard time telling the difference between your teeth with veneers and those without.

Straighten your smile. It's never too late to have a crooked smile straightened. And you might not even have to wear braces: Clear aligners are computer-generated plastic trays worn in sequence to straighten teeth. They're removable, so you can take them out to eat or clean your teeth. Best of all, they're hardly noticeable—and they can give you a more attractive smile.

These and other cosmetic treatments are relatively easy ways to make a big impact on your appearance. Be resolved, then, that with a little help from us this can be the year you'll gain a more attractive smile through the art of dentistry.

If you would like more information about smile enhancements, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Cosmetic Dentistry: A Time for Change” and “Beautiful Smiles by Design.”

By Smile Solutions
December 23, 2019
Category: Oral Health
HealthySmilesforAlfonsoRibeiroandFamily

If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."

Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:

  • Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
  • Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
  • Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
  • Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
  • Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.

Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.

If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”

GettingaNewToothinOneDayWillDependonYourBoneHealth

If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.

The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.

Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.

The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.

If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.

The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.

Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.

If you would like more information on restoring missing teeth with dental implants, 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 “Implant Timelines for Replacing Missing Teeth.”

HeresHowtoCutThroughAlltheChoicestoFindYourRightToothbrush

Henry Ford famously said a customer could have any color they wanted on their Model T “as long as it was black.” Those days are over—today’s cars and trucks come with a slew of options, and not just their paint color.

There’s something else with a wide array of possible options: your choice of toothbrush. Your local store’s dental care aisle has dozens of toothbrushes in a myriad of sizes, shapes and features. And many promise better hygiene outcomes because of their unique design.

It’s enough to make your head spin. But you can narrow your search for the right toothbrush— just look for these basic qualities.

Bristle texture. At this all-important juncture between brush and teeth, softer-textured bristles are better. That might sound counter-intuitive, but soft bristles are just as capable at removing bacterial plaque, that sticky tooth film most responsible for dental disease, as stiffer bristles. Stiffer bristles, on the other hand, can damage gums and cause recession. Also, look too for rounded bristles (gentler on the gums), and multi-leveled or angled ones for better access around teeth.

Size and shape. Toothbrushes come in different sizes because, well, so do mouths. Look, then, for a brush and bristle head that can comfortably reach all the teeth in your mouth. If you have problems with manual dexterity, choose a brush with larger grip handles. A brush that’s comfortable to use and easy to handle can make your brushing more effective.

ADA Seal of Acceptance. The American Dental Association tests hygiene products like toothbrushes. If they pass the association’s standards, the manufacturer includes the ADA Seal of Approval on their packaging. Not all submit their brushes for this evaluation, so the seal’s absence doesn’t necessarily mean a brush is of low quality. The seal, though, does tell you the product passes muster with dental professionals.

It often takes a little trial and error to find the right brush, but since you should change yours out every six months, it’s a small price to experiment. And, no matter how great the brush, it’s only as good at removing plaque as the hand that holds it. So, be sure you learn proper brushing techniques—that and the right brush will keep your teeth and gums healthy.

If you would like more information on choosing the right toothbrush, 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 “Sizing Up Toothbrushes.”





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