George Washington wanted a Root Canal Therapy

I recently visited the Heinz History Center in Pittsburgh, PA where there was an exhibit about George Washington (it will be there through July), and I was inspired by how much modern dentistry could have helped good old George.  This is part two of a four-part series about how America’s first President would have benefited from modern dentistry.  This time we’ll be delving into how we could have saved George Washington’s teeth instead of taking them out (without anesthesia). 

As Stated in our last post, denstists of Washington’s day used a “fire fighting” approach, where if a problem announced itself (usually as pain), it was then taken care of.  Modern dentistry has taken on a preventive approach.  In this approach we are looking for small problems and fixing them before they announce themselves.  Let’s talk about the different options available.

Compliments of the National Dental Museum in Baltimore

The National Dental Museum in Baltimore has a fantastic Presidential Collection with artifacts from George Washington on display.

With the advanced diagnostic techniques available, today we are able to diagnose decay at its earliest stages now and manage decay effectively with minimal to no pain.  If George had visited a modern dentist like those at Chips Dental Associates, he would have had access to DiagnoDent©, where we would have screened the grooves of his back teeth for the earliest signs of decay.  When decay is found at this early stage, it can be treated with the smallest restoration possible using modern tooth colored resins.  These restorations can actually serve to strengthen the tooth and with regular care and maintenance, may be all that ever needs to be done on it. 

George Washington would also have had access to regular periodontal screenings and maintenance.  These would have caught any signs of periodontal disease at an early stage and steps could have been taken to minimize its effect on his dentition.  By diagnosing this disease at an early stage, most of the time it is possible to treat it non-surgically and keep the patient on a maintenance program where they have cleanings and periodontal screenings at every visit.  This step would have helped George Washington to avoid losing any teeth to this disease.

When decay became more advanced, 18th century Americans were occasionally fortunate enough to have a dentist place fillings.  While fillings were a part of the 18th century dentist’s repertoire, they were time consuming, expensive, had a relatively low success rate.  The technique called for the drilling out or cleaning out of the cavities and placing a material (usually a metal such as gold or even tin) into the space to keep it from becoming sensitive.  This was executed without local anesthesia.  Unfortunately, not many 18th century dentists placed fillings and when decay reached the pulp, the modern root canal therapy was not an available option. George Washington would probably not have had access to dental fillings as they were a more popular treatment in France during his lifetime.

The modern root canal therapy was developed within the last 100 years and has changed the face of dentistry from a philosophy of extracting teeth and putting in dentures to one of saving and restoring teeth with modern scientifically proven materials.  According to John L. Santopolo, an endodontist (root canal specialist) in Long Island, NY, the oldest theories regarding the birth of the root canal therapy date back to the second or third century BC.  A skull with a bronze wire inside one of its teeth has been studied and researchers suggest that this may have been used to treat an infected pulp making it the first evidence of such treatment.  While George Washington may have had access to this treatment, it was uncommon in the 1700’s and most dentists would not have provided it as an option.

For the sake of our discussion, we’ll assume that even with our modern preventive dental model, George Washington got a toothache during his lifetime.  What would have happened?  If he had been going to his regular maintenance appointments, it is likely that his tooth could still have been saved.  He would have, most likely, wanted to have a root canal therapy, build-up (a type of filling to prepare a tooth for a crown), and crown.   By completing this sequence of treatment, he would have saved his tooth and with regular maintenance thereafter (including the occasional replacement of the crown), he would have been able to, most likely, maintain his tooth for the rest of his life.  So, going back to our title, if George Washington had known about it, he would have actually wanted not only a root canal therapy, but also a build-up and a crown.

Coming next, local anesthetics, bridges, and dental implants.

Brought to you as a community service by Chips Dental Associates, LLC.

If it’s been a while since your last dental visit or you just want to get together to discuss our favorite historical character, visit www.chipsdentalLLC.com.

George Washington, what makes him smile?

I recently visited the Heinz History Center in Pittsburgh, PA where there was an exhibit about George Washington (it will be there through July), and I was inspired by how much modern dentistry could have helped good old George.   This is not Part II of this four part series about how America’s first President would have benefited from modern dentistry.  The second installment will be posted shortly but needs a few finishing touches. 

In Part II we’ll be talking about the measures available now through peer review medicine that allow us to treat dental patients differently and better than in colonial America.  These will include our basic fillings, crowns, and root canal therapies as alternatives to the extractions that were done a few years ago.  You’ll really come to appreciate the advances that modern dentistry has available to you now when you see what was done throughout history.  

This is a photo, compliments of the Heinz History Center in Pittsburgh, PA, of George Washington’s dentures.  I think we can all agree that while this is interesting now, having these in your mouth as George did would hardly be something to smile about.  Go see them for yourself, they’ll be at the Heinz History Center through July.

Brought to you as a community service by Chips Dental Associates, LLC.

If it’s been a while since your last dental visit or you just want to get together to discuss our favorite historical character, visit www.chipsdentalLLC.com.

George Washington and Jerry Seinfeld

I recently visited the Heinz History Center in Pittsburgh, PA where there was an exhibit about George Washington (it will be there through July), and I was inspired by how much modern dentistry could have helped good old George.  This is part one of a four-part series about how America’s first President would have benefited from modern dentistry.  We’ll start with the basics, oral hygiene, regular periodontal maintenance (cleanings) and professional dental examinations.

In the early to mid 1990s The Seinfeld Show was running at its peak and it came to light that Jerry Seinfeld was an oral hygiene fanatic.  In fact he was so fanatical about his oral hygiene that the American Dental Association essentially made him the poster child for their preventive dentistry campaign.  There was actually a poster in our office with Jerry on it, the caption read “Look Ma, I flossed!”  How does this relate to George Washington? You may not believe it, but for the mid 1700’s, George was about on par with Jerry when it came to the care of his teeth.

As we mentioned in the last post, George Washington had a litany of dental problems and he had many sets of ‘not so wooden’ dentures. This may lead you to conclude that he was not as adamant about his oral health care as Jerry Seinfeld, but you would be mistaken.  George, like Jerry, was also a fanatic, having found from a young age that he had difficulty with his teeth. He had his first tooth removed at age 22.  He worked especially hard to maintain his oral hygiene, almost always owning a toothbrush (not the norm for the day).  His brush would have had boars hair bristles and would have been nearly as effective as those we use today according to Dr. Scott Swank curator of the National Dental Museum in Baltimore.  George also had an ongoing relationship with several dentists, he was always seeking out who was “the best.” This relationship was meant to handle any problems that arose with his teeth and to manufacture high quality, comfortable dental prosthetics (dentures and partials).  

This is Napoleon’s toothbrush made with horse hair bristles, it is very similar to George Washington’s boars hair toothbrush.  George’s toothbrush is on display the Heinz History Center in Pittsburgh, PA through July. 

In the 1700’s a regular periodontal maintenance program and professional dental exam were not part of a dentist’s repertoire.  For the mid 1700’s in America though, George Washington was the Jerry Seinfeld of oral hygiene.  Unfortunately for George, he didn’t have any of the advantages that we have today in preventive dentistry.  In addition, according to Dr. Scott Swank curator at the Smithsonian affiliate National Dental Museum in Baltimore, George Washington took a popular medicine called calomel (mercurous chloride) which would have been the major culprit in the destruction of his teeth through the years.  This medicine, was a sort of cure-all for the time.  It was given for many reasons sometimes as a laxative, sometimes as a soother for teething babies and for a variety of other reasons as well.  Research has since shown what a catastrophic effect calomel had on people’s teeth.

If George had access to a Sonicare or Oral B electric toothbrush, dental floss, Fluoride toothpaste, and even Listerine or Act mouth washes, his dental history would have been dramatically different.  Regular periodontal maintenance, dental x-rays, and oral cancer screenings would have also provided tremendous benefit.  These simple measures, which you most likely take for granted, would have made it possible for George Washington to restore (fix) his cavities when they were smaller, stabilize and maintain his periodontal status, and prevent the slow onslaught of destruction that oral disease wrought on him.  So we can all thank goodness that we’re in this fascinating modern era of dentistry with everything from x-rays to dental implants to local anesthetic (novocaine) helping us fight this ongoing battle with oral disease.  Chips Dental Associates takes advantage of many of the latest advances in modern dentistry that George as well as Jerry would appreciate. 

Next week we’re going to be touching on what might have been one of George Washington’s favorite subjects (had it existed then) the Root Canal Therapy.

Brought to you as a community service by Chips Dental Associates, LLC.

If it’s been a while since your last dental visit or you just want to get together to discuss our favorite historical character, visit www.chipsdentalLLC.com.

George Washington’s (not so) Wooden Teeth

This past weekend I had the opportunity to visit the Heinz History Center in Pittsburgh, PA.  They had a wonderful exhibit about America’s first commander-in-chief, George Washington.  What an interesting character he was, from the tender age of 19 he was an active part of American history and our local Pittsburgh history.  As a dentist, I was most captivated by what seemed to be the centerpiece (forgive my skewed point of view) of the exhibit, the litany of his teeth.    I was so inspired by how modern dentistry could have helped old George so dramatically in his lifetime that I’ll be changing the format of my blog for the next few weeks to talk about it.  Part One will be finished shortly, so bookmark my site!  In regards to the title here, it is a myth that George Washington had wooden teeth.  His teeth were made of many substances throughout his lifetime, but wood was never used for the teeth in George Washington’s dentures.

Tips For Caregivers on Oral Health

Q: I’m caring for an elderly, infirm parent.  Any tips for me on their dental care?

A: Here is how to brush someone else’s teeth: Make sure the lighting is good in the room you choose, it does not need to be a bathroom.  Wherever your parent feels comfortable is the right place.  Wash your hands and put on sanitary, disposable gloves.  Stand or sit so that you have a good view of all of the teeth.  Put only a small amount of toothpaste on the brush.  Brush all surfaces of each tooth and angle the brush.  Brush gently at the gum line (this is an area that is particularly susceptible to decay in this type of patient) front and back.  Gently brush the tongue after you’ve done the teeth.  Help them to rinse with plain water. 

Consider, with your parent’s consent, of course, whether a power toothbrush might make the work easier and more efficient.  Arrange for a professional checkup at least twice a year, Chips Dental Associates is happy to make arrangements for these patients in either of our offices.  You can also speak with us about making special arrangements for having a home-bound relative seen. 

As a Chips Dental Associates patient, you have access to our preventive program for adult patients.  This involves regular applications of a highly concentrated topical fluoride varnish that has been shown to reduce the rate of decay.  Many times cavities found in this aging population can be managed with a fluoride releasing material that will also reduce the rate of decay.  The doctors at Chips Dental Associates have special training in the use of these and other modalities of treatment specifically targeted at this segment of the population. 

Brought to you as a community service by Chips Dental Associates, LLC.

For more information or questions visit www.chipsdentalLLC.com

What is the pulp of the tooth?

Q: What is the pulp of the tooth?

 A: Inside every tooth, protected by the casing of enamel, is a mass of tissue that holds the nerves and blood vessels that are essential to the health of the tooth.  People generally refer to the pulp as the ‘nerve’ of the tooth because it’s extremely sensitive and painful when exposed.  Through tiny openings in the tips of the roots of the teeth, the vessels and nerves in the tooth connect with the arteries, veins, and nerves of the jaw, and on to the circulatory and nervous system of the body.  The pulp brings nutrients that help with the ongoing formation of dentin, the highly calcified material that accounts for about 75% of the bulk of a tooth.

 If the pulp becomes infected and dies, the dentin will not get the nutrition it needs.  It will gradually dry up and the tooth will become brittle.  If the dead pulp is not removed through a root canal therapy procedure, the tooth may turn yellow, gray, or black.  Once a root canal therapy procedure is complete, since the tooth is without a nervous system or blood supply, it is a necessity to protect your tooth with a crown or ‘cap’ that helps to strengthen this tooth.  The crown, once placed, reduces the risk of tooth fracture after a root canal therapy significantly.  Without having the crown placed, your tooth would be at very high risk of fracture and may possibly need to be removed if it fractures.  One of the goals of a good oral hygiene program is to prevent decay of the enamel and dentin that protect the pulp.  

Brought to you as a community service by Chips Dental Associates, LLC.

For more information or questions, please visit www.chipsdentalLLC.com

Importance of Mouth Guards

Q: Why are mouth guards important for athletes?

A: For athletes engaged in certain high-contact sports like hockey and football, the benefits of wearing a mouth guard are obvious. Dental injuries can be permanent and, in some cases, though, they are costly.

The American Dental Association advocates the wearing of mouth guards as the most effective defense against sports-related dental injuries. They cushion blows that might otherwise result in chipped or broken teeth and severe lacerations to the lip or tongue. Additionally, the ADA notes that athletes at all levels, organized or unorganized, recreational or competitive, are at risk for dental injury. Even individual recreational activities like skating and gymnastics can expose a person to a mouth injury.

Ideally an athlete should be wearing a mouth guard during any physical activity, from riding bikes to playing football. The standard “boil-and-bite” type mouth guard offers the minimum protection required to help prevent dental and other injuries, but are not the most effective and can be uncomfortable to wear. The most comprehensive protection and comfortable fit is achieved by a custom made mouth guard. These are made from an impression or mold of your teeth taken at Chips Dental Associates. The dental laboratory technician can then manufacture a mouth guard just for your teeth. It will stay in on it’s own and does not obstruct breathing. Although these are more costly than those available in the sporting goods store, they more than make up for the added Q: Why are mouth guards important for athletes?
costs with added protection. As mentioned before, if it prevents one dental injury, it has paid for itself.

Mouth guards also play a role in minimizing the occurrence or severity of concussion. Some experts maintain the shock absorption quality of a mouth guard can take the sting off some blows that cause concussion.

Chips Dental Associates, LLC is committed to helping our community protect their teeth and reduce the risk of concussions. We have partnered with local schools to provide custom mouth guards for student athletes at a reduced fee. If you are a student or parent from a local school, please contact our office for more information.

Brought to you as a community service by Chips Dental Associates, LLC.

For more information or questions, visit www.chipsdentalLLC.com

Does Gum Disease Affect my Overall Health

Q: Does Gum Disease affect my overall health?

 

A: Current literature suggests a strong relationship between gum disease or periodontal disease and overall health. There are relationships between gum disease and heart disease, diabetes, pregnancy outcomes, kidney function, and even Alzheimer’s disease.

Periodontal disease is a chronic infection inside the gums. The disease has a hereditary component but is also contageous. The hereditary component is immune mediated and is a shortfall of certain functions of the immune system. This allows bacteria to infiltrate this delicate area and slowly breaks down the tissues that connect your tooth to your mouth. The contageous component shows up in families or couples. The exchange of the virulent bacteria through utensils and personal contact will inocculate those closest to you and potentiate the process of developing periodontal disease.

The following diagram shows the progression of the disease from healthy gums and tissues through advanced periodontal disease.  It was taken from an ADA pamphlet published about Periodontal disease. 

The scientific research indicates that patients with periodontal disease are twice as likely to have a heart disease. The internal cells of the blood vessels become disfunctional in the presence of chronic inflammation.  Periodontal disease is a form of chronic inflammation which therefore leads to disfunction of these cells in the blood vessels and the development of atherosclerosis (hardening of the arteries).  Atherosclerosis is a risk factor for coronary artery and cardiovascular disease. 

 

 

Patients with diabetes are at higher risk for developing periodontal disease.  Their immune system is less able to handle the chronic inflammation and therefore their tissues are more succeptible to this disease.  With good oral hygiene and regular check-ups there is no additional risk, however when proper oral hygiene protocol and regular check-ups are not maintained, the risk of developing periodontal disease increases significantly.  This maintenance can help patients with diabetes to better maintain their blood sugar levels as well.

 

 

There are higher risks of lower birth weight and pre-term birth in patients with periodontal disease.  There is a documented relationship between the periodontal status of an expectant mother and her newborn baby’s weight as well as the incidence of premature birth.  This simply means that if you are expecting, it’s important to maintain your oral hygiene for the health of your child.  Regular check-ups and good oral hygiene will help to reduce this risk.

 

 

It is clear that kidney function and Alzheimer’s disease are both related to periodontal disease, however the link is still being studied.  The link is particularly noticeable in patients with impaired kidney function or if they are on dialysis.

 

 

Another relationship to realize is that each of these diseases can have a multiplier effect on your risk of developing the other.  For example, a patient with uncontrolled diabetes and rampant periodontal disease will be at much higher risk of having heart disease.

 

 

Most Physicians are not trained to recognize the signs of periodontal disease, recognizing the diseases associated with periodontal disease can be an important method of screening patients who are at risk for periodontal disease.  If your Physician diagnoses you with one of these other diseases it would be beneficial to schedule a periodontal screening with Chips Dental Associates.  The staff at Chips Dental Associates are highly trained at recognizing the signs of periodontal disease and can help you to maintain your oral and overall health.

 

 

Brought to you as a community service by Chips Dental Associates, LLC.

 

 

For more information or questions, visit http://www.chipsdentalLLC.com

A Primer on New Dentures

Q: What are some common problems with new dentures?

A: New dentures are most likely going to feel a bit awkward for the first few weeks. The muscles of your cheeks and tongue have to learn to keep them in place. Soreness and irritation are also not uncommon at the beginning. Eating will also take a little getting used to. Dr. Chips will probably suggest you start off with soft foods cut into small pieces. As you become more comfortable, you can return all your favorites to your diet.

You might also find pronouncing certain words to be challenging. Reading out loud and repeating the troublesome words can help. Dr. Chips will advise you on how long to wear your dentures. At the outset, he may recommend that you wear them most of the time, including while sleeping. After an initial adjustment period, your dentist will most likely want you to remove your dentures at night.

For whatever minor inconveniences your new dentures might cause, just remember that they are going to improve your smile and help you eat properly. The Drs. Chips will be able to answer whatever other questions you may have about dentures. Many patients are very happy with a new set of dentures as tooth replacement therapy, however make sure that you investigate all of your options before deciding upon which tooth replacement is the best for you. Crowns, bridges, implants and partials are all acceptable and beneficial for replacing any teeth that are in poor condition and in need of replacement.

Brought to you as a community service by Chips Dental Associates, LLC.

For more information or questions, please visit http://www.chipsdentalLLC.com

Dental Care and Overall Health

Q: Does dental health carry implications beyond the mouth?

A: The simple answer to this is a resounding YES. Studies have shown that taking good care of your teeth and gums can lower your risk for heart disease. Researchers have found that people who suffer from gum disease, also called periodontal disease, are twice as likely to suffer from coronary artery disease as those without gum disease. The bacteria that breed under the gums can spread to other parts of the body, including the blood vessels of the heart.

Also, earlier this year, the journal of Obstetrics and Gynecology cited the case of a California woman who had a stillborn birth. Doctors determined that the baby’s stomach and lungs contained the same strain of oral bacteria that the 35-year-old mother had in her untreated gum disease.

It’s not uncommon for pregnant women to experience bleeding gums as a result of hormonal changes. If you’re in that situation, check with the Drs. Chips about the cause of bleeding. For the rest of us, it’s a good idea to talk with the Drs. Chips and your primary care physician about the importance of oral health in overall well-being.

Brought to you as a community service by Chips Dental Associates, LLC.

For more information or questions, visit www.chipsdentalllc.com