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IfYouvehadJointReplacementyoumayNeedAntibioticsBeforeDentalWork

If you’ve had a total joint replacement or similar procedure, you will want your surgeon to decide if you need to take an antibiotic before you undergo dental work. This is a precaution to prevent a serious infection known as bacteremia.

Bacteremia occurs when bacteria become too prevalent in the bloodstream and cause infection in other parts of the body, especially in joints and bone with prosthetic (replacement) substances. It’s believed that during invasive dental procedures bacteria in the mouth can enter the bloodstream through incisions and other soft tissue disruptions.

Joint infections are a serious matter and can require extensive therapy to bring it under control. Out of this concern, the use of antibiotics as a prophylactic (preventive measure) against bacteremia once included a wide range of patients for a variety of conditions and procedures. But after an in-depth study in 2007, the American Dental Association concluded that the risks for many of these patient groups for infection triggered by a dental procedure was extremely low and didn’t warrant the use of antibiotic premedication therapy.

As a result, recommendations for antibiotic therapy changed in 2009, eliminating many groups previously recommended for premedication. But because of the seriousness of joint infection, The American Academy of Orthopedic Surgeons still recommends the therapy for joint replacement patients about to undergo any invasive procedure, including dental work. It’s especially needed for patients who also have some form of inflammatory arthritis, a weakened immune system, insulin-dependent diabetes, hemophilia, malnourishment or a previous infection in an artificial joint.

The guidelines for antibiotic premedication can be complex. It’s best, then, to speak with both your orthopedic surgeon and us about whether you should undergo antibiotic therapy before you undergo a dental procedure. The ultimate goal is to reduce the risks of any disease and to keep both your mouth and your body safe from infection.

If you would like more information on the use of antibiotics in 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 “Premedication for Dental Treatment.”

NeilPatrickHarrisWhattheOscarsHostTreasuresMost

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Golden Dental
November 07, 2017
Category: Oral Health
Tags: toothache  
WhattoDoAboutYourChildsToothacheBeforeSeeingtheDentist

If your child begins complaining of tooth pain without an accompanying fever or facial swelling, it’s likely not an emergency. Still, you should have us check it—and the sooner the better if the pain persists or keeps your child up at night. There are a number of possible causes, any of which if untreated could be detrimental to their dental health.

Before coming in, though, you can do a cursory check of your child’s mouth to see if you notice any abnormalities. The most common cause for a toothache is tooth decay, which you might be able to see evidence of in the form of cavities or brown spots on the tooth’s biting surfaces. If you notice swollen or reddened gums around a tooth, this could be a possible sign of a localized area of infection known as an abscess. You should also ask your child if they fell or were hit in the mouth and look for any signs of an injury.

If you don’t see anything unusual, there may be another cause—stuck food like popcorn or candy lodged and exerting painful pressure on the gum tissue or tooth. You may be able to intervene in this case: gently floss around the affected tooth to try to dislodge any food particles. The pain may ease if you’re able to remove any. Even so, if you see abnormalities in the mouth or the pain doesn’t subside, you should definitely plan to come in for an examination.

In the meantime, you can help ease discomfort with a child-appropriate dose of ibuprofen or acetaminophen. An ice pack against the outside jaw may also help, but be careful not to apply ice directly to the skin. And under no circumstances rub aspirin or other painkiller directly on the gums—like ice, these products can burn the skin. If these efforts don’t help you should try to see us the same day or first thing the next morning for advanced treatment.

The main thing is not to panic. Knowing what to look for and when to see us will help ensure your child’s tooth pain will be cared for promptly.

If you would like more information on handling dental issues with your child, 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 “A Child’s Toothache.”

Are you worried about your missing teeth ruining your smile? Do you want to have them replaced, but aren't sure what your options are? If restorative dentistryso, then you've come to the right place. Dr. Roland Markarian offers his patients crowns and bridges at Golden Dental, located in Lancaster, CA.

Dental Bridges

The dental bridges your Lancaster dentist offers are custom-made oral appliances that will match the rest of your teeth.

There are two types of bridges:

  • Fixed partial dentures are attached to dental implants or natural teeth, but they come in various forms, such as conventional fixed bridges, cantilever bridges and resin-bonded bridges.
  • Removable bridges can be taken out of your mouth so you can give them a thorough cleaning yourself.

Bridges are helpful in improving aesthetic issues, as well as functional issues:

  • Conceal spaces and gaps between teeth
  • Restore bite and chewing functions

Dental Crowns

Dental crowns, like bridges, can offer you so much. The custom-made dental installations, also referred to as caps, are made of porcelain, which makes them durable. They are placed over a tooth after your doctor carves the tooth enough so that it can fit under the crown. Sometimes a tooth is so severely decayed, the doctor needs to rebuild the tooth before placing the crown over it.

Crowns can also help you with the following:

  • They hide chips and cracks caused by injuries, like when playing sports.
  • The can conceal stained and/or discolored teeth caused by smoking.
  • They are used for covering restorative procedures like a root canal.
  • They are strong so they add reinforcement to your teeth, which makes biting and chewing easier.
  • They are placed over fillings that are about to be dislocated.

Crowns and bridges conceal many issues, as well as add reinforcement for your teeth. They are great treatments that can improve the quality of your life and the appearance of your smile. If you have any questions, please don't hesitate to call Dr. Markarian at his office in Lancaster, CA.

EarlyOrthodonticTreatmentCouldLessenSeverityofCertainBiteProblems

You’ve been concerned for some time about your child’s bite, so you’ve visited an orthodontist for an evaluation. Even though your child is quite young and still with primary teeth, the orthodontist recommends they begin wearing a retainer device, with the possibility of braces in a few years.

That may at first sound like an overly extensive treatment plan. For certain bite problems, however, undergoing an early stage of orthodontic treatment could reduce or even eliminate the need for more advanced and costly treatment later.

An example of such a problem is a crossbite, also known as an underbite. With this type of malocclusion (bad bite) the lower front teeth bite in front of the upper front teeth rather than behind them as in a normal bite relationship. Because the teeth and jaws are still in development (including the primary teeth, which are preparing the path for the permanent teeth erupting later), wearing a retainer device could exert just enough pressure to influence the teeth toward a better alignment.

In essence, the goal of early orthodontic treatment is to intercept a bite problem ahead of time and prevent it from becoming a more serious one later. If early treatment isn’t undertaken or delayed until after the eruption of the permanent teeth, it will be much more difficult, if not impossible, to correct the malocclusion. Even if the initial treatment doesn’t correct the problem it could at least lessen its severity so that future treatment like braces or clear aligners can correct it with less difficulty and cost.

By getting an early start on bite problems, you’ll increase the chances your child will achieve an optimum bite when they reach adulthood. Not only will this enhance their appearance, it will greatly benefit their overall health and mouth function. In these cases, early orthodontic treatment could make all the difference in the world.

If you would like more information on orthodontic treatment for children, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Preventative & Cost Saving Orthodontics.”





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803 West Avenue J
Lancaster, CA 93534
661-948-8100

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