Brosy Family Dentistry
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Alzheimer's Disease Linked to Oral Health

True or false: Poor oral hygiene and gum disease can increase your risk for developing Alzheimer’s.  If you guessed true, you’re correct! The link between oral health and systemic health has been a hot research topic over the past decade.  We know that people with healthy teeth and gums tend to have less systemic health issues and vise versa.  Some may think that is simply because people who value oral health also spend more time focusing on overall health, but there may be more to it.  It may also have to do with the type of bacteria that set up shop in your mouth. 

Human babies are born with little or no oral bacteria.  We acquire the bacteria that will inhabit our mouths through birth, nursing, and exposure to environmental factors.  This is one reason why dental cavities and oral health issues tend to “run in the family”.  If parents have poor oral hygiene, gum disease, or a strong history of decay/gum disease, the harmful bacteria can be passed on to children through sharing spoons, drinks, kisses, etc.  Most studies show that once a bacteria is present it will remain indefinitely at varying levels.  The amount of each bacteria can be impacted by oral hygiene practices and overall nutrition. 

A research study that was published in the Journal of Alzheimer’s Disease examined ten brain samples from patients with dementia alongside ten brain samples from people who had not had the disease. Examination of the tissues revealed the presence of a bacteria known as Porphyromonas gingivalis in the brains affected by Alzheimer’s.  Porphyromonas gingivalis is a bacteria that is typically found in the mouths of people with moderate to severe periodontitis. 

Generalized oral infection in patients with periodontitis leads to a constant increased level of inflammatory mediators. The increase in inflammation leads to an increased risk for oral bacteria to enter the bloodstream and infect other areas of the body.  Once the bacteria makes it across the blood brain barrier, it settles in the brain and triggers a low-level inflammatory response in the brain tissues. This inflammatory response leads to destruction of brain cells (neurons) and could contribute to dementia symptoms. 


Research is currently being done to create a simple blood or saliva test to determine if someone is a systemic carrier of Pophyromonas ginigivalis.  Once it is determined that someone is a carrier, potential antibiotic treatment options may decrease the risk of brain tissue destruction.  The best way to decrease your risk at this time is to practice excellent oral hygiene, receive regular professional dental care, and eat a nutritious diet.

  

Updates to your upcoming appointment


 Dear Patients of Brosy Family Dentistry,

We hope this post finds you and your family in good health. Our community has been through a lot over the last few months, and I am looking forward to resuming operation and seeing your smiling faces once again. While many things have changed, one thing has remained the same: our commitment to your safety.Infection control has always been a top priority for our practice.

As we learned more about Covid-19, and it's ability for aerosol transmission, all non-emergency dental procedures were halted. We have implemented extra measures throughout our office to treat our patients as safely as possible. We follow strict guidelines set forth by CDC and OSHA as well as implement extra precautionary methods we feel are in the best interest of our patients and staff.

In all of our operatories we have installed air filters that help reduce aerosols created from dental procedures. We will be requiring a new health history form for all patients. We will also be adding a pre-appointment mouthwash required for all patients.If you feel you have flu like symptoms, have traveled outside of the Reno/Sparks area in the last three weeks, or have been in contact with someone suspected or confirmed of having Covid-19 you must cancel your appointment. 

You will see the following changes at your next appointment to help protect our patients and staff.
- A screening health history form will be required for every patient and will be texted prior to your appointment. If you arrive and this is not completed, you must remain in your vehicle until this is filled out. Paper copies will be available for those without access to text.
- When you arrive for your appointment (with a previously filled out form) you will call our office and we will notify you when your room is ready. This allows us to properly sanitize each room between patients and adhere to proper social distancing procedures
- Once your room is ready you will be contacted, and a staff member will meet you at the entrance.
- Your temperature will be taken prior to entering the building. If your temperature is over 100.4 degrees Fahrenheit you will not be allowed to enter our office.
- Temperatures on all staff members will be taken daily
- Before sitting down, you will be given a Peroxyl mouthwash. Peroxyl is an alcohol free mouthwash with 1.5% hydrogen peroxide. For asymptomatic carriers, this will reduce the amount of viral load prior to a dental procedure.
- The checkout process will also be a bit different. Our insurance and billing specialist, Donna, will call you prior to your appointment to answer any questions and verify payment information. There will be no charges to your account until after all treatment is completed.
- Once your appointment is complete, you will be able to walk out and enjoy the rest of your day.
- We will call you to schedule your next hygiene or restorative appointment.

Throughout this process, my biggest concern is that you, the patient, will feel rushed. I hope your experience at our office, while different, will still have a Brosy Family Dentistry feel. Our staff has not changed, and our level of care for you and your family will never change. If you ever have additional questions, concerns, or good jokes I am always available. My email is [email protected]

All of us at Brosy Family Dentistry look forward to seeing you again and are happy to answer any questions you may have about the steps we take to keep you, and every patient, safe in our practice.

Thank you for being our patient. We value your trust and loyalty and look forward to welcoming back our patients, neighbors and friends.

Sincerely,
Dr. Erin 
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Dental Treatment and CoVid 19: What we want you to know

Life certainly has changed over the past few months. We hope that you are well and still able to find joy in your days (and in your flossing). Let's talk a little bit about why the COVID pandemic has impacted dental procedures.

SARS-CoV-2 (the virus that causes COVID-19) is spread by respiratory droplets. These droplets can be aerosolized by coughing, sneezing, and by medical/dental procedures that combine air and water with bodily fluids. In a dental office, we use high speed drills, ultrasonic scalers, and air/water syringes to perform dental treatment. These instruments create a visible spray that contains large particle droplets of water, saliva, blood, and microorganisms, and it also contains aerosolized particles that continue to hangout in the air even after treatment has been completed. Breathing in an area where COVID has been aerosolized greatly increases your risk for aquiring and transmitting the virus.

Surgical masks protect mucous membranes of the mouth and nose from droplet spatter, but they do not provide complete protection against inhalation of airborne infectious agents. People who are unable to wear a mask (dental patients receiving treatment), have no protection at all.

According to the CDC, the virus has been shown to survive in the air for hours and on surfaces for several days. People may be able to spread the virus while pre-symptomatic or asymptomatic. Because of this, the CDC recommended that all non-emergent dental procedures be postponed for the time being.

This situation is new...to everyone. It is important to stress that the safety of our patients and our employees has and always will be a driving priority in our business. As you may have noticed, we use multiple plastic barriers. This does increase waste into our landfills, but it also minimizes a chance of exposure to any infectious disease between patients. Once you leave our office, the room you were in is completely stripped down and an antiviral wipe or spray is used on exposed surfaces. These are infection control procedures that have always been done at Brosy Family Dentistry and we will continue to closely follow CDC/OSHA guidelines to keep you safe. 

As new information comes in, new recommendations and guidelines will follow. You can expect to see some changes in how your future dental appointments look. There will likely be new guidelines for waiting rooms, office equipment, and personal protective equipment for providers. One thing that will not change is the love we have for our patients and the passion we have for providing excellent care in the safest way possible.

Thank you for your support through this unprecedented time. We have such an amazing local community. We will get through this together! We are here for your emergent needs now and look forward to seeing your smiles for routine procedures as soon as we can. We'll keep you in the loop as the situation changes.

Best wishes,

Your Brosy Family

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National Children's Dental Health Month & Give Kids a Smile

February is National Children's Dental Health Month and every year Brosy Family Dentistry celebrates by participating in the Give Kids a Smile program. The Give Kids a Smile program was launched by the American Dental Association in 2003 as a way to reach underserved children who may not have dental care otherwise. Every year on the first Friday in February, thousands of dental care providers and other volunteers join forces in communities around the country to provide free oral health education, screenings, and treatment to children in need. Since 2003, more than 6 MILLION children have been cared for by more than half a million volunteers through Give Kids a Smile!

Our local Give Kids a Smile event was held on Friday February 7th at Champagne Family Dentistry. Dr. Erin spent the day with dozens of other dental professionals and volunteers from our amazing community. More than 130 local children received free dental care!

Dental health is a vital component of overall health and proper dental care is important for people of ALL ages! Here are a few quick facts about children's dental health:

1. First dental check-ups should begin by a child's first birthday. Kids who start receiving professional dental care at the age of one have significantly lower childhood cavity rates.

2. Brushing should begin with the first tooth!

3. Flossing should being as soon as teeth are touching or when first baby molars have come in. Even if teeth aren't touching completely, it's great to start healthy habits early.

4. Having fluoride varnish treatments at least twice a year beginning at the age of one can decrease decay rates by 50%.

5. Non-fluoride toothpaste (aka training toothpaste) should be used until a child can completely spit and rinse after brushing.

6. Children who have constant/frequent access (through bottles, sippy cups, etc.) to anything other than water have higher decay rates.

7. Juice, even when watered down, has very little nutritional benefit and children who regularly consume it have higher decay rates.

8. Kids whose parents have healthy oral hygiene habits and regular professional dental care have lower decay rates.

9. The bacteria that causes cavities and gum disease is transmissible and can be spread to children through sharing drinks and utensils.

10. Dental sealants placed on permenant molars decrease decay on chewing surfaces by 90%.

FREE FLUORIDE

FREE Fluoride February!

February is National Children's Dental Health Month! To celebrate, we are offering a FREE mint FluoriMax fluoride varnish treatment to ALL of our patients during the month of February!

Fluoride varnish is a type of concentrated topical fluoride that can be professionally applied to help prevent cavities and dentinal sensitivity in people of all ages. Fluoride varnish is quickly and easily applied with a small paintbrush. Topical fluoride works by hardening the outside shell (enamel) of the tooth and by temporarily decreasing bacterial growth. Fluoride varnish has the ability to re-mineralize weakened areas of the enamel and can stop early onset decay in it's tracks. Fluoride varnish is approved for those 6 months and older.

Varnish is far more effective than the older fluoride foam or gel methods that many of us may remember doing as kids. The fluoride in the professional gel and foam is only absorbed into the teeth while the fluoride trays are in your mouth. Fluoride varnish adheres to the teeth and continues to release fluoride for 24 hours after application. The additional fluoride uptake leads to more effective and longer lasting results.

Research consistently shows that fluoride varnish is the most effective and safest form of fluoride used to decrease dental decay rates in children and adults. Varnish has been shown to decrease decay rates by at least 50% in people who consistently have twice a year treatments along with proper oral hygiene. Varnish decreases the risk of overexposure to fluoride in children when compared to gel, foam, and prescription toothpaste options because the varnish adheres directly to the tooth and is not easily swallowed.

We recently made the switch to Elevate Oral Care fluoride and xylitol products at Brosy Family Dentistry. We think you are going to love them just as much as we do and here's why:

  • Elevate FluoriMax fluoride varnish contains half the concentration of sodium fluoride compared to traditional varnished (2.5% instead of 5%). Research showed fluoride uptake into enamel was statistically the same or better at 2.5% than 5% concentrations.
  • It dries to a clear, non-tacky coating that is 7-40 times thinner than traditional varnishes which makes for a much more pleasant experience. You can eat and drink like normal right after the treatment.
  • It's thin and flowable which allows it to flow across and between the teeth better than traditional varnishes.
  • FluoriMax is hypoallergenic and the pharmaceutical facility where it is manufactured does not process any of the potential allergens listed below, therefore there is no risk of cross-contamination:
    • Tree-based/synthetic resins
    • Milk • Dyes • Glutens • Eggs • Peanuts • Tree nuts • Pine • Fish • Shellfish • Soy • Wheat • Sunflower seeds •Sesame seeds

If you don't already have your next dental cleaning on the books, give Cindy a call today! We hope to see you soon!

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Welcome Donna!

Please help us in welcoming Donna, our new insurance coordinator! Donna may be our newest Brosy Family team member, but she is not new to Brosy Family Dentistry. We have had the pleasure of treating Donna and her family in our office as patients for many years. Donna has worked in the dental field for over twenty years and comes to us with a wealth of dental and insurance knowledge.

Donna has been married to her husband Jerry for 32 years. They have two grown children, Cydni and Aaron. Donna and Jerry love country music, campimg, spending time at the lake, and riding their Harleys. Fun fact, Donna has a twin sister who also lives here in Reno! We are grateful and excited to have her in our Brosy Family!

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Charcoal Toothpaste

You can't walk down a toothpaste aisle or scroll through your social media feed without seeing ads for charcoal toothpaste. It started off in natural oral care product lines as an alternative to traditional whitening products. It quickly became popular and the more mainstream companies jumped on the wagon. So, how do they work and is it worth all of the hype...and the potential mess?

Charcoal toothpastes contain activated charcoal. Activated charcoal is a form of carbon that has been treated to make it's surface rough and porous. The rough surface scrubs stains away while the porous areas attract and grab onto the particles that have been removed from the tooth's surface. Charcoal toothpastes work well on surface level extrinsic stains, but they do not have the ability to change intrinsic stains. Most product comparisons show that charcoal toothpastes are more effective than other popular whitening toothpastes at removing stains. The high efficacy comes from the abrasiveness of the activated charcoal. It is important to use charcoal toothpastes sparingly and not more than 1-2 times per week. If used too often, the abrasiveness of activated charcoal can cause irreversible tooth damage and sensitivity. Bottom Line: Charcoal toothpaste is safe/effective when used sparingly.

There are two types of tooth stain, extrinsic and intrinsic. Extrinsic stains are those that sit on the surface of the tooth. These stains are typically caused by food and drinks such as coffee, tea, wine, and berries. Extrinsic stains are not incorporated into the tooth structure, therefore they can typically be removed by brushing and/or by your hygienist during your professional dental cleaning. Intrinsic stains are those that have become incorporated into the actual tooth structure. These stains can also be caused by food and drinks, as well as medication and some health conditions. Intrinsic stains cannot be removed by brushing or scaling done by your dental hygienist. Intrinsic stains require bleaching procedures to be lightened and removed.

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Geographic Tongue

We know geographic tongue sounds like something out of a Jurassic Park movie, but it's definitely not something prehistoric! Geographic tongue is a common condition that is characterized by harmless patches on the surface of the tongue. It effects about 5-10% of the population. Geographic tongue is benign and not related to oral cancer or other oral pathologies. Geographic tongue can occur at any age and it may come and go. More women than men experience geographic tongue.

Signs and Symptoms:

  • Red/pink/white patches on the tongue that change often, sometimes even daily
  • Sometimes the patches have a map-like appearance, hence the term "geographic"
  • Soreness or burning, most often with acidic and spicy food

The top of the tongue is covered by little bumps called papillae. There are four types of papillae, three of which contain taste buds. Typically these papillae evenly cover the tongue's surface. In people with geographic tongue, there are areas where papillae are temporarily lost. When the papillae are lost, smooth patches of the tongue's surface are exposed.

The mouth has incredibly fast and efficient healing abilities. Most oral tissues heal faster than any other cells in your body. The exposed patches of the tongue's surface heal quickly and papillae regrow to cover areas where they were lost.

Causes:

The cause of geographic tongue is unknown. It seems to run in families and it is definitely agrivated by acidic food and drinks. There has been some speculation that it is related to B vitamin deficines or psoriasis, though a definitive link has not been proven.

Treatment/Management:

  • Avoid spicy or acidic foods if they bother you
  • Weak warm salt water rinses can be soothing
  • Some studies show that taking a B-complex and/or zinc supplement may be beneficial
  • Most cases of geographic tongue show no symptoms at all. If your tongue isn't bothering you, there is no treatment needed

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November: Type 1 Diabetes Awareness

November is Diabetes Awareness Month! Let's take a moment to shine some light on one specific type of diabetes that is often misunderstood. Type 1 diabetes (T1D) is an autoimmune disease that can develop in anyone at any age. T1D occurs when your immune system attacks and destroys insulin producing cells in your pancreas. A few quick facts:

Type 1 Diabetes:

  • IS an autoimmune disease. This means that it occurs when your immune system attacks cells in your own body.
  • IS NOT caused by eating sugar or being overweight. Most current research shows that genetics, certain viruses and environmental factors may all play a role in triggering the autoimmune attack that quickly leads to T1D.
  • IS NOT a childhood disease. The autoimmune attack that leads to type 1 diabetes can happen at any age. In 2018 there were approximately 40,000 people newly diagnosed with T1D in the US - 18,000 of those people were under the age of 20, while 22,000 were over the age of 20. There is not a cure for T1D at this time.
  • IS often initially misdiagnosed, especially in adults. Blood testing for autoantibodies is important if someone is exhibiting symptoms of T1D

Type 1 Diabetes and Oral Health

Maintaining healthy blood sugar levels is very important for overall health, including your oral health! When blood sugar levels consistently run high, sugar content in salvia is also high. The excess sugar feeds the bacteria that cause cavities and gum disease. It also creates an more acidic environment which is harmful to oral tissues. Healing abilities are diminished during periods of low or high blood sugar. All of these things together make it harder for your body to repair damaged tissues, which can lead to an increase in cavities and gum disease. The good news is that there are ways to prevent oral complications!

Having healthy teeth and gums will actually help you achieve healthy blood sugar levels. Active infections such as gum disease make it very difficult to rein in blood sugar levels. Prevent infection by practicing excellent oral care, maintaining a healthy lifestyle and working hard to keep blood sugar in optimal range.

7 Tips for Healthy Teeth and Gums:

  • Use an electric toothbrush
  • Use floss, proxy brushes, and/or a Waterpik daily to get the tough in-between spots
  • Don't use tobacco
  • Use dry mouth products if you feel like your oral tissues are dry or cracking
  • Try your best to keep blood sugar levels in range
  • Eat a healthy balanced diet rich in vitamins and nutrients
  • See you dental hygienist and dentist at least twice a year. It is often beneficial to have your teeth cleaned more frequently when you have diabetes. Discuss the option of a 3 or 4 month cleaning schedule with your dental professional.

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Diving Deep into Scaling and Root Planing

Routine dental cleanings are done to prevent gum disease and maintain optimal oral health. But, what happens when you fall off of the prevention wagon or when you have a troublesome area of periodontitis (aka gum disease)? If you have areas of moderate to heavy calculus build-up, deep gum pocketing, inflammation, and/or bleeding, your dental hygienist may recommend scaling and root planning.

To understand why scaling and root planing is sometimes necessary, it's important to understand the different levels of gum disease. Gum disease can be split into two main categories: gingivitis and periodontitis. Each category can be broken down into mild, moderate, and severe forms. All forms of gum disease are influenced by a variety of factors. Oral hygiene, diet/nutrition, genetics, drug and alcohol use, frequency of routine dental care, and systemic health conditions all play a role.

Gingivitis is defined as inflammation of the gum tissue without loss of supporting structures such as bone, periodontal ligaments, and marginal gum tissue. According to the American Dental Association, almost 100% of people will experience gingivitis in their lifetime. Poor plaque control is one of the most common causes of gingivitis. Gingivitis is reversible and can typically be treated with routine dental cleanings, improved oral hygiene, and over-the-counter products. If left untreated, gingivitis can progress into periodontitis.

Periodontitis is defined as inflammation of the gum tissue and support structures that has resulted in permeant damage and loss of tissue. Severity is determined by the degree of bone loss, tooth mobility, and tissue destruction. Periodontitis is typically a multifactorial process and must be addressed promptly to achieve the best possible outcome. This is where scaling and root planing comes in!

Scaling and root planning is often referred to as a "deep cleaning" because it is more involved than a routine cleaning. Often times, this means splitting the cleaning into multiple appointments. Your dental hygienist will evaluate and make a treatment plan by quadrant (upper right, lower right, upper left, lower left) to determine appointment length. You can usually plan on at least two 90 minute appointments to complete your treatment, sometimes more. You may need to be numb for the procedure to allow for all of the plaque, calculus, and debris to be removed comfortably. Don't fret! Different types of anesthetic (some topical and needleless) can be used. Once your comfort needs have been met, your dental hygienist will remove the plaque, calculus, and stain using an ultrasonic scaling device and hand scalers. The ultrasonic scaler works quickly to access hard to reach areas, remove caked on build-up, and help irrigate inflamed gum pockets. It also helps kill bacteria as it cleans which improves healing outcomes. Hand scalers leave a smooth, healthy finish to allow for healing. During the cleaning process, as well as when it is complete, it is very important to practice excellent oral home care to allow the gum tissue to heal. You will typically return in 6-12 weeks for a follow up appointment. At this appointment, your dental hygienist will likely do a thorough periodontal maintenance cleaning and evaluate overall healing. He or she will also determine what type of routine cleaning you need moving forward.

Stopping progressive gum disease in it's tracks is the only way to prevent further destruction. Calculus build-up under gum tissue creates a similar situation to a splinter buried deep in a finger. If you let the splinter stay stuck under the skin, an infection develops and it will continue to worsen until the splinter is removed. The calculus must be removed for the gum tissue to heal to the best of it's ability. The sooner you get started, the better the outcome. You'll never regret taking steps towards better health.

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