882C Emerson Street
Palo Alto, CA 94301
Palo Alto Dental Wellness
2700 Middlefield Road
Palo Alto, CA, 94306
Din, Ala Ud D.D.S.
777 Welch Rd # G
Palo Alto, CA, 94304-1602
Palo Alto Dental Assoc
517 Byron St
Palo Alto, CA, 94301-2007
(650) 327-7525
Glerum, John R D.D.S.
3920 Middlefield Rd
Palo Alto, CA, 94303-4733
Have you heard about biofilm? Our dental office monitors it daily. Possibly you'll catch something on TV about biofilm as some sort of newly discovered health threat. It's neither, really. Here are the facts:
Most of our dental equipment is connected to long, flexible tubes that deliver water to your mouth. We call these tubes dental waterlines. Every day, fresh water rushes through them. But overnight or over the weekend, water trapped in these long tubes has the potential of being colonized by a thin layer of microorganisms.
Those microorganisms are biofilm. It's just as important we keep our waterlines free of biofilm as it is you keep your teeth free of plaque through regular brushing.
We've known about biofilm for years. Every morning, all our waterlines are cleared before the first patient arrives. Our dental chairs are equipped with check valves that make sure waterline delivery goes only one way-into the mouth and down the drain.
All this to combat a health hazard that is so far only theoretical-we have no evidence of illness related to water from a dental waterline. Even if it existed, the marginally higher bacteria counts wouldn't necessarily pose a hazard to healthy patients. Bacteria is everywhere-in drinking water, the air we breathe. Getting rid of it is the job of our immune systems.
News organizations love to discover what they believe to be health threats, because it keeps viewers tuned in. But biofilm (if it exists at all) is something we've known about and protected patients against for years.
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People are living longer and keeping their natural teeth more than ever before. The advances in tooth retention, the desire to look one's best, and higher expectations about oral health have raised dental awareness among older adults.
With the significant increase in the older portion of society, with even greater increases expected, more older adults will have more teeth that are susceptible to root caries. Root caries may emerge as one of the most significant dental problems among older adults during the next decade. A recent study conducted by the National Institute for Dental and Craniofacial Research (NIDCR) showed that over half of older adults have decayed or filled root surfaces. The frequency of root caries is strongly age-dependent and will continue to be a major dental problem among the elderly.
Root caries lesions can be caused by new or primary root caries, caries around existing dental fillings or recurrent caries, and abrasion or erosion of the root surfaces. Root caries progress quickly due to the relatively soft nature of the root surface, as well as the risk factors associated with the incidence of root caries.
Risk factors associated with the high prevalence of root caries among older adults include decrease salivary flow or xerostomia, exposure of root surfaces due to periodontal (gum) disease, chronic medical conditions, radiation treatment for head and neck cancer, physical limitations, and diminished manual dexterity due to stroke, arthritis, or Parkinson's disease, cognitive deficits due to mental illness, depression, Alzheimer's disease or dementia, Sjögren's syndrome (an autoimmune disease), diabetes, poor oral hygiene, multiple medication use, and changes in dietary habits. One or more of these risk factors or life changes, which are more common among older adults, can increase root caries in an individual who has not had dental caries for many years.
Root caries can be a challenge for the dentist to treat depending on the size and the type of root caries lesion, the extent and rate of caries activity for that person, the physical and mental condition of the individual, and where the root caries are located in the mouth. Many root lesions have limited accessibility and visibility, are often more complicated by pre-existing extensive dental work, and are difficult to isolate from oral fluids during the restoration process. Also, many people who have widespread root lesions have limited tolerance for dental treatment because of medical conditions, illness, and mental health problems.
By Denise J. Fedele, DMD, MS
