Berks County Medical Society Medical Record Summer 2019 - 18

Is Oral Health coming to Your Office?
continued from page 17
* Primary teeth are important - some remain in the oral cavity until
age 12!

* Silver diamine fluoride is being used more frequently for treatment
of dental caries in primary teeth and in senior citizens. It is an
effective, painless treatment, just produces a black spot where
the cavity was. Medical professionals are familiar with using
silver nitrate for tissue cautery. This compound adds fluoride
which integrates with the tooth's normal healing processes to
form fluoroapatite which is harder than the naturally occurring
hydroxyapatite.

* Persons with special healthcare needs are at high risk for oral
health problems because of reduced saliva, gingival overgrowth,
and oral candidiasis, and should see the dentist immediately with
the appearance of the first tooth and at least every 3-6 months to
maintain their teeth in good condition.
* There are places in the world with naturally occurring fluoride in
the ground water at levels of 65-95 ppm (current recommended
levels are 0.7-1.2 ppm)! Among these are China, India, the Rift
Valley of Africa. This information is very important for those who
go on missionary trips to these areas. They need to be aware of the
manifestations of fluorosis (broken bones and teeth along with tooth
staining among them!). Fluorosis looks like this on teeth:
* Fear and cost are major deterrents to people accessing healthcare
services - both medical and dental.
* On the way to the tonsils, examine teeth and soft tissues for white
spots, dark spots, ulcers, bleeding gums, heavy plaque, and unusual
lumps and bumps.
* Preventing abscesses after dental trauma is part of our job of
physicians as well as that of dentists. Please, when you receive calls
from patients about injured teeth, have them look at the gums above
the teeth for redness for the next 6 months and report to their dentist
immediately if redness occurs before the abscess develops!

* Fluoride combines with hydroxyapatite to form fluoroapatite
which is stronger than the normal hydroxyapatite found in tooth
enamel. USPSTF now recommends that if children live in areas
deficient in fluoride, supplementation (fluoridated water at a level of
0.7-ppm, fluoridated toothpaste, or fluoride supplement) be begun
at 6 months of age and fluoride varnish be applied 4 times per year
(2-3 in medical office, 1-2 in dental office) to the primary teeth of all
infants and children starting at the age of primary tooth eruption.

18

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Berks County Medical Society Medical Record Summer 2019

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