Our Blog

The American Academy of Periodontology stresses the importance of good oral health since gum disease may be linked to heart disease and stroke. Thus far, no cause-and-effect relationship has been established, but there are multiple theories to explain the link between heart disease and periodontal disease. One theory suggests that oral bacteria may affect heart health when it enters the blood and attaches to the fatty plaque in the heart's blood vessels. This can cause the formation of blood clots. Another theory suggests the possibility that inflammation could be a contributing link between periodontal disease and heart disease. Gum disease increases plaque buildup, and inflamed gums may also contribute to the development of swollen or inflamed coronary arteries.

What is coronary artery disease?

Coronary artery disease is caused in part by the buildup of fatty proteins on the walls of the coronary arteries. Blood clots cut off blood flow, preventing oxygen and nutrients from getting to the heart. Both blood clots and the buildup of fatty proteins (also called plaque) on the walls of the coronary arteries may lead to a heart attack. Moreover, periodontal disease nearly doubles the likelihood that someone will suffer from coronary artery disease. Periodontal disease can also worsen existing heart conditions, so many patients who suffer from heart disease need to take antibiotics before any dental procedures. This is especially true of patients who are at greatest risk for contracting infective endocarditis (inflammation of the inner layer of the heart). The fact that more than 2,400 people die from heart disease each day makes it a major public health issue. It is also the leading killer of both men and women in the United States today.

What is periodontal disease?

Periodontal disease is a chronic inflammatory disease that destroys the bone and gum tissues around the teeth, reducing or potentially eradicating the system that supports your teeth. It affects roughly 75 percent of Americans, and is the leading cause of adult tooth loss. People who suffer from periodontal disease may notice that their gums swell and/or bleed when they brush their teeth.

Although there is no definitive proof to support the theory that oral bacteria affects the heart, it is widely acknowledged better oral health contributes to overall better health. When people take good care of their teeth, get thorough exams, and a professional cleaning twice a year, the buildup of plaque on the teeth is lessened. A healthy, well-balanced diet will also contribute to better oral and heart health. There is a lot of truth to the saying "you are what you eat." If you have any questions about you periodontal disease and your overall health, give our Malden office a call!

Hearing that you need a root canal can be highly intimidating. What is a root canal? It is the removal of the nerve supply from the tooth. Here, Dr. Fernandes, Dr. Melito, and Dr. Sharma will describe the parts of a tooth and explain the reasons for a root canal and how it is done when you visit us in our Malden office.

Your tooth is made up of many layers. The outside layer is called enamel and is made of minerals. The middle layer is dentin, which is also a calcified tissue, but less dense. The center of the tooth is called the pulp, and that hosts the nerves and blood vessels. A root canal is the removal and replacement of this center with a sterile filling.

A root canal is needed when an infection spreads to the center of the tooth. This can be from trauma (recent or previous), a cavity, a severe crack, or other compromise that causes nerve damage. An X-ray and examination are required to see if a root canal is needed. Symptoms may include but are not limited to pain, swelling, change in tooth color, and over-reaction to temperature change or pressure.

When it is time to begin, you’ll receive local anesthesia (via injection) to make you most comfortable. A rubber dam is used to isolate the tooth, while other equipment determines the nerve location and maintains a sterile working environment. All of the infected area is removed including the nerve tissue and blood vessels. Then, medicines are used to sterilize and alleviate any pain. Next is the placement of a filling material in the spot where the nerve used to be.

When your nerve and blood supply are taken away, the tooth is non-vital, or dead, and can become weak and fragile. If your tooth is badly decayed, a large portion of it will have to be removed. It is recommended to place a crown on the tooth to keep the enamel from breaking or falling apart. If you do not get a crown, you could eventually lose the tooth to more decay or infection. The tooth could also break off completely and you would have to have an extraction. The crown fits over the top of the tooth and secures it from breaking down.

A root canal saves the life of a tooth that would otherwise succumb to further infection and eventually extraction. Infection is the cause of most-needed root canals. If you are ever unsure what is happening at your appointment, don’t be afraid to ask questions so you understand the procedure completely.

Water picks, sometimes called “oral irrigators,” make an excellent addition to your regular home care regimen of brushing and flossing. Especially helpful to those who suffer from periodontal disease and those patients of ours undergoing orthodontic treatment with full-bracketed braces, water picks use powerful tiny bursts of water to dislodge food scraps, bacteria, and other debris nestled in the crevices of your mouth. Children undergoing orthodontic treatment may find using a water pick is beneficial if their toothbrush bristles tend to get caught on their wires or brackets.

When you use a water pick, you’re not only dislodging any particles or debris and bacteria you might have missed when brushing, you are also gently massaging the gums, which helps promote blood flow in the gums and keeps them healthy. While water picks are an excellent addition to your daily fight against gingivitis and other periodontal diseases, they are incapable of fully removing plaque, which is why Dr. Fernandes, Dr. Melito, and Dr. Sharma and our team at Malden Endodontics want to remind you to keep brushing and flossing every day.

If you have sensitive teeth or gums and find it uncomfortable to floss daily, water picks are a good alternative to reduce discomfort while effectively cleaning between teeth. Diabetics sometimes prefer water picks to flossing because they don't cause bleeding of the gums, which can be a problem with floss. If you have a permanent bridge, crowns, or other dental restoration, you may find that a water pick helps you keep the area around the restorations clean.

So how do you choose the right water pick?

Water picks are available for home or portable use. The home versions tend to be larger and use standard electrical outlets, while portable models use batteries. Aside from the size difference, they work in the same manner, both using pulsating water streams. A more crucial difference between water picks is the ability to adjust the pressure. Most home models will let you choose from several pressure settings, depending on how sensitive your teeth and gums are. Most portable models have only one pressure setting. If you want to use mouthwash or a dental rinse in your water pick, check the label first; some models suggest using water only.

Please give us a call at our Malden office if you have any questions about water picks, or ask Dr. Fernandes, Dr. Melito, and Dr. Sharma during your next visit!

A dental emergency can strike anywhere, anytime, and without warning. Perhaps you’re playing a game of touch football on Thanksgiving and your brother-in-law decides to up the ante and tackles you, accidentally knocking out your two front teeth. Or maybe you’re on vacation somewhere in the tropics and decide to go deep-sea fishing, but when you’re climbing onto the boat you slip on the dock, fall, and chip three of your teeth. From misplaced fly balls to bagel seeds causing a painful bout of inflammation, there are all kinds of dental emergencies.

Here are the five most common reasons for emergency care visits.

1. Somehow you've managed to knock out a tooth. Whether it's the result of a sports injury or because of decay, when you lose a tooth, you need emergency dental care. If the tooth is salvageable, then it can be reattached to the socket, but this needs to be done within a one- or two-hour window.
2. A chipped tooth is the most common dental emergency. Small chips can be caused by food (chicken bones and nuts have sent many people to the dentist); however, it's usually some sort of accident or injury that more often causes a chip. While you might be embarrassed to walk around with a gaping chip in your front tooth, it is easily fixed with a bond, crown, or veneer.
3. A broken tooth is more severe than a chipped tooth. When a tooth breaks, it might be due to a small or hidden chip. However, chances are the pain and discomfort will be more severe.
4. It might seem comical, but getting a piece of food lodged in the wrong place can result in a dental emergency. If something gets stuck deep in a crevice, it can cause pain and inflammation.
5. The loss of a filling happens more often than you think. When you lose a filling, you need to receive emergency care immediately. If you don’t, you risk further damage to your tooth.

When you injure your teeth or mouth, you need to seek emergency care as soon as possible. In the event of a suspected emergency, don't wait. Contact Dr. Fernandes, Dr. Melito, and Dr. Sharma immediately.