Sam Nicolosi, Author at Adam Brown Dentistry

About Sam Nicolosi

This author has not yet filled in any details.
So far Sam Nicolosi has created 3 blog entries.

Is Sparkling Water Bad for Your Teeth?

Sam Nicolosi2020-07-16T16:55:40+00:00May 20th, 2019|Dentist Office Monroe NC, General, Oral Health|

There has been a lot of buzz lately about sparkling water, with many people touting it as an alternative to regular or diet sodas. Also, with the many flavorings out there now, sparkling and seltzer waters have become far more attractive as a choice for a soft drink. In fact, sales of sparkling water have doubled since 2011. That said, some have questioned whether sparkling water is bad for your teeth and, if so, how?

It is important to understand the impact of the trend in sparkling water consumption and its impact on your teeth. We want to delve into this controversy, clear up some misconceptions, and give you a few pointers so you can continue to take care of your oral health.

Firstly, it is important to understand that carbonated water has CO2 in it, which gives the bubbly effervescence to carbonated water. But when you drink the fizzy carbonated water, a chemical reaction transpires in your mouth, which turns the Co2 into carbonic acid. But know this: this is a relatively weak acid on its own, so unless you choose sparkling or seltzer waters flavored with citrus (and thus a more acidic sparkling water), the acidic levels are quite low.

In 2016 the Journal of the American Dental Association (JADA) released a study of the acidity of various beverages. As a baseline, spring water was used (it has a neutral acidity level of pH 7.4) to assess the acidity of sparkling waters. Sparkling water was found to have an average of pH 5 or 5.5 (for example, Perrier is 5.5), making them definitely acidic in nature. The ADA concluded that, on the whole, sparkling water exceeds the acidity of regular tap or spring water. Thus, our attitudes toward sparkling water need to be adjusted slightly, for sparkling water is not the same as any old, regular water.

However, the ADA has not found conclusive evidence of any kind that suggests drinking sparkling water is harmful to your tooth enamel. In fact, the acidity level of coffee is far higher, and thus worse, for your teeth than is sparkling water. Compare coffee’s pH level of up to 6 (depending on the coffee), in contrast to sparkling water’s pH 5 level, and you can see that coffee is a bigger culprit in tooth enamel’s loss.

Helpful Strategies

Don’t sip sparkling waters throughout the day, like you would spring or tap water. Rather, drink them in one sitting (in a short span of time), in order to decrease the length of exposure of your tooth enamel to the acidity levels.
If you have dry mouth, which is decreased salivation production due to other illnesses like diabetes, it is best to avoid acidic drinks of any kind.
Brush your teeth after consuming these drinks (and coffee, too, for that matter!). So many of us tend to think we should only brush after eating, forgetting that sugary or acidic elements in drinks we imbibe can be just as harmful to our oral health. So, carry a small toothbrush and toothpaste tube with you to take on the go, and brush after both eating and drinking anything (other than plain water).
Use a mouthwash twice a day, morning and evening. If you are a real enthusiast, you can certainly take a swish-and-spit moment after lunch, following a good tooth brushing. Mouthwash can clear away bacteria and harmful sugars from your teeth. Remember, acidity breaks down tooth enamel and then it is the bacteria, feeding on sugar in your mouth, that creates the problem. Mouthwash can eliminate the bacteria and wash away the sugar—this will preserve your tooth enamel as well.

On the whole, choosing seltzers and sparkling waters is a far better choice for your teeth than drinking regular or diet sodas. The pH levels of most seltzers and sparkling waters are better for your teeth than the average soda. However, from a basic health standpoint (which will always be the best choice for your teeth), drink eight glasses of tap or spring water a day. Plain, pH neutral water is the best choice for your health at every level. And, if you are apt to drink seltzers or sparkling waters, a single swig of plain water after you finish the can, with a bit of a swish of that plain water about your mouth, can help to wash away some of the acidic build-up.

Have more questions? Talk to your oral hygienist or one of our dentists at Carolinas Dental Choice.

Comments Off

Alternative Pain Therapies: Dentist Respond to the Opioid Crisis

Sam Nicolosi2020-07-16T16:55:54+00:00May 14th, 2019|Dentist Office Monroe NC|

It’s been all over the news the past few years and, if you haven’t seen it yet, there are several state attorneys general who are bringing class action lawsuits against the makers of opioid medications for their negligence to disclose how addictive certain kinds of pain medications are. And because surgeries provide the pretext for the prescription of such heavy-duty painkillers, the American Medical Association and the American Dental Association have begun to reconsider the kinds of pain medications they prescribe.

Most people usually think about surgeries at hospitals, but quite a few forget that dentists also perform surgeries, and can also prescribe painkillers to their patients. So, we want to highlight the ethical responsibility we feel, here at Carolinas Dental Choice, for handling painkiller medications. We also want to highlight some of the good things happening across America in a concerted effort to deal with the opioid crisis (as it relates to the dental industry), and lastly, we want to point you in the direction of some pain management alternatives that do not involve taking heavy-duty painkillers. We want you, our patients, both to be well-informed and to know you have choices when it comes to how we administer your oral health care.

The ADA and the Opioid Crisis

The American Dental Association has begun to acknowledge the role it has in diminishing the impact of opioid drugs on Americans. It has begun to address the issue by training dentists, and issuing advisements, about the dangers of opioid addiction, as well as, ways to recognize signs of such addiction in our patients. In 2018, the ADA resolved and enacted a policy regarding the prescribing of opioid painkillers. They committed the organization to three initiatives around the issue of calling for mandatory education on opioid prescription practices: provision for continuing education credits for dentists, developing coursework for dentists on issuing these painkillers, and enacting a phase-in period so that dentists can reach compliance with Congressional concerns.

In other words, the ADA is making strides in seeing how it can, as an organization, ensure that its dentists to not contribute to the opioid crisis and are, therefore, well-educated in how to prevent the spread of addiction to such classes of painkillers like OxyContin, Vicodin, or similar drugs. The ADA has also resolved issuing guidelines for dentists, advising them to prescribe a maximum seven-day dosage of opioid-classed painkillers, bringing the ADA into compliance with the CDC’s guidelines.

These resolutions by the ADA mean a safer, better America for us all. They also mean that dentists are better informed about the risks and responsibilities associated with prescribing opioid painkillers to their patients. That means they can better instruct their patients on how to take a painkiller and how to avoid developing an addiction to an opioid. Dentists and patients alike can take responsibility, together, for growing their knowledge of opioid use and thus help put an end to the crisis. A recent webinar, led by Dr. Cathy Carlson and Dr. Aaron Gilson at the ADA, addressed these concerns. Simply know this: the ADA is taking steps to help curb the opioid addiction in this country, and we too are following in their footsteps by adhering to ADA’s guidelines for prescribing opioids. We at Carolinas Dental Choice want you as safe and as healthy as you can be. We know about the crisis our doctors, Dr. Brown and Dr. Kashyap along with the whole team, and are committed to seeing this crisis abate.

The Benefits and Risks of Using Prescription Painkillers

When you have any kind of oral surgery—and the most common or familiar surgery is the removal of wisdom teeth—it means you will have to manage post-surgical pain. So, we want to highlight the pros and cons of using any opioid painkillers, so that you are as informed as possible. Our recommendations draw on the ADA’s advice to patients, found here. We will highlight a few key pieces of information and make a few suggestions, below:

Know what kinds of opioids there are: Vicodin, OxyContin, Percocet, morphine, and codeine are all drugs that call into the opioid class of painkillers. They can be made from natural substances occurring in the poppy, for example, morphine, or synthetic drugs that mimic the substances of the poppy (fentanyl-based drugs like OxyContin are synthetics).
Understand how they work: opioids work by making you feel that pain is lessened and they also increase the “feel-good” hormone in your brain, called dopamine. (Dopamine is one of several hormones that give you a “feel-good” rush after exercise, for example.)
Pain management choices: over-the-counter painkillers, like acetaminophen or ibuprofen, can be highly effective painkillers for post-oral surgeries. That said, prescription drugs are available but it is extremely important that you: a) update your medical history to us; b) disclose to us any previous drug addictions or use you (or others in your family) had or have now; and c) keep an open, honest dialogue with us, including asking questions.
If you prescribed an opioid, in consultation with your dentist, then seek to understand: the goal of the prescription; dosage and usage instructions; length of prescription; risks involved in taking the painkiller; how to dispose of extra, unused medication (you can return the remainder to a pharmacist for disposal).
Talk to your family! It is important that they stay informed about your prescriptions and the risks they could pose (not just opioid prescriptions but all of them). They can help monitor your progress, after surgery and while taking painkillers.
It is importation that you, the prescribed patient, are the only one who takes the medication. You should never turn over your medication to others, or give it to another person to use. If you feel at risk of developing an addiction, talk to your dentist as well as your general practitioner/family doctor.
Know those groups at higher risks of developing addictions: adolescents (tooth extractions) and those with a history of past or current drug abuse struggles.

This is how we can, together, stop the opioid crisis. It’s up to us, so staying informed about how to handle our responsibilities together means we empower ourselves and each other to make healthy, proactive decisions about prescription painkillers. If you feel at risk, it’s important to convey that to us so that we can help you find alternative ways of planning for pain management, after oral surgery. We want to help you make the best, most informed and healthiest choices for post-surgical care. We are here for you.

Pain Management Alternatives

Because dental providers are among some of the leading prescribers of prescription painkillers, especially for tooth extractions, it is important to know what other choices you have available to you for pain management, besides prescription-strength opioids.

Firstly, be aware that we can prescribe both prescription-strength ibuprofen and prescription-strength acetaminophen, which means they have to be picked up from a pharmacy. These are stronger versions of the over-the-counter (OTC) painkillers you’re used to seeing on the shelf. Many times, regular OTC ibuprofen or acetaminophen can be enough of a painkiller; depending on the kind of oral surgery you have, prescription-strength versions of these can also be highly useful.

If you know yourself to have a relatively high pain tolerance, then consider either OTC or prescription-strength ibuprofen or acetaminophen. There isn’t much use in filling a prescription for a stronger class of painkiller if you don’t really need it. You know your body well, so make an informed decision. And, when it comes to caring for your children, you know their pain tolerances well, also, so bear those facts in mind.

Secondly, consider homeopathic remedies for pain management and pain relief. Some practitioners of homeopathic medicine have made the following suggestions:

Consider taking pre-surgery immunity-boosters. Bulking up on Vitamin C, Vitamin B complex, and Vitamin A can help boost your body’s immune system in preparation for fighting off any potential for infections.
See food as medicine: post-surgery nutrition can be part of the solution for easing the healing process. Consider eating foods that have anti-inflammatory properties (like olive oil, avocados, and other foods). Pineapple contains “bromelain,” an enzyme that is meant to help with pain relief; you could make a smoothie that features pineapple.
Make use of supplements: you can use Calendula (marigold) leaves to make a tea or mouth rinse. Calendula contains antiseptic and anti-inflammatory properties. Or you can use myrrh oil, which also contains antiseptic and anti-inflammatory properties, in a homemade mouthwash. Licorice root has numerous properties, which can promote healing and restoration, as well as, reduce pain or inflammation.
Consider ingesting or using (depending on the substance) some natural antimicrobials, like honey, coneflower (Echinacea), or myrrh. A cloth soaked in witch hazel tea, and applied to site of extractions, was a common practice among Native Americans. Slavic peoples of Russia and the Balkans have, for centuries, made use of nettle root to deal with inflammation and pain. Blueberries have also been found to contain anti-inflammatory properties (you can make a paste out of them and apply to inflamed gums.)

If you are interested in exploring, more in-depth, these alterative homeopathic remedies or treatments, look at this site as well as this one. (We highlighted some of the points these websites made in the numbered list above.) Though we as Carolinas Dental Choice cannot endorse or support all of the claims made by homeopathic sites, we do respect your right to explore all of the options available to you for pain management and relief. Just talk to us about what strategy you want to take, if you decide to go the homeopathic route so we can help you to monitor your pain relief and post-surgical recovery.

Final Thoughts

Pain management and relief is a responsibility, and we all need to see it as such. Carolinas Dental Choice sees the need to curb and end the opioid crisis, and we want to assure you that we are committed to making responsible, informed decisions together with you, about your own oral hygiene and care.

We want you to talk to us about any health issues you have, as well as any previous exposure to illicit or prescription drugs. You don’t need to be afraid or ashamed about previous drug use or abuse, but we do need to know so we can make an informed decision. Also, if you feel at risk for developing a dependency on a painkiller, alert us right away. It’s best we know beforehand, during the initial consultation, of any risks you might face for dependency, but we also want to help intervene if you are post-surgery and find yourself growing dependent. We are here to ensure you stay safe and healthy, so keep the lines of communication open with us at all stages of your oral health care.

Let’s sit down and talk about ways to manage pain and find relief after your oral surgery. Our doctors and staff at Carolinas Dental Choice are committed to your total well-being. Let’s make responsible choices, together.

Comments Off

Advancements in Dentistry Make for Happier Patients

Sam Nicolosi2020-07-16T16:57:33+00:00February 14th, 2019|Dental Trends, Implants, Oral Health|

Better Dentistry is Here and More Advancements are on the Way!

Ah, remember the eighties? Shoulder pads, big hair, and bigger braces! Times and trends have changed, both in fashion and in dentistry.

Gone are the days of walking into an awkward waiting room with uncomfortable chairs and stacks of decade-old magazines, the sounds of drilling in the background. At Carolina’s Dental Choice, our waiting rooms are comfortable with music, televisions, and a welcoming face behind the desk there to help you.

Scheduling options have improved a lot! With more offices offering expanded hours and online appointment scheduling, finding the perfect time to visit the dentist is easy. Reminders can be emailed—you can even have a text message, if you prefer—helping you keep your busy day on track.

One of the biggest advancements is dentistry today isn’t techy or scientific at all. Dentists today discuss procedures to you as they go along, openly explaining treatment options. A visit to the dentist has become less rigid and uncomfortable. Plus, they use hi-tech equipment that is cool and more precise—and less scary!

Specific ways visiting the dentist has changed over the years:

Hygiene and safety are incredibly important. These days you will see clean and sanitized and newly opened equipment in use. Staff wear gloves and masks for your protection and, as mentioned earlier, there is more communication—a better relationship between staff and patient. It is more evident now than every before that your dentist and dental team are there to help you. You will notice that the dentist or hygienist is telling you what they are doing as they go along. Taking away some of the fear of years gone by when you just laid in the chair and hoped for the best! For your benefit, be clear about any discomfort or issues you have been having prior to your examination. We want you to be completely comfortable!
Dental insurance. Decades ago, many people did not have the option of obtaining dental insurance through their employer or on their own. With multiple options available now, the staff at the dentist is able to discuss what your procedure will cost in advance when ever possible so you will not be caught unaware. Many dentists will work with you if you don’t have insurance. Another popular option that did not used to exist is buying a dental care package directly through your dentist. This annual plan will include cleanings, X-rays and discounted procedures.
Extended office hours are becoming more common at dentists around the country. Knowing that many people have day jobs and limited flexibility, Carolina’s Dental Choice opens at 8 a.m. Monday-Wednesday (7 a.m. Thursday-Friday) so you can arrive at work with a smile! In many communities, there are emergency dental offices open in the evenings and weekends for those issues that just cannot wait.
Advancements in X-rays. There are big changes in this arena. The first use of X-rays in dentistry of a living person in the United States took place in 1896. Advances in dentistry and the availability of the equipment grew and X-rays became part of the normal dental routine in the 1950s. 3-D imaging has become more popular as machines have become more advanced and more available in the medical community. Popular for ultrasounds, mammograms, and other uses, they are helping doctors and dentists better diagnose health issues, while making it easier on the patient. This is truly technology changing lives.
A cavity’s best friend. Fillings used to appear silver and were in fact made of a combination of metals including: tin, zinc, copper and silver. White fillings (a composite material) started becoming popular in the 1980s, and both the silver amalgam and white fillings are still used in dental practices today. So, what’s new? We now know that fillings, while strong, don’t last forever and advancements in X-rays and exam techniques will help discover issues much sooner.

A brighter smile is now possible!

According to the ADA (American Dental Association), about 1990 was a turning point with new tooth-colored restorative materials, plus increased usage of bleaching, veneers, and implants inaugurate an era of esthetic dentistry.

Whitening of teeth was very rare until recent years, as it seemed like only movie stars and models had truly pearly whites. Today you can choose from whitening options including bleaching and whitening trays, just to name a few.

Restorative dentistry has seen great advancements in the last twenty years. In the past, if you had a tooth removed, you learned to live with that gap in your mouth. Missing teeth can be unattractive and negatively affect your eating habits, because missing teeth also make the remaining teeth work harder. At Carolina’s Dental Choice, we provide restorative, or prosthodontic. This process involves repairing or replacing bad teeth in order to restore the mouth. This can involve multiple procedures, including using fillings, crowns, veneers, bridges, dental implants, and partial dentures. The main goal of restorative dentistry is to preserve the natural teeth as much as possible and to give you the smile that you deserve. The use of dental implants, partial dentures and other restorative tools, is important if teeth are to be removed.

Braces used to be the first thing you noticed if someone had them and some kids just wanted to avoid having them altogether, with those sharp wires and clunky metal brackets. Traditional braces caused sores, were tricky to keep clean, and restricted enjoying many favorite snacks. Having straighter teeth is beneficial for appearance, but also for the health of your teeth. A popular option for youth and adults today is Invisalign Braces. This modern approach is less invasive and much more attractive.

New ideas in dentistry:

Pediatric dentistry. Specialty dentists for kids began popping up around 15 years ago. Because dentists can be intimidating for kids, these new specialty pediatric practices feature graphics, games, and friendly and familiar themes making kids feel engaged and safe. In general, they’ve had additional and specialized training in pediatric dentistry and can work with babies through teens more effectively than ever.
No gain from pain. Back in the day, people only went to the dentist when they were in pain. Because of this, the opportunity to prevent issues was often lost and going to the dentist became associated with pain and, for some, trauma. Getting into the habit of twice-yearly check-ups with cleanings will allow the dentist to look for problems in advance of you having to have a dental emergency. Dentistry has become incredibly preventative. X-rays, oral exams, and cleanings all help detect current and potential future problems. Most dental insurance plans cover much, if not all, of this cost and offer discounts on any additional procedures required.
Gum disease used to be something patients had to live with. Gum disease is generally not curable, but it is treatable and more importantly, preventable. Prevent gum disease by seeing your dentist on a regular basis—at least twice a year. Early stages can be treated with a dental hygiene therapy called scaling and root planning. While it might sound scary or like an outdoor adventure, the treatment is actually a deep cleaning measure that helps fight back against gum disease. This is a nonsurgical procedure to treat your teeth and gums against plaque, bacteria, and tartar deposits.
Beyond the teeth. Checking for oral cancer is another recent addition to a routine dental check-up. Your dentist can examine your oral tissues easily by looking at your lips and inside your mouth, as well as, check your gingivae (gums) carefully, the inside of your cheeks and your tongue (the sides and underneath). The more preventative we are today, the brighter your future!
More options than ever. Some still have a slight fear of going to the dentist and the potential pain of dental treatments. In the past, they had little options and would avoid getting needed dental work and even check-ups. But today there is I.V. sedation. Intravenous (I.V.) sedation has become more common and works well for those with fear of the dentist and dental procedures. It is also ideal for patients whose fear of dentistry has led to a large amount of dental work needing to be completed. V. Sedation is also used for outpatient procedures, like colonoscopies. Referred to as “twilight sleep,” you will wake with little or no memory of the procedure. Anesthesia is given via the I.V. and recovery requires someone take you to/from the procedure.

Healthy at home, advancements and options:

Advances in types of toothbrushes have made cleaning your teeth much more thorough and, dare we say, even fun! Gone is the “one size fits all” toothbrush of 20-30 years ago. Now there are multiple sizes and types of bristles, easy to grip handles, and electronic versions on the market in all price ranges.

Flossing is an important thing to do at least daily (after every meal is ideal) to remove plaque and excess food particles. Many types of floss are on the market now (vs. one type fits all 20 or so years ago). Flavored floss, flosser sticks (or picks), waxed and unwaxed string floss, dental tape, electric flossers and natural floss are all options available.

Water picks (the most commonly known one being manufactured by Waterpik) are water flossers that are handy for reaching those hard to get to teeth in the back. These come in a variety of price points and models, from table top to hand held.

With all dental tools, check with your dentist about the best fit for you and their recommendations.

The more we know, the better your health:

Poor oral health has been debated as a possible cause of heart disease for years. In 2012, experts from the American Heart Association reviewed the available scientific evidence and concluded that poor oral health hasn’t been proved to cause heart disease — and that treating existing gum disease hasn’t been proved to reduce the risk of heart disease. Still, studies have shown:

Gum disease (periodontitis) is associated with an increased risk of developing heart disease.
Poor dental health increases the risk of a bacterial infection in the blood stream, which can affect the heart valves.
Tooth loss patterns are connected to coronary artery disease.
There is a strong connection between diabetes and cardiovascular disease and evidence that people with diabetes benefit from periodontal treatment.

Even though oral health isn’t a key to heart disease prevention, it’s important to take care of your teeth and gums:

Brush your teeth at least twice a day.
Floss daily.
Schedule regular dental checkups and cleanings.

Protect yourself by learning more about the connection between your oral health and overall health. Remember, be preventative!

The connection between oral health and overall health:

Like many areas of the body, your mouth is teeming with bacteria, most of them harmless. Normally the body’s natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease.
Certain medications — such as decongestants, antihistamines, painkillers, diuretics, and antidepressants — can reduce saliva flow. Saliva washes away food and neutralizes acids produced by bacteria in the mouth, helping to protect you from microbial invasion or overgrowth that might lead to disease.
Studies also suggest that oral bacteria and the inflammation associated with periodontitis, a severe form of gum disease, might play a role in some diseases.

So even if you still have big hair, shoulder pads, or drive your DeLorean to the office, the team here at Carolina’s Dental Choice is ready to treat your dental health needs, whatever they may be. Let us help you take preventative measures to keep your smile bright and glowing into the future.

*Mayo Clinic

Comments Off