Wahl Family Dentistry Blog

Dr Mike’s daughter Kira is a 5th grader at Brandywine Springs School. Her essay on fire safety in the kitchen was entered anonymously into a contest with all the 5th graders from Red Clay School District. After winning 1st place, her essay was entered into all of New Castle County, where she won 1st place again.

Finally, her winning essay was submitted to the State of Delaware finals at Hartly Fire Company in Hartly, Delaware on January 6, 2013, where Kira won 1st place for the whole state! Congratulations Kira! We’re very proud of you! We’re planning a large bonfire celebration soon!

Our patient Wilma Yu is both a scuba diver and a photographic artist — and the amazing thing is that she can do both at the same time! (I, on the other hand, can neither scuba dive nor take good pictures). She has traveled around the world to capture intriguing marine life. She recently completed a month long art show in September 2012 at the Gallery at 919 Market Street in Wilmington.

Please check her website at wyuphotography.com, where her calendars and prints may be purchased. Her art is available for display and she also enjoys giving presentations on marine life and her photography. Way to go Wilma!

She has shared two remarkable photos with us from Anilao, Batangas, Philippines 2012:

Yellow pigmy seahorse, about ¼ inch in size and hides amongst the gorgonians for protection.

Nudibranch – Chromodoris, a type of sea “slug” noted for their external lungs (numerous projections on the tail end) and rhinophores (2 antennae like structures at the head).

Patients with artificial hips and knees can sometimes develop infections of these joints. These infections can be very serious, and it has been thought that dental procedures can cause such infections since dental procedures can cause “bacteremia” or short episodes of bacteria in the bloodstream. Some physicians and dentists have recommended that antibiotics be administered before dental procedures (“antibiotic prophylaxis”) in hopes of preventing such infections, but others have pointed out that there is little or no evidence that dental procedures cause artificial joint infections or that antibiotic prophylaxis can prevent them.

There is also a small, but significant, risk of harm from an unnecessary antibiotic. I have written articles about this controversial topic since 1995 (“Myths of prosthetic joint infections” in the journal Clinical Infectious Diseases), calling for an end to the practice of antibiotic prophylaxs in such patients. Now the American Academy of Orthopaedic Surgeons and the American Dental Assocaition have questioned this practice also.

After convening a group of distinguished physicians and dentists to review the available scientific evidence, the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) have issued a joint statement (no pun intended) in December 2012. It can be accessed at http://www.aaos.org/Research/guidelines/PUDP/PUDP_guideline.pdf

A summary of the statement can be found at http://www.aaos.org/Research/guidelines/PUDP/DentalSummofRec.pdf

The conclusion is that there is no evidence that dental procedures are related to artificial joint infections and that prophylactic antibiotics do not reduce the risk of artificial joint infections. The AAOS and ADA recommend that dentists and physicians consider discontinuing the routine prescribing of prophylactic antibiotics for patients with artificial joints. On the other hand, good oral health and hygiene is encouraged in patients with artificial joints.

Please share any concerns or questions with us (and your physician) about this important issue.

Toothy recently visited our patient Mecca C. at AI duPont Childrens Hospital and brought him some gifts. Mecca was thrilled by this surprise visit! We hope you get well soon Mecca!

I saw this picture and read that it is a dentist who works only with children – a pediatric dentist. Many of his young patients are afraid and have a lot of anxiety with dental visits. The dentist brings his dog to work and allows the dog to interact with his patients. It helps them with their fears. The dog doesn’t look worried either.

In the past, many physicians and dentists have recommended delaying needed dental treatment for up to six months because of a recent heart attack. A group of researchers from the University of Minnesota studied over 2,000 patients who suffered a recent heart attack, over 400 of whom suffered a repeat event while in the survey. The researchers found no relationship between dental treatment within 30 to 180 days after a heart attack and a repeat heart attack. Their article “Dental procedures and risk of experiencing a second vascular event in a Medicare population” was published in the November 2012 issue of the Journal of the American Dental Association.

The conclusion: the traditional recommendation to delay needed dental treatment for as long as 6 months after a heart attack should be reassessed.

The article can be found at

http://jada.ada.org/content/143/11/1190.abstract

There have been many studies in the past decades proposing an association between periodontal disease and cardiovascular disease. As a result, some authors have deduced a causative relationship — that is, it has been hypothesized that periodontal treatment can reduce the risk of cardiovascular disease. The American Heart Association convened a committee of experts who reviewed the available evidence and concluded that while there is evidence of an association between dental disease and cardiovascular disease, there is no evidence of a causative relationship. This April 2012 American Heart Association statement was endorsed by the American Dental Association and the World Heart Association, and it is entitled “Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association?”

We recommend treating periodontal disease because good dental health is part of your overall health, but we do not recommend this dental treatment as a way to prevent cardiovascular disease. To prevent cardiovascular disease, diet and exercise are recommended along with the recommendations of your primary care physician or cardiologist.

The article is available at
http://circ.ahajournals.org/content/early/2012/04/18/CIR.0b013e31825719f3.full.pdf+html

I saw this office tour on YouTube and I thought it was very interesting.

Dr. Mike’s daughter Kira’s essay “Fire Safety in the Kitchen” was chosen as 1st place for 5th grade in the Red Clay School District. She then moved on to the countywide contest and received 1st place in that on November 18, 2012.

In January, her essay will be competing against the first place essays from Kent and Sussex Counties for first place in Delaware. Congratulations Kira! Perhaps we’ll have a bonfire to celebrate! (Just kidding.)

Dr. Mike and Tina visited Mrs. Wilt’s 2nd grade class at Mount Pleasant Elementary School, where their daughter Leah attends.  Dr. Mike talked about what being a dentist is all about and why he enjoys it so much.

Although it would make a great story, Tina did not give Dr. Mike his black eye!  Dr. Mike earned that on the racquetball court a few days ago!