We like to keep our community up-to-date with the latest happenings in the dental world as well as offer helpful tips and tricks for their smiles, which is why you can find us everywhere in the local news and media! Read below to see Dr. Hackbarth’s updates on advancements in dental science.
There is a 70% chance that you have an infection that is eating away at your body right now as you read this article. This potential infection could also be increasing your chances of having a heart attack or stroke. It can also be responsible for increased risk of premature birth, erectile dysfunction and may vastly increase your risk for Alzheimer’s disease.
The infection is located in your mouth, and it’s called periodontal disease. As I said, it is present in around 70% of American adults. Most people who are suffering with this disease are unaware of its presence.
Some signs of periodontal disease that you may notice in yourself or your loved ones are:
Maybe you are aware of some of these symptoms in yourself, but be warned, there may be no symptoms that you personally recognize. You don’t have to have severe disease to be at risk of dire consequences. I have seen many people who have waited for weeks or years before they come in to find out about dental problems they knew they had.
It is always sad for me when people put off coming in until it hurts. Most often, they could have prevented problems, or stopped problems easily and inexpensively, but since they waited, things got worse and became painful. In the case of periodontal disease, waiting can lead to the loss of your teeth, or even worse.
Now, this is not just my opinion. It’s widely known in scientific circles that periodontal disease is responsible for an increase in inflammatory factors in the body. These factors are thought to be primary causes of the blood clots that break loose and cause heart attacks and strokes.
There is no way you want any of this to happen to you, right?
This is where Esther comes in. She is a dental hygienist. Dental hygienists don’t just “clean teeth.”
They are on the front line of the attack on periodontal disease. They provide treatment to help stop the infection, get you healthy, and also consult with you about what tools and strategies you need to keep your smile infection-free.
Now, I know that many people are worried about visiting a dental office. They are afraid of the cost, of being hurt, or being embarrassed at learning that they have an oral health problem.
At the Dental Cosmetic Center-Bay Area, we can help you overcome these fears. We go out of our way to make you feel welcome and at home. We help you remain comfortable during whatever treatment you choose. You should know that treatment is your choice, just as choosing us to help you is your choice.
Our patients report that we are kind and gentle. We know because we have asked them.
Now let’s talk about money. We have a person whose job is dedicated to helping you with your insurance and making comfortable financial arrangements, whether or not you have insurance. We even have payment plans available if you should need one.
In any event, I assure you that getting your mouth healthy doesn’t cost as much as a hospital stay and rehab for a heart attack or stroke.
Don’t wait, see your dentist today and find out if you are one of the 70% who are at risk not only of losing their teeth, but also experiencing the dire health consequences of periodontal disease.
John Hackbarth, DDS
I recently wrote about new information regarding bacteria and its association with Alzheimer’s disease. Now, a new paper has been published from the University of Louisville, where researchers report the discovery of Porphyromonas gingivalis(PG)–one of the main pathogens behind chronic periodontal disease(aka gum disease) –in the brains of deceased Alzheimer's patients.
This, in addition to what I recently reported to you about spirochetes in the brains of Alzheimer’s patients, is another clue that Alzheimer’s is caused by infections. These bacteria enter the body through the mouth. The dangerous thing is that until gum disease is approaching the severe levels, there are very few symptoms that you may notice. Bleeding gums, when you brush or floss is usually the first symptom.
I see people all the time who don’t really know the extent of their periodontal problems, or who don’t even know that they have the disease. We do know that 50% of adults have some level of periodontal disease. As you age, this percentage increases to over 70%. One positive thing is that we have simple tests that can determine the presence of PG bacteria in your mouth, so we can use this to evaluate the effectiveness of your treatment. Unfortunately, there is no test to determine if you have spirochetes present. My advice: see a dentist who can determine if you have periodontal disease, treat it and help you get back to great oral health, so you can lower your chances of developing Alzheimer’s disease.
John Hackbarth, DDS
The importance of oral health and regular maintenance. Don’t ignore this, it is more important than you think.
One horrible disease found in our aging population is Alzheimer’s disease. Almost everyone knows somebody who is or has been affected. The results of Alzheimer’s are frightening.
So, what does Alzheimer’s have to do with oral health? According to Herbert B Allen, Rina M. Allawh, and Kavita Goyalfrom the Drexel University College of Medicine, a lot. (Curr Neurobiol 2018: 9(1): 29-32):
“The key pathological finding on routine bright field microscopy of Alzheimer’s disease brains are the presence of Spirochetes, ....”(Spirochetes are a class of bacteria.) The authors go on to detail how they think the cascade of events from the Spirochetal infection affects the brain tissues. The look of Alzheimer’s brains and tertiary syphilitic dementia brains are like mirror images of each other, the authors report.
“The spirochetes (bacteria) involved are oral treponema (T. denticola as representative), Borrellia burgdorferi (the cause of Lyme disease), and T.pallidum, the etiologic agent in syphilis.
”In post mortem studies, over 90% of Alzheimer’s patients' brains show evidence of spirochetes. This was reported by Judith Miklossy in the “Journal of Neuroinflammation,” August 4, 2011.
That all sounds like a bunch of scientific talk, but now it appears that we have the “smoking gun” for most dementia cases, and it is infection, specifically infection by spirochetes.
Periodontal disease is caused by a chronic infection of the gums and bone in the mouth that involves many types of bacteria. One of the types of bacteria often involved are spirochetes.
In light of these recent scientific reports, you can easily see that having good oral health is critical to your future. No one wants to face the effects of Alzheimer’s disease.
What is important for you to get and maintain good oral health?
Great home care is very important. One must clean their teeth and gums on a daily basis, and do it well. I recommend a power toothbrush. I think Sonicare is the best. Also, daily flossing is critical. A Water Pic is a great addition to your home care routine.
Regular professional care and cleanings are important in maintaining oral health. You cannot skip those.
Cleanings are great if there is not already the presence of gum disease. If gum disease is present, it needs to be professionally treated and infection should be controlled, so that the symptoms don’t progress.
Along with the bone loss and infection of periodontal disease comes bleeding gums. The way Spirochetes make their way to the neural tissues in the brain is through blood. If you have an oral spirochetal infection, if the gums bleed, then these bacteria can be carried by the bloodstream to the brain. A good immune system offers good protection from these infections, but everyone should have a good home care routine and regular professional visits to the dentist and hygienist. There should be zero-tolerance for bleeding gums. A good resource can be found at ZT4BG.com. Conclusion: find out what’s happening in your mouth. Get yourself to a dentist!
John Hackbarth, DDS
Headaches and neck pains are unfortunate problems that people deal with in life. If you have daily or weekly headaches, or days-long headaches, it is almost like robbing you of good life. Most headaches are caused by muscular tension and pain. Even severe ones. There are several reasons for these headaches. One of the most common is often called TMJ. The TMJ is the temporomandibular joints, also known as the jaw joints, that hinge your jaw to your skull. Dysfunction of these joints can cause pain, but the muscles that open and close your jaw go into spasm similar to a “Charlie horse.”
TMJ is better called TMD or Temporomandibular Dysfunction. TMD is usually related to the way the teeth fit together, as well as clenching and grinding of the teeth. The way that your upper and lower teeth come together (your bite) is part of a system of teeth, muscles and joints. If your teeth do not fit together properly (misaligned bite), the muscles and joints have to work hard to get them together.
Teeth, when in function, should work like a fine set of gears, but if one of the gears is mismatched, something is going to break. It is the same with your jaw. Jaw joints can begin to make grinding noises and pop when your mouth opens and closes, causing head and neck muscles to spasm and hurt.
Stress and tension make things worse.
Now we have what I think is the most effective way of getting folks out of this kind of pain and back into normal function. It is called neuromuscular dentistry.
Neuromuscular dentistry utilizes technology to help get the jaw into a relaxed position where the joints and muscles are happy, thus reducing or eliminating pain and headaches. This approach has consistently given the best results so far.
The following are some common symptoms of TMJ dysfunction. If you have one or more of them give us a call. We can help.
It is wrong to believe that when someone gets false teeth or dentures, they are worried about going to the dentists or spending more money on their mouth. This is not true. False teeth are made of plastic and like anything else, plastic doesn’t last forever. They break, crack and become worn-down over time. Also, it is normal for the bony ridge of the jaws to shrink over time and affect the fit of the dentures.
It is not true that just because you knew someone with false teeth could eat anything with their dentures, that everyone could do the same. Everyone comes in different shapes, different personalities, different types of bone, different kinds of chewing habits, etc. Having all your teeth extracted can be compared to the handicap you would have if you had both your legs amputated. Some people seem to get around well with prosthetic legs, and some can strap on those spring-like things and run around a track, but many never get out of their wheelchairs--and they would all tell you they would rather have their legs back.
It is wrong to think just because you get old, you are going to have to wear false teeth. That is not true. I have many patients in their 70’s, 80’s and 90’s that still have their natural teeth. Why? Because they took care of them and had timely repairs if needed.
It is also a false belief that all dentists are the same, especially when it comes to making an extremely good fitting set of dentures. Dentures are probably the most difficult of all dental services to do well, especially on a consistent basis.
It is true there are individuals with no teeth who can wear just about anything and make it work. They are what dentists call adaptors. There are stories of people using dentures they got from garage sales or funeral homes. I have seen tons of horrible dentures that the patients use and eat anything and everything. If you are an adaptor, you can get by with bad dentures. If you are not an adaptor, your dresser drawers may be full of plates that never worked.
If false teeth are made too small, the following can be observed:
If false teeth are made too big:
If a denture is properly made:
The basic rules of getting a proper fitting, beautiful denture are:
John Hackbarth, DDS
A new patient came to see me and was sick and tired of dealing with her bad teeth. She had three options after the removal of her bad teeth:
Do nothing and have no teeth forever.
Wait three to six months after the bone healed and get dentures.
Replace the bad teeth with dentures the day the teeth are removed.
The patient chose to have same-day dentures. The results speak for themselves. For almost 100 years this process has been called immediate or healing dentures. Marketing techniques have changed the term into dentures-in-a-day as you can see on TV.
The purpose of this article is for the reader to get an idea of how most dentures-in-a-day work.
First—It is important to know the denture has to be made, in its entirety, prior to the teeth being removed.
In order to have custom-made, prefabricated dentures, extremely accurate impressions need to be taken before the teeth are removed. To get an idea of what is necessary for proper impressions, take your tongue and roll it around the roof of your mouth, all upper and lower teeth, upper and lower cheeks and anything else the tongue can touch has to be recorded. The molds have to perfectly duplicate everything.
It is also important to have an accurate record of how the upper and lower jaws fit together. This is not always easy when the remaining teeth are broken and worn and have many missing. The doctor will also have to help you decide on a color and tooth style for your new teeth.
The upper jaw is a part of the skull and is fixed, while the lower jaw is the bone that does all the moving. It is connected to the skull by two joints, muscles, tendons, ligaments and the skin of your face. The laboratory technician, the one who actually makes your teeth, has to know exactly how that particular person’s jaw opens and closes. If the impressions are not accurate and the bite registration is not right, it will be a disaster for everyone.
The laboratory steps are complicated and boring, but the end result is upper and lower dentures made for the patient and to the dentist’s specifications.
On the delivery day the patient is prepared for surgery by numbing the mouth. Some patients also choose to be sedated. The teeth are then removed, the bone is smoothed, sutures are placed if needed and the dentures are inserted and adjusted.
The procedure is a very emotional experience for both the doctor, team and patient. Once the teeth are gone there is no going back. As a dentist, even with years and years of experience, there is always a small amount of worry that something has gone wrong with the denture making process. It is always wonderful to see the uppers and lowers slip right in giving the outcome you see in the photos.
Second—Not everyone's the same and not every dentist is the same. Dentures -in-a-day should be done by experienced dentists who work with experienced technicians who are versed in making dentures. All dentures-in-a-day, in fact all dentures, are 100% customized for just that one person. If it doesn’t look right, it’s not right. If the bite is not right, the denture is not right.
Third—The immediate/healing dentures had one main purpose: to give a person teeth to smile with until all bone healing has taken place. In six to 18 months the existing denture should be replaced. The length of time depends on how the bone heals. We have also found that having dentures-in-a-day also helps a person adjust to wearing a prosthetic.
Fourth—Having a trusting relationship between the patient and the dentist is important. The patient needs to be aware of each step, and have all the benefits and pitfalls explained. In my experience, it is always best to expect to have a new set of dentures made after everything is healed.
This procedure is one of the most rewarding as well as one of the most complicated dental procedures.
John Hackbarth, DDS
Did you ever wish your teeth were straighter? You may have heard about ClearCorrect, or Invisalign, or even seen the advertisements on TV suggesting that you could straighten your own teeth with their product. Many folks look at their teeth and wish they could easily straighten them, but they are not interested in having braces. Aligner orthodontics is often a great answer for them. This, however, is not something you should attempt yourself, any more than doing your own appendectomy.
Aligner orthodontics use a series of clear plastic trays to make incremental changes in the alignment of teeth. This procedure has been around for a long time. Initially models were altered manually to change the position of teeth. This was a slow process and was used only to make minor corrections to a few teeth.
Aligners came into their own when computers were first used to digitally move the teeth in small increments and then models were made of each increment which could then be used to make aligners. At that time many more advanced cases were possible. Aligners cannot do everything that can be done with braces but are a good alternative for many people.
They are not easily seen and are more comfortable to wear than braces. Many aligner cases can be accomplished in less than one year.
If you wish your teeth were straighter, see an experienced dentist who works with aligners and see if you are a candidate for this kind of treatment.
John Hackbarth, DDS
Of the three basic problems one can have with their teeth, two are infections. The third is the way the teeth fit and work together.
Today, I am going to discuss the infections. Decay eats up and destroys teeth. Gum disease infects the gum tissues and can eat up the bone surrounding the teeth. Both decay and gum disease can spread infection all over the body.
If food debris is allowed to stay on the teeth for days, then bacteria can flourish and destroy both the teeth, gums and bone. These disease processes are slow and progressive. They are non-painful until it is too late.
Whether you are 6 months old or 90 years old, clean teeth and gums do not rot.
Starting with infants, a baby should have their mouth swabbed with a damp towel after they eat. This will start creating the lifelong habit of cleaning their mouth. As the teeth come in, the parents should go from the towel to a child toothbrush. Brush their teeth after each meal. Toothpaste is not necessary.
Toothpaste is only good for the flavor and for making brushing more pleasant. The key is to get all the food particles and residual bacteria off the teeth and gums.
Children should visit the dentist by their first birthday. Mom or dad should bring them so they can begin to feel comfortable in the dental office environment and have a positive experience.
Too often parents wait until the child has a toothache before they take them to the dentist. This usually involves treatment and shots, so the dentist can treat the cause of the pain. It is often a very traumatic first experience for a child and can set up a lifelong fear of going to the dentist. I’m sure many of you can relate.
There are studies that show the children of dentists have very few to zero cavities during their lifetimes. This is not because the child has access to dental care, but because the parents are adamant about their children keep their teeth clean at home. This is something every parent can do.
The transition from baby teeth to adult teeth starts around 6 years old and lasts to around 12 years old.
If the teeth are kept perfectly clean, then there will be no decay. Of course, there are always exceptions.
The more dental work you have, the harder it is to keep your teeth clean. Natural teeth are the easiest to clean, but that can be more difficult if the teeth are crooked or crowded. Your hygienist should be your hygiene coach for the needs for your specific conditions.
Our dental office loves seeing children in hygiene, so that we can do thorough evaluations not only for disease but also for proper growth of the jaws. If we find problems that require the care of a specialist, we will refer them to the proper doctors.
The purpose of this article is to educate the public and medical community on dentistry. Dentistry can be confusing both to the lay public and to other health care providers. That is not a good thing. If you have questions, please call my dental office.
John Hackbarth, DDS
Besides the circumstances of trauma or tumors, there are three ways people get in trouble with their teeth and oral health.
Two of those are infections.
First is decay. Decay is bacteria that eat holes in your teeth and make cavities. The bacteria make byproducts that leach the minerals out of a tooth, and then invade and infect the tooth. If decay is not stopped and treated, it will lead to weakened hurting teeth and eventually to abscesses.
The second infection is bacteria that attack the gums, bone and supporting structures to your teeth. Bacteria that are not sufficiently cleaned off the teeth, especially in between the teeth will make byproducts that cause inflammation and breakdown of the gum tissues. Then the bacteria can invade the gums and begin to cause bone loss. If this is not stopped and treated it will lead to the loosening of teeth and periodontal abscesses.
Worse than that is the fact that periodontal (gum) disease is an overall health risk. It is associated with a wide variety of systemic problems including cardiovascular disease, heart attacks, strokes, preterm births, and even erectile dysfunction in men. Every time you eat or brush your teeth, you are sending millions of bacteria and their inflammatory byproducts directly into your bloodstream. This creates a constant immune challenge for your body, and one doesn’t have to be a doctor to know this is not good.
The third way you can get in trouble with your teeth involves the way the teeth hit together. The bite, to function properly, must be aligned like a set of gears. If it is not, one gets excessive tooth wear, broken and cracked teeth and even headaches and TMJ problems. These things increase the longer an incorrect bite persists. TMJ, jaw joint, problems can be really debilitating to anyone who suffers from these problems. Fortunately, we have developed increasingly sophisticated ways to help people who are suffering from these issues.
It is always better to avoid these problems, or to at least correct them at their early stages. That is what we are here for, and why regular exams and hygiene visits are important.
Likely,we can help you prevent these problems, but if you already have any of these issues, we dentists are here to help you.
John Hackbarth, DDS
As a 2nd generation dentist, I fear for the dental profession. I am also worried about how the public’s dental needs will be served in the future.
Dentistry is a very special profession for many reasons. Dental fear is part of our history, which has barbaric roots. Amazingly enough, the major breakthroughs in anesthesia have been created by dentists.
When we were first able to numb teeth and mouths, in my grandfather’s time, most dentists charged for the new procedure. It usually costs $1 for anesthesia. Given the option, many parents chose to save $1 and not get the shots.
Dentists and teams held the child down and drilled and pulled without anesthesia. These horrible experiences created dental cripples for life. I still hear this story from older patients. Today, some dentists are still hurting people. Something I just don’t understand.
Dentistry is and always should be a service profession where the doctor takes time to listen to the patient’s wants and needs. This includes listening to and respecting true concerns like anxiety, claustrophobia, gagging, etc. Being in partnership with your dentist is a win-win situation. Everyday, we work in mouths that are connected to living, thinking and feeling human beings. Some are easy to work on, but many are terrified and would rather be in a fist fight than in our dental chairs.
In 2019, there should be extremely few painful dental experiences, hopefully none. If you are hurting and being ignored at your dentist's office, you should find another dentist.
There is a growing trend to make dentistry a common commodity, much like a fast food restaurant where food is fast and cheap. When dentistry becomes fast and cheap, but without the human touch that the service industry demands, dental fear and disappointment will become more rampant. What a horrible outcome for our patients and profession.
If you are on a dental plan that requires a Preferred Provider, you are part of the process of the decline of dentistry as a personal service. The same holds true in medicine. A Preferred Provider is not someone whom the insurance company has vetted as a superior dentist. Preferred Provider simply means a dentist or dental corporation has agreed to take a discount of up to 40 % of their normal fees. That’s correct, 40%. Dentists sign up due to the fear of losing patients. This is not an imagined fear: it’s real.
Being on a plan is the same as placing bids on a job. And company policy is to accept the lowest bid. This happens in everyday business. It especially happens in government entities and is perfectly legitimate. It is perfectly legitimate in dentistry as long as the patient knows they are going to the lowest bid, which will affect the quality in some form or fashion.
The good part of being a dentist is spending time with patients and solving their dental problems. The bad part is working in the mouth. Fighting the tongue, saliva, cheeks, gagging, etc., is not an easy thing to do all day. When A dentist signs up with these plans, they either must get people in and get them out in a hurry, or they lose money. The more hurried they are, the more frustrated everyone is including the dentist, team and patients. Patient dissatisfaction or bad dental experiences are unintended consequences of these kinds of dental insurance plans.
Of course, employers like discounted plans because it makes the dental benefit costs cheaper. Patients like it because it helps with dental bills. Most dentists hate it and feel as slaves to the insurance companies. Physicians feel the same way. Burnout is a huge problem in all medical fields and is an unintended consequence of discounted plans.
Dentists who own their own solo dental offices are also victims of the unintended consequences of dental insurance. In order to compete with the chains whose business plan is based on the plans, they too feel pressured to sign up as preferred providers.
This creates a circumstance in the dental office. Do patients who are members of the “plan” get the same care as patients who pay full price? It’s an ethical dilemma any way you look at it. If the doctor doesn’t provide the same care, then he is creating a two-tiered dental office and not providing his best care to all his patients. If he does provide the same care, then the private patient, who is paying full price, is being asked to subsidize an insurance company.
You, as the patient, need to know exactly what your insurance plan provides. If you are on a plan and your trusted dentist is also on the plan, with frank discussion, the two of you can work together in a way that will be beneficial to all. At least, if you have a Preferred Provider plan, you can still get benefits at a dentist’s office who is not a member. In this case, the benefits may be reduced a bit, but you can be sure that the dentist will not be cutting your time or treatment short. In any case, you need to understand the system, and that is the purpose of this column.
The worst unintended consequence of discounted dental insurance, and my fear for the profession, is the best and brightest of our younger generation will scratch off dentistry, and possibly medicine as a profession.
John Hackbarth, DDS
A great question to ask your kids is “Why do you brush your teeth?” Answers can range from “You make me,” “I don’t know,” “To keep my breath fresh,” it is not usually “So I will not get cavities.” This is a great mealtime discussion, and you should try it.
So, reader, why do you brush your teeth? Do you do it without thinking about it? Is it just a habit? Do you figure that as long as you brush once or twice a day, you are good? Is it mindless, like buttoning your shirt? Or, could you be one of those who are determined to remove every bit or food or debris, dental plaque and calculus after you eat something?
I just asked that question to the last patient of the day and the young man told me, “So my girlfriend will kiss me after lunch.” No brushing, no kissing! That is a very clear rule and easy to follow, and it works.
Last week we filled a tooth for a young lady in high school. We did an exam a few weeks ago, and listed the decay, talked about plaque and gingivitis and showed her photos of both. Once we gave her mom the treatment plan, for budget reasons, she is doing one cavity at a time.
We have now filled four different teeth in four visits. I asked her why brush and she stated that before she started getting the fillings, she would have said to keep her breath fresher, but now she knows to brush them to keep her teeth healthy. I was happy to hear that. We could tell she has been working very hard over the last few weeks because her mouth was very clear, healthy, no swelling, no bleeding and in perfect health.
It is amazing how many people come in to see us with teeth that are not really clean even though they spent extra time brushing before they came in. They know we are going to check their teeth. We can tell who cleans and who does not.
Dentists can live in their own isolated world and think teeth should be cleaned so they don’t get disease. We can be so wrapped up in what we were trained to do, that it is hard to look at the situation from a layman’s point of view.
The public thinks more of fresh breath and white teeth; something others notice. I never admonish a patient for having plaque and calculus. We just point it out, and the damage they cause. My job is to teach not to judge.
You have heard me say before, that clean teeth don’t rot. If there is no food left in the mouth to feed bacteria, there is no infection, no deep scaling, injections, no drilling, no fillings or crowns and no high dental fees.
That is a logical statement, but logic doesn’t always change behavior. As an emotional plea, I can promise that once you are taught how to remove all the debris from your mouth each and every time you eat something, and you make a habit of doing that, you will not be able to tolerate a dirty mouth, and you will eliminate infection and cavities.
John Hackbarth, DDS