Franklin Park Dental Associates, Ltd.
General Dentistry

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9767 West Franklin Avenue
Franklin Park, IL 60131
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TO TELL THE TOOTH : Read Dr. Pietrini's current monthly article

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To Tell The Tooth
Read Dr. Pietrini's current monthly article from the Fra Noi newspaper.

 

Surgical Services...

Dr. Pietrini writes a monthly column for Fra Noi, an Italian newspaper. Articles related to the topic of Surgical Services are featured below. Click here to view this month's article

 

Oral Cancer by Dr. Pietrini
In past months, I have begun most of my articles with a humorous story. This year more than 30,000 Americans will be diagnosed with oral cancer-not a laughing matter. Even with early diagnosis and advances in patient care, the five-year survival rate is less than 50 percent. More than 8200 deaths (about one every hour) will occur this year due to throat and mouth cancer, which is more than the number who die from either cervical or skin cancer. Two out of every three are men, usually past the age of forty. Last month I wrote about the high correlation of head and neck cancer with people, who use tobacco and/or consume large amounts of alcohol, yet 25 percent of these cancers occur among people who do not smoke or are social drinkers.

As with other types of cancer, prevention and early detection are important. The sooner the diagnosis is made, the greater the chances are for successful treatment. Your dentist can check you for oral lesions; but, you can also help by doing a self-examination. When you are brushing and flossing your teeth check for any unusual changes in your oral tissues, such as:

1. Unusual changes in the color of your oral tissues
2. Lumps or ulcerated lesions, especially if they bleed easily
3. Swelling in the jaw or neck
4. Pain or numbness in the mouth, throat or neck
5. Red or white patchy lesions on your lips, cheeks, tongue, throat or gums

If a suspicious lesion is detected, your dentist may recommend that you have a biopsy to confirm the diagnosis. Remember, the vast majority of oral lesions are benign and are easily treated. Usually a general dentist, oral surgeon or periodontist does the procedures in the office. There are several methods that can be used to obtain the tissue sample, depending on the size and location of the lesion.

1. A wedge of tissue is removed with a scalpel-taking part of the lesion and some healthy tissue to be sent to the laboratory for analysis
2. A special surgical device is used to take a small punch biopsy of the lesion
3. A scalpel or laser is used to remove the entire lesion, including a zone of healthy tissue
4. A computer assisted analysis of an oral brush biopsy

Certain types of pre-cancerous and cancerous lesions were difficult to detect on routine examination and biopsies were often difficult to obtain. A group of researchers evaluated a computer-assisted method of analyzing oral brush biopsies and determined that this type of testing was very reliable as a diagnostic aide. Your dentist can easily obtain a sample of the tissue from a suspicious oral lesion, which is placed on a pre-coded glass slide and is sent to a laboratory for evaluation. Do yourself a favor by periodically performing a self-examination and see your dentist for an oral cancer screening.

 

A Little Long In The Tooth by Dr. Pietrini

As the aging process sets in, people are often teased about being a little long in the tooth. This expression actually originated with horse breeders. By checking the amount of gum recession around a horse’s teeth, breeders are able to estimate the age of the horse.

In a previous column, I wrote about the treatment of the early stages of periodontal disease. This month, I would like to discuss some of the surgical services available for the treatment of more advanced cases of gum disease. The goal of the dental team is to help the patient maintain healthy attachment of the bone and periodontal tissues surrounding the teeth. When periodontal surgery is necessary, generally two conditions exist—the gums have receded and require a soft tissue graft or deep pockets with accompanying bone loss require that a surgical flap be reflected to gain better access to the inflamed/infected tissues. To avoid early loss of teeth, let me review some of the latest treatment options.

In the healthy mouth, two types of tissue surround the teeth. The first is called “attached gingival” a calloused tissue that form a barrier around the teeth, which prevents bacteria-laden plaque from penetrating between the teeth and gums and helps to avoid injury caused by friction from foods and brushing. The second type of tissue is mucosa, which is the more fragile tissue found in the lip and cheek areas. When moderate to severe recession occurs, a gingival graft may be indicated to replace the lost gingival. A piece of tissue from the palate (roof-of-the-mouth) or from an adjacent area is placed to cover the exposed root surfaces. The palatal graft most commonly used is referred to as a “connective tissue graft”. A small window is made into the palatal tissue. The surgeon removes some of the underlying tissue and grafts it to the area requiring coverage. With the use of local anesthetic, these procedures are virtually painless. The surgical sites heal in a few days with minimal discomfort.

 

When bone loss has occurred, a bone graft may be necessary to help stabilize the teeth or to enhance the placement of dental implants. Several choices of materials and techniques are available:

·        Allografts—purified human cadaver bone

·        Alloplasts—synthetic materials that are used to stimulate growth of new bone

·        Xenografts—purified animal tissue (more often used in life-threatening situations such as heart valve replacement, orthopedic reconstruction or severe burn cases)

·        Autografts—using the patient’s own tissues to stimulate new bone growth

It appears that autografts are the wave of the future. By utilizing the patient’s own growth factors new bone can be regenerated. A small amount of the patient’s blood is placed in a centrifuge to separate the various components. The platelet rich plasma (PRP) containing many growth factors has been shown to be important in soft and hard tissue wound healing. The PRP is mixed with other materials to create a gel, which can be placed into bony defects to stimulate new bone growth.

The Jewel of Denial by Dr. Dennis R. Pietrini

Throughout history, jewelry has been used to adorn the mouth and its surrounding structures. The ancient Mayans placed elaborate inlays in their teeth made of beautiful gems and stones, such as turquoise and jade. For centuries, tribes in Africa have pierced the lips, tongue, cheeks and ears with bones or metal objects as part of their religious rituals. Even in the 21st Century, young girls in several areas of South America insert sharpened sticks of bamboo or other woods into their cheeks and lips or file their teeth into sharp points believing that they enhance their beauty. In recent years, there has been a dramatic increase in oral-facial piercings among American youth--a trend that can lead to serious health consequences. 

Tongue piercing is of particular concern. Even if a dentist or physician performed these procedures, there would be inherent health risks. Since people with no medical or surgical training usually do the piercings, serious complications are not uncommon. It is unlikely that a sterile environment is maintained, which may lead to severe infections or transmission of bloodborne diseases, such as hepatitis. As I have mentioned in previous articles, certain patients require pre-medication with antibiotics prior to dental treatment to avoid subacute bacterial endocarditis (SBE), a disease affecting the heart valves.

Since the tongue is a constantly moving structure, attempting the piercing can be tricky, often leading to injury of nerves and blood vessels. Prolonged, excessive bleeding may occur. Post-operative swelling can inhibit swallowing or affect speech patterns. Severe swelling can be serious enough to prohibit proper breathing.

The most common type of jewelry used in tongue piercings is metal barbells. These appliances are capable of causing damage to the teeth and gums and interfere with normal oral function. Some patients have allergic reactions to the metal in the barbells. Food and plaque accumulate around the tongue and the appliance, which can cause gum recession and decay. The constant trauma caused by the jewelry striking the teeth may result in chipping and fracturing of the enamel or damage to fillings and crowns. The jewelry can stimulate the over production of saliva causing difficulty with chewing, swallowing and speech. If the appliance were to loosen or break, it could be accidentally swallowed.

For additional information on a wide variety topics related to oral health visit the website of the American Dental Association (ADA) at www.ada.org. You can click on their interactive “ADA Dental Minute” to view the short videos presented by oral health professionals.

 

 

 

 

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