Michael W. Dukes, DMD, PA

100 Royal Palms Dr Atlantic Beach, FL 32233-3921

My Blog
By The Island Dentist
October 16, 2018
Category: Oral Health
Tags: oral hygiene  
GoodOralHygieneIsntJustforTeeth

In October, the American Dental Hygienists’ Association sponsors National Dental Hygiene Month to remind everyone that having good oral health is directly related to practicing good oral hygiene at home. This includes brushing twice each day with fluoride toothpaste and flossing at least once per day. But sometimes we forget that dental hygiene applies not just to your teeth but also to anything you regularly wear in your mouth. This includes removable dentures (full or partial), clear aligners, nightguards, mouthguards and retainers. If you (or your kids, or seniors you know) wear any of these, please review the three appliance-care tips below.

1. CLEAN IT. Just like natural teeth, an oral appliance worn every day needs daily brushing. But toothpaste isn’t an appropriate cleanser for these devices; it’s too abrasive. The grainy particles it contains are great for scrubbing plaque and bits of food from the hard enamel coating of teeth—but they can actually leave little nicks in the plastic of your oral appliance, creating areas for bacteria to hide. This can eventually cause odors and stains. Instead, clean appliances with liquid dish soap or denture paste. Buy a separate brush for your appliance—don’t use the same one that you use on your teeth. It can be a very soft regular toothbrush, nail brush or denture brush.

2. RINSE IT. After cleaning your appliance, rinse it thoroughly. But don’t use hot water—and never boil an oral appliance to sterilize it! Your device was custom-made for your mouth, and it needs to fit precisely to do its job. Hot water can warp the appliance and change the fit, possibly rendering it useless or even harmful. For example, a warped orthodontic aligner might not move teeth into the correct position. Remember: the goal is to kill bacteria, not your appliance!

3. STORE IT. Keep your appliance in a safe place—away from curious pets and toddlers. When you are not wearing it or cleaning it, your device should be packed away in its case or soaking overnight in water or a cleaning solution according to your original instructions.

If you have any questions about oral appliance care or oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “10 Tips for Cleaning Your Oral Appliance” and “10 Tips for Daily Oral Care at Home.”

By The Island Dentist
October 06, 2018
Category: Dental Procedures
Tags: dental care  
KnowtheFactsBeforeyouGoAbroadforDentalCare

Each year, over a million Americans venture abroad for healthcare, with roughly half for dental treatment. Cost is the main reason — “medical tourists” believe they can save substantially on treatment, even with travel.

But before undertaking such a venture for dental work, there are some things you should take into consideration. For one, although quality care exists all over the world, you’ll also find different standards of care. In the United States, for example, not only must dental providers graduate from accredited schools, they must also pass state examinations before they can practice (specialists even more). In some parts of the world, educational standards aren’t as difficult to attain. You may also find differing standards for infection control, drug applications or appliances: for example, you may find a lower quality in implant or crown materials or craftsmanship than you might expect in the U.S.

Communication can also be an obstacle. Language barriers make it more difficult to understand what to expect before, during and after a procedure, or to have your questions answered. It may also hinder your provider from fully accessing your medical and dental history, which could have an impact on your treatment and outcome. Limited communication also increases misunderstanding about services offered, charges and treatment expectations.

Finally, many dental procedures have multiple phases to them, some of which normally span several months and visits. Many who go abroad for more complex procedures may try to have them performed in a much shorter time frame. Doing so, however, could prove disappointing both in the quality of the final outcome and your own well-being under such an arduous schedule. Even if your dental work is performed in an exotic locale, recovering from extensive procedures where you must rest and refrain from strenuous activity is best performed in the comfort of your own home.

It’s important to get the facts before traveling to a foreign country for any medical or dental treatment, especially about a region’s accreditation and care standards, as well as what you can expect in terms of amenities and culture during your stay. One good source is the U.S. Center for Disease Control’s web page for medical tourism (//goo.gl/75iWBk).

Going abroad for dental care is a big decision — be sure you’re prepared.

If you would like more information on dental treatment abroad, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental & Medical Tourism: It’s No Vacation.”

By The Island Dentist
September 26, 2018
Category: Oral Health
Tags: oral hygiene  
ToPreventToothDecayPracticeEffectiveBrushingandFlossing

There are two basic facts about tooth decay: 1) next to the common cold, it’s the world’s most prevalent infectious disease; and 2) with modern dentistry, it’s preventable.

Getting from Fact 1 to Fact 2 requires the daily hygiene habits of brushing and flossing. You probably learned these tasks when you could barely peer over the bathroom sink; but the real question is: are you getting the most benefit from your efforts? It’s not merely doing them, but doing them the right way.

For example, bearing down on your teeth and brushing vigorously isn’t just unhelpful, it’s damaging. Instead, you should hold your brush with perhaps just two fingers at a 45-degree angle relative to your gum line and “gently” scrub with short circular or “wiggly” strokes. Continue this action around each arch brushing all tooth surfaces, which should take about two minutes.

Your toothbrush itself is also important: most people (unless otherwise directed by their dentist) should use a multi-tufted brush with soft bristles. If you brush with the proper pressure it should last 4 to 6 months before replacing it. You should also replace it if the bristles become worn or splayed.

Flossing once a day is important for removing the plaque between teeth your toothbrush bristles can’t reach. The best technique is to form a “C” with the floss that wraps around each tooth and move it up and down gently three or four times until you hear a squeaky clean sound on both sides of the tooth.

The ultimate test of your efforts comes during your regular dental checkups. You can get a check now, though, on how you’re doing by using your tongue to feel your teeth at the gum line. If they feel smooth and slick, you’re probably doing a good job of plaque removal; but if they feel a bit rough and gritty, you’re missing some of the plaque and need to be more thorough when brushing. You can also use floss by running it up and down the tooth surface — if it squeaks, they’re clean!

Your particular dental condition may require specific treatment or the use of other dental products like antibacterial mouthrinses. But learning and practicing proper brushing and flossing is key to keeping teeth and gums healthy and disease-free.

If you would like more information on proper oral hygiene, please contact us or schedule an appointment for a consultation.

FifthHarmonysCamilaCabelloChipsaToothbutConcertStillWorthIt

Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.├é┬áRecently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.

Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.

A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.

Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.

If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.

If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”

By The Island Dentist
September 06, 2018
Category: Oral Health
Tags: oral health   cancer  
LookAfterYourTeethDuringCancerTreatmenttoAvoidDentalDisease

Cancer treatment can be an all-out battle with intense side effects for your entire body. One particular area that can suffer is your mouth.

Chemotherapy and radiation target and destroy cancer cells, which can lead to non-cancerous cells caught in the crossfire and also destroyed. The salivary glands in the mouth are prone to such damage, which could greatly impact your ability to ward off dental disease.

Saliva, what salivary glands produce, plays a major role in oral health. The bodily fluid disseminates antibodies throughout the mouth that fight disease-causing bacteria. It also neutralizes acid, which can erode tooth enamel, and helps restore lost minerals to the enamel.

If the salivary glands become damaged, however, they may produce less saliva and create a condition called xerostomia or “dry mouth.” This is a common occurrence for cancer patients, which can rob them of saliva’s benefits and make them more susceptible to tooth decay or periodontal (gum) disease. The end result could be tooth loss.

There are things you and your dentist can do to prevent this. First, have a complete dental checkup before undergoing cancer treatment. If at all possible have any necessary dental work undertaken (with adequate recovery time afterward) before beginning chemo or radiation. Your dentist and oncologist (cancer specialist) may need to coordinate any planned dental work.

You should also practice daily oral hygiene with brushing and flossing, along with keeping up your regular dental cleanings. This will prevent the buildup on teeth of bacterial plaque, which in turn will reduce your chances for dental disease. Your dentist may also prescribe antibacterial as well as fluoride mouth rinses to help limit the growth of oral bacteria.

To minimize dry mouth, increase your water consumption as much as possible. You may also use saliva boosters like xylitol, an alcohol-based sweetener found in many gums or mints that promotes salivation (it also deters oral bacterial growth).

And don’t forget to maintain a healthy diet, which will not only benefit your stamina during cancer treatment but can also help you maintain better dental health. Providing good care for your mouth during this trying time will help ensure your teeth and gums stay as healthy as possible.

If you would like more information on oral care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Health During Cancer Treatment.”





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