Tatiana Barton, DDS

Dr. Barton received her D.D.S. degree from New York University College of Dentistry following her education at the State University of New York College at Purchase...

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Tatiana Barton, DDS
144 Morgan Street, Suite 6
Stamford, CT 06905
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ChangesComingintheUseofAntibioticsinDentistry

In a little over a century, antibiotics have changed the face of healthcare. We no longer fear cholera, strep throat or even a small cut as our forebears did a hundred years ago. Antibiotics are also an essential weapon against infection in dental situations.

But evidence is mounting that we're overusing these miracle drugs. Besides continued growth in antibiotic prescriptions, sometimes to preempt a possible infection rather than treat an existing one, food producers are increasingly adding them to animal feed and other products as a preventive measure.

The problem with expanding our uses of antibiotics is the ability of targeted microorganisms to develop defenses against our most common drugs. Some may even mutate into a kind of "super bug" like Methicillin-resistant Staphylococcus aureus (MRSA), which no longer responds to a particular antibiotic.

As older antibiotics become less effective, we must develop newer drugs to overcome the strengthened defenses of targeted microorganisms. But this takes time—meanwhile, as antibiotic options dwindle, more than 2 million people each year encounter an antibiotic-resistant infection that results in around 20,000 deaths according to the Centers for Disease Control (CDC).

But there are hopeful signs that the world is now rising to meet the threat of antibiotic resistance. For example, support is growing within the U.S., Canada and the EU to ban the use of antibiotics in animal feed except for treating actual infections.

Many healthcare organizations are also exploring ways to reduce unnecessary antibiotic prescriptions. One way is to make better use of testing, especially to identify the precise bacteria causing an infection so that it can be targeted with a specific antibiotic that will best respond to it.

We're also seeing modifications in the use of antibiotics as a preventive measure. For example, people with certain conditions like congenital heart problems or joint prosthetics have routinely received antibiotics before dental procedures to preempt infection. In recent years that list of conditions has been trimmed substantially.

The move toward a more conservative use of antibiotics will have an impact on healthcare, including dentistry. But whatever the changes, dentists and other health professionals will continue to place their patient's health at the forefront.

If you would like more information on the use of antibiotics in dentistry, 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 “Antibiotics: Use and Abuse.”

5TipsStudentsandEveryoneElseShouldHeedforHealthyTeethandGums

Though it sounds like an elite academic society, "The Freshman 15" is anything but. The phrase stands for the weight, pegged at 15 pounds, that many incoming students gain in their first few months at college—the result of poor dietary habits brought on by a hectic schedule and newfound freedoms.

These and other habits have consequences—and not just for unwanted pounds. Many can lead to dental problems, which could continue to overshadow a student's oral health long after college is over.

Here, then, are 5 tips to pass along to your newly minted college student (or anyone else, for that matter) to keep their teeth and gums as healthy as possible.

Brush and floss daily. While a hectic course load beckons, a student should still make time every day to brush and floss their teeth. Along with regular dental cleanings, these two tasks remove the daily buildup of plaque, a bacterial film that causes dental disease. Daily oral hygiene is good insurance against developing future tooth decay and gum disease.

Cut back on sugar. A student may rely on sugary snacks for a boost of energy throughout their day, but it could be setting them up for dental disease. That's because harmful oral bacteria also feed on sugar. Choose instead real, whole foods and snacks that are better for teeth—and for avoiding those dreaded freshman pounds.

Limit acidic beverages. Besides added sugar, sodas, sports and energy drinks also contain acid, another ingredient unfriendly to teeth. During prolonged contact, acid softens and erodes the mineral content in tooth enamel, opening the door to tooth decay. Those who drink these kinds of beverages should limit their consumption as much as possible.

Don't smoke. Smoking dries out the mouth, preventing saliva from buffering the acid that causes tooth decay. Its main ingredient nicotine restricts the mouth's blood vessels, further increasing the chances of dental disease. Tobacco use in general, including smoking, is also a key risk factor for oral cancer.

Avoid mouth "jewelry." It might be the bomb on campus, but lip rings, tongue bolts and other mouth jewelry can cause dental damage. Besides the possibility of chipped teeth, metal jewelry in or around the mouth is more likely to cause infection. Better to skip this fashion statement for healthier teeth.

If you would like more information on good oral practices, 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 “10 Health Tips for College Students.”

TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. ¬†And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

KnowingHowtheMouthandFaceGrowCanImproveBiteTreatment

Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.

Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.

And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.

Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.

This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.

More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.

Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.

If you would like more information on orthodontic treatment, 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 “Understanding Aging Makes Beauty Timeless.”

4TipsforHelpingaSeniorAdultKeepTheirOralHealth

By the time a person passes the half-century mark, they've done quite a bit of living: their share of ups and downs, successes and failures, and joys and sorrows. But while aging can take its toll on their physical and cognitive health, older adults still have much to offer from their life experience. It often falls to other family members to keep them in the best health possible—including their oral health.

Helping an older adult maintain healthy teeth and gums is crucial to their overall well-being. So in recognition of Older Americans Month in May, here are 4 tips for helping an older family member keep a healthy mouth.

Support their daily hygiene. Age-related physical and cognitive impairment can make the simple tasks of brushing and flossing much more difficult. You can help by providing an older family member with tools that make it easier for them to clean their teeth, like larger handled toothbrushes or water flossers. In some cases, you may have to perform their hygiene tasks for them, but it's worth the effort to reduce their risk of dental disease.

Watch for "dry mouth." If an older person complains of their mouth being constantly dry, take it seriously. Chronic dry mouth is a sign of not enough saliva, which could make them more prone to dental disease. The likely culprits, especially for older adults, are prescription medications, so speak with their doctor about alternatives. You can also encourage them to use saliva boosters or to drink more water.

Ask for oral cancer screens. Ninety percent of oral cancer occurs in people over the age of 40, with the risk increasing with age. Be sure, then, to ask for an oral cancer screen during their dental visits, presuming it's not already being done. Screenings usually involve visual and tactile examinations of the inside of the mouth and the sides of the neck, looking for unusual lesions, swelling or discolorations. The sooner oral cancer is found, the better the chances of a successful treatment outcome.

Have dental work checked. An older person may have acquired various forms of dental work like bridges, implants or removable dentures. Because these play an important role in their oral health, you should have their dental work checked routinely. This is particularly true for dentures, which can lose their fit and comfort over time. Dental work in need of repair makes dental function more difficult and can increase their risk of disease.

Given the depth of responsibility in caring for an older adult, it's easy to let some things slip by the wayside. Their oral health shouldn't be one of them—giving it the priority it deserves will pay dividends in their health overall.

If you would like more information about oral care for an older adult, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Dry Mouth.”





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