(360) 629-7229

7204 267th St. NW, Suite 102
Stanwood, WA 98292

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New Technology Announcement

Sample CBCT Software Analysis

We are excited to announce the installation of a new digital cone beam CT machine at Cascadia Dentistry!  Cone beam CT (CBCT) technology is a great tool for diagnosing a variety of conditions as it gives us a three-dimensional view of the hard tissue of your skull allowing us to map critical areas such as your trigeminal nerve and maxillary sinus without exploratory surgery.  A CBCT scan is instrumental in treatment planning for any implant placement and restoration and has quickly become the standard of care.  Once a scan is obtained it even allows us to fabricate surgical guides for surgeries like sinus lifts and implant placement(s) which ultimately makes your surgery easier. 

Previously we utilized a third-party service to acquire CBCT scans which required scheduling and payment through a mobile service which was just another hurdle to get through when planning for your surgery.  The ability to take CBCT scans on site will remove that hurdle altogether and provides us easy access to obtaining any scans as we need them.

We are very pleased and excited to announce this new development at our office.  We always strive to balance the need for advancing our technology with the timing that will best serve our patients.  If you would like to discuss how this change may serve your dental needs, please do not hesitate to contact us at 360-629-7229.

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Opioids in Dentistry

As the current opioid epidemic continues to grow and impact communities across our nation, one of the challenges I face as a dental provider is assisting my patients in very real pain while also considering the body of evidence linking opioid overprescription with addiction.  To address this correlation, I’d like to briefly discuss the practices I have always followed in prescribing pain relievers.  First, there are many compelling studies that show that taking Ibuprofen and Acetaminophen together at certain dosages are more effective than traditional opioid medications (see https://www.nytimes.com/2018/04/25/well/common-pain-relievers-beat-opioids-for-dental-pain-relief.html).  Studies have examined the way in which these two medications, when taken together, amplify each other and become more effective at controlling pain.  For many adult patients, a dosage of 600mg of Ibuprofen (3x Advil regular strength) and 650mg of Acetaminophen (Tylenol 2x regular strength) taken together every 5-6 hours can help to manage pain until we are able to determine the dental issue they may be experiencing, or during recovery post treatment.

Opioids, although a good pain reliever, have some very nasty side effects. The most obvious effect of opioids is that they are incredibly addictive. National prescription policies have been linked with a substantial increase in opioid related deaths and higher levels of addiction nationwide.  Long-term dependence on opioids, besides its damaging effects on the addicted individual’s quality of life as it relates to mental, social and financial considerations, can cause major health concerns, including nausea and vomiting, constipation, liver damage, brain damage due to hypoxia (depressed breathing) and in many cases, death. Opioids impair mental and physical activity and should be avoided in patients needing to drive or operate heavy machinery.

We understand that dental emergencies happen and pain is, unfortunately, a significant side effect of any oral condition.  It has long been the policy of Cascadia Dentistry to only prescribe any opioid-containing medications as a last resort and only at minimal quantities.  Our first line of pain management will continue to be the combination of Ibuprofen and Acetaminophen to help our patients manage their discomfort until we can assist with addressing the source of their pain through treatment at our office.

If you have any questions about this policy or how Cascadia is focused on reducing the risk of addiction in our communities, please do not hesitate to contact us to discuss further. For more information about our nation’s opioid epidemic, please see https://www.cdc.gov/drugoverdose/prescribing/guideline.html

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Antibiotics For Treating Dental Patients With Artificial Joints Are No Longer Recommended

In December 2012, the American Academy of Orthopedic Surgeons (AAOS) and the American Dental Association (ADA) collaboratively announced revised guidelines on the use of antibiotics as a means to prevent the infection of prosthetic joints.  The most recent guidelines no longer recommend the routine use of antibiotics in most cases of patients with artificial joints. This revision to existing best practices has been slow to reach the general public.  In summary, based on considerable research (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927664/), antibiotics before dental procedures has not been found to be beneficial for the vast majority of patients with artificial joints and in many cases can actually be harmful.

This topic comes up fairly often in the dental chair as many of my patients have artificial joints.  For years the guidelines have been moving toward the reduction of the use of prophylactic antibiotics before dental visits and the frequently changing opinions can often be confusing.  The idea was that bacteria can enter your bloodstream during invasive dental procedures that could, potentially, after a torturous path, end up making their way into the joint space, resulting in a harmful infection of that prosthetic joint.  If this theory were correct, the use of antibiotics as a means to prevent it could make sense.  However, after years of research, they cannot find any cases where this has actually happened.  At the same time, they have also found that simply brushing your teeth can also result in bacteria from your oral cavity entering your bloodstream; and yet, there are no recommendations for the use of preventive antibiotics before brushing teeth.  After years of ongoing research, the AAOS and ADA have finally eliminated the general recommendation for the use of antibiotics in the case of prosthetic joints.  Ultimately, however, their recommendation defers to the patient and their orthopedic surgeon to make the final decision.

If this topic applies to you, the Cascadia Dentistry team continues to defer to you and your surgeon and recommend that you talk with your surgeon about the revised guidelines.  In both personal experience and in doing our own research, we have found evidence that scaling down the overuse of antibiotics is beneficial, as instances where they are over-prescribed can reduce their effectiveness or even lead to life-threatening digestive issues.  As a result, we follow the guidelines of the ADA and the AAOS and do not routinely recommend the use of antibiotic prophylaxis for prosthetic joints.  If you have any questions or concerns, please let us know at your next dental visit. We would be more than happy to discuss this with you further.

To schedule an appointment, please call Cascadia Dentistry in Stanwood:  (360) 629-7229