DENTAL CARE

Q: Doctor, I Take A Baby Aspirin Every Day A:

I hear this statement quite frequently in the office. Depending on the patient and the procedures that are planned, this fact may or may not have an impact as to how I proceed. Other patients tell me that they take a full aspirin tablet is part of their regimen. Does this make a difference? Are these people more ill or at more risk than the baby aspirin group? Why is anyone even taking an aspirin?

Let’s talk about this for a moment. Cardiovascular disease, including heart disease and stroke, affects millions of people in the United States. May times this is due to blood clots that form and occlude or block a vital pathway. This could be to the heart or the brain. When this happens people suffer a heart attack or stroke. If we can thin the blood and make the ability to clot less likely then in theory, we can help a person avoid these problems. Sometime people who have never had a problem take aspirin and others take it only have having some type of health issue. The former is called Primary Prevention and the latter is Secondary Prevention. The difference in these two approaches has been studied and debated for years. Sometimes even countries have different recommendations as to what and how much to take. Like anything in life aspirin has benefits but it also has the potential for creating bleeding issues. So how do we decide how much to take if our doctor makes this recommendation.

In an article and study published last week, a Professor Peter Rothwell in the Department of Clinical Neuroscience in Oxford University in the United Kingdom the following conclusion was reached. There is not one dose of aspirin that is universal for all people.

Low doses of aspirin (75–100 mg) were only effective in preventing vascular events in patients weighing less than approximately 150 lbs, and had no benefit in the 80% of men and nearly 50% of all women weighing more than that. On the flip side, higher doses of aspirin were only effective in patients weighing more than the first group of people. So yes, a 200 lb man will need more than a 100 lb woman. The correct amount of aspirin to help keep the blood flowing freely is weight dependent. So a baby aspirin may be appropriate for that slender lady whereas that muscular man will need a full adult aspirin.

This concept of applying the correct dose to the individual is an example of creating a personalized approach to medicine. In my world, this means a personalize approach to a dental problem. We need to look at the entire mouth and the entire patient to come up with the correct treatment and sequence of procedures. Your thoughts, desires and goals all go into the decision making process. In fact we make this decision together through a process called co-diagnosis.

For example, this week a patient just finished the special “get a new set of teeth in one day” procedure. These teeth are permanent and she will never take them out. She never wanted to wear a denture and this was the solution for her. Another patient could deal with a denture but only if it locked in on implants. This one comes in and out but solves the need to use adhesive paste. Another patient is also loosing many teeth. She also wants an instant solution. In her case a permanent same day bridge is in her cards. Similar situations but a variety of choices are available.

Just like Dr. Rothwell in England found that one dose of aspirin is not appropriate for everyone, so too one size fits all in dentistry will also not be a correct approach. If you would like to hear options for a variety of procedures in one office, please pick up the phone and call Megan. She can be reached at 440.951.7856 and she will get you in for a discussion in the most expedient manner. I look forward to meeting you.

The Healthy Smile 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com