Posts for: November, 2013
If your gums appear reddish, puffy and bleed easily — especially at the margins where they meet your teeth — instead of their normal pink, you have gingivitis (“gingiva” – gums; “itis” – inflammation). Gingivitis is one of the first signs of periodontal disease (“peri” – around; “odont” – tooth) that affects the tissues that attach to the teeth, the gums, periodontal ligament and bone. Other common symptoms of periodontal disease include bad breath and taste.
If periodontal (gum) disease is allowed to progress, one possible consequence is gum recession exposing the root surfaces of the teeth. This can cause sensitivity to temperature and touch. Another sign is that the gum tissues may start to separate from your teeth, causing pocket formation; this is detectable by your dentist or hygienist. As pocket formation progresses the bone supporting the teeth is destroyed leading to loose teeth and/or gum abscesses. Unchecked or untreated it leads to tooth loss.
Inflammation, a primary response to infection is actually your immune (resistance) system's way of mounting a defense against dental plaque, the film of bacteria that concentrates between your teeth and gums every day. If the bacteria are not removed, the inflammation and infection become chronic, which literally means, “frustrated healing.” Smoking is a risk factor for periodontal disease. Smokers collect plaque more quickly and have drier mouths, therefore, cutting down or quitting smoking can reduce the severity of gum disease. Stress has also been shown to affect the immune (resistance) system, so stress reduction practices can help here as well as in other parts of your life. Gum disease can also affect your general health especially if you have diabetes, cardiovascular or other systemic (general) diseases of an inflammatory nature.
Periodontal disease is easily preventable. The best way to stop the process is to remove each day's buildup of plaque by properly brushing and flossing your teeth. Effective daily dental hygiene has been demonstrated to be effective in stopping gingivitis. It sounds simple, but although most people think they're doing a good job, they may not be. Effective brushing and flossing requires demonstration and training. Come and see us for an evaluation of how well you're doing. Regular checkups and cleanings with our office are necessary to help prevent gingivitis and periodontal disease. In addition if you already have periodontal disease you may need a deep cleaning known as root planing or debridement to remove deposits of calcified plaque called calculus or tartar, along with bacterial toxins that have become ingrained into the root surfaces of your teeth.
Gum disease is often known as a silent disease because it doesn't hurt, so see our office for a periodontal exam today.
Contact us today to schedule an appointment or to discuss your questions about gingivitis and periodontal disease. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”
Many people view a tooth extraction (removal) as a major ordeal; but from a dentist’s standpoint it’s a routine procedure. That’s not to say, though, that all extractions are alike — there are varying levels of complexity depending on the type, size and location of the tooth.
Teeth are held in place to the jawbone by a tissue known as the periodontal ligament, whose collagen fibers attach the tooth to the bone of the jaws. By gently manipulating the tooth, we can release the hold that these fibers have on the tooth. This takes not only skill but also a kind of “feel” that comes with experience.
From that point, removing the tooth will depend on its root structure and how it’s positioned in the jaw. Upper front teeth have a single, straight root usually shaped like a cone; their path of removal is relatively straight and uncomplicated. Many teeth in the back, however, have more than one root, and not as straight in shape as an upper front tooth, that complicates the path of removal. Depending on the level of complication, the extraction may require an oral surgeon, a dental specialist.
After the tooth is extracted, it may be necessary to fill the socket (the area of the bone once occupied by the tooth) with some form of grafting material that will encourage bone growth. This new growth will aid with any future plans for dental implants.
After the procedure, we will give you instructions for cleaning and caring for the extraction site as you recover over the next few days. We may also prescribe medications to help you cope with discomfort and swelling, as well as antibiotics and antibacterial mouth rinses.
Before undertaking any extraction, we would first conduct a thorough examination and provide you with your options and our recommendations for treatment. We would also discuss your options for replacing the teeth after theyâ??ve been extracted.
The thought of having an extraction may fill you with anxiety. But in the hands of an experienced professional, removing a tooth is a routine and safe procedure.
If you would like more information on tooth extractions, 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 “Simple Tooth Extraction?”
That “squeaky clean” feeling on your teeth might be the most noticeable result of a professional cleaning performed by a dental hygienist. Rest assured, though, there's more to it — regular professional cleanings yield long-term benefits to your oral health.
A basic procedure known as coronal cleaning removes plaque (bacteria and leftover food deposits) on the crowns, the visible portion of the teeth. If you are showing signs or are at risk for gum disease (a bacterial infection of the gum tissue) your hygienist may also initiate cleaning below the gum line with a procedure called scaling. This common technique removes plaque and tartar (hard deposits) above and below the gum line using either a traditional set of hand instruments (known as curettes) or an ultrasonic scaler, a device that uses vibrations from ultrasonic frequencies and water to remove plaque and tartar.
Root planing takes the cleaning even deeper, using curettes to remove plaque and tartar adhering to tooth roots. This is typically necessary for patients with advanced gum disease, and may need to be repeated over a number of visits as inflammation subsides.
Polishing is another common hygienic procedure performed both above and below the gum line. It's the procedure you most associate with that feeling of smoothness after a cleaning. The hygienist will typically apply to the teeth polishing paste held in a small rubber cup attached to a motorized device. As the motor rapidly rotates the rubber cup, the paste works into the teeth to remove surface stains and bacterial plaque. While it's considered a cosmetic procedure, it's more accurately defined as a prophylaxis, a dental term derived from the Greek meaning to guard or prevent beforehand.
Professional cleaning performed by a dental hygienist is only one half of an overall hygiene plan; the other half is your own daily habit of brushing and flossing. Both your daily hygiene and regular dental checkups and cleanings will go a long way toward preserving your teeth as they were meant to be — for a lifetime.
If you would like more information on teeth polishing, 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 “Teeth Polishing.”
If you were to look closely at many of your teeth, you would notice deep, natural grooves in the enamel surface. Often referred to as “pits and fissures,” these are some of the most difficult places in the mouth to keep clean. Toothbrush bristles simply can't reach deep enough into them to be effective; what's more, their warm, moist environment is the perfect breeding ground for bacterial growth. Consequently, pits and fissures are the most common location for tooth decay.
Children are especially susceptible — pits and fissures account for 43% of tooth decay in patients between the ages of six and seven. This is because when children's teeth erupt (first become visible in the mouth) the new enamel is more permeable and less resistant to decay than older teeth. Until the enamel matures, the risk for decay remains high.
Fortunately, in recent years there has been a decrease in the occurrence of tooth decay among children. Better hygiene practices, fluoride products and fluoridated drinking water, better nutrition, and regular dental visits are all factors in this improvement. One development in particular provides children an extra layer of protection — the use of sealants on the tooth surfaces.
Sealants are protective coatings applied to tooth surfaces, especially in pits and fissures that act as a barrier between bacteria and the immature enamel. Although the degree and extent of sealant use varies across the profession, many dentists recommend sealant application in children for all permanent molars and many primary molars soon after eruption.
The accessibility of regular dental care also plays a factor — those who have no or limited access (and thus are at high risk for tooth decay) may benefit from sealants on all of their back teeth, while children with regular care access (low risk) may need only a few. In fact, some dentists only recommend sealants in low-risk children when tooth decay is already present and after first removing as much decay as possible.
The goal, of course, is to prevent decay, or reduce its effects, in children. Sealants can help, but only when coupled with other measures — and a good habit of oral hygiene.
If you would like more information on sealants for children's teeth, 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 “Sealants for Children.”