Posts for: December, 2015
There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.
As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.
Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.
There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.
Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.
If you would like more information on surgical procedures for gum disease, 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 “Periodontal Surgery: Where Art Meets Science.”
Since as many as 26 percent of older U.S. adults have lost all their teeth, there are a large number Americans who wear full removable dentures, also known as false teeth. You may be one of them.
How much do you know about dentures? See if you can answer the following questions connected with lost teeth and dentures.
- Which word refers to the loss of all permanent teeth?
- What is the name given to the bone that surrounds, supports, and connects to your teeth?
- What tissue attaches the teeth to the bone that supports your teeth?
- Periodontal Ligament
- Periodontal Muscle
- Parietal Ligament
- Achilles Tendon
- When a person loses teeth, the stimulus that keeps the underlying bone healthy is also lost, and the bone resorbs or melts away. Pressure transmitted by dentures through the gums to the bone can accentuate this process, which is called
- None of the above
- A device that replaces a missing body part such as an arm or leg, eye, tooth or teeth is referred to as
- When teeth have to be extracted, bone loss can be minimized by bone grafting. Bone grafting materials are usually a sterile powdered form of
- Allograft (human tissue)
- Xenograft (animal tissue)
- Wearers of full dentures must re-learn to manipulate the jaw joints, ligaments, nerves, and muscles to work differently in order to speak, bite, and chew. The name for this system of interconnected body mechanisms, originating with the root words for “mouth” and “jaw,” is
- Boca biting
- None of the above
- A type of plastic that is artistically formed and colored to make prosthetic teeth and gums look natural is called
- methyl methacrylate
- beta barbital
- Success in denture wearing depends on
- The skill of the dentist
- The talent of the laboratory technician
- The willing collaboration of the patient
- All of the above
Answers: 1c, 2d, 3a, 4b, 5d, 6c, 7b, 8a, 9d. How well did you do? If you have additional questions about full removable dentures, don’t hesitate to ask us.
Taking care of your child’s teeth is a high priority, not only for their health now but for the future too. And that means dealing with their teeth’s most common and formidable enemy, tooth decay.
Your focus, of course, should be on preventing decay through good oral hygiene practices, a healthy diet low in foods with added sugar and regular office visits for cleaning and checkups. But some children at higher risk or who’ve already encountered tooth decay may also need a little extra help in the form of dental sealants.
The most common use of sealants addresses a weakness in young teeth that disease-causing bacteria exploit. Deep grooves known as pits and fissures form within the biting surfaces of developing back teeth and in the rear of front teeth.Â It’s very difficult to reach these areas with daily brushing, so some plaque may be left behind (hence the importance of semi-annual office cleanings).
Inside the mouth, these pits and fissures are in a warm and moist environment and are a haven for bacteria that feed on plaque and produce high levels of acid as a by-product. The acid softens enamel to eventually create a hole, or a “cavity” in the tooth. Children’s young enamel is highly susceptible to this process — it hasn’t developed enough strength to resist the adverse effects of acid.
A “pit and fissure” sealant made of resin fills in the grooves in the teeth to inhibit the buildup of plaque — a kind of “mini” filling. It’s an added layer of protection that complements other prevention efforts. But applying them isn’t an automatic practice — we only recommend it for children at high risk, especially where decay is beginning or it appears the conditions are conducive for it. When needed, though, it can be quite effective in preventing decay or minimizing its effects.
The best way to know if your child could benefit from a sealant is to have them undergo a complete dental exam. From there we can advise you on whether a sealant application is an important investment in their current and future health.
If you would like more information on dental disease prevention for children, 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.”
One of the most widely used forms of dental imaging is the bitewing x-ray. So called because of the shape of the device that holds the exposable film a patient clenches between their back teeth, the bitewing x-ray is an effective means for detecting the earliest stages of tooth decay.
These early signs are small lesions on a tooth surface caused by mineral loss in the enamel. While we can identify them on front teeth through visual examination or bright lighting, they’re nearly impossible to see on the biting surfaces of back teeth. The bitewing x-ray solves this problem.
During the procedure, a narrow beam of x-rays is directed at the back teeth area. Since X-rays can transmit through solid matter, they pass through the teeth and gums to expose the film attached to the bitewing assembly.
X-rays pass through matter at different rates depending on the density of the tissue — a slower rate for harder tissues like teeth and bone and a faster rate for soft tissues like the gums. As a result, x-rays through teeth expose less of the film and appear as a lighter image than the gums. This difference is so precise even a tooth’s softer dentin appears slighter darker than its harder outer enamel.
This precision helps us identify decay lesions. Because the lesions on the enamel are less dense than the normal enamel, they’ll appear as dark spots. By detecting them at this stage we have a better chance for reversing the effects of decay or at least minimizing damage that’s already occurred.
Because x-rays emit radiation, there’s a natural concern about over-exposure and we go to great lengths to reduce it. Children may undergo a bitewing x-ray twice a year for developing teeth, while adults with healthy teeth are typically x-rayed just once a year. Advances in digital film and other technology have also helped lower the exposure rate.
Today’s standard 4-film bitewing x-ray produces about four days worth of what we receive on average from normal background radiation, so the health risk is quite negligible. The benefit, on the other hand, is much greater — the early detection of tooth decay could ultimately save a tooth.