Periodontal (gum) disease is a serious infection that can damage more than periodontal tissues — supporting bone structure is also at risk. Any bone loss could eventually lead to tooth loss.
To stop it from causing this kind of damage, we must match this disease's aggressiveness with equally aggressive treatment. The various treatment techniques all have the same goal: to remove bacterial plaque, the source of the infection, from all oral surfaces, including below the gum line. Buildup of plaque, a thin film of food particles, after only a few days without adequate brushing and flossing is enough time to trigger gum disease.
The basic removal technique is called scaling, using hand instruments called scalers to manually remove plaque and calculus (hardened plaque deposits) above or just below the gum line. If the disease or infection has advanced to the roots, we may use another technique called root planing in which we shave or “plane” plaque and tartar from the root surfaces.
Advancing gum disease also causes a number of complex problems like abscesses (localized infections in certain areas of gum tissue) or periodontal pockets. In the latter circumstance the slight normal gap between tooth and gums becomes deeper as the tissues weaken and pull away. This forms a void or pocket that fills with inflammation or infection that must be removed. Plaque buildup can also occur around furcations, the places where a tooth's roots divide off from one another.
It may be necessary in these more complex situations to perform a procedure known as flap surgery to gain access to these infected areas. As the name implies, we create an opening in the gums with a hinge, much like the flap of a paper envelope. Once the accessed area has been cleansed of plaque and infected tissues (and often treated with antibiotics to stop further infection), the flapped tissue is closed back in place and sutured.
To avoid these advanced stages it's important for you to see us at the first sign of problems: swollen, red or bleeding gums. Even more important is to reduce your risk for gum disease in the first place with dedicated daily brushing and flossing to remove plaque and regular dental visits for more thorough cleaning.
Gum disease can be devastating to your long-term dental health. But with diligent hygiene and early aggressive treatment you can stop this destructive disease in its tracks.
If you would like more information on treating 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 “Treating Difficult Areas of Periodontal Disease.”
Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.
First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.
Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?
Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.
Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.
Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.
So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.
While tooth decay and periodontal (gum) disease destroy more teeth than any other causes, both of these diseases are largely preventable with proper oral hygiene and dental treatment. It’s more than possible, then, to enjoy a lifetime of healthy, disease-free teeth.
But even with healthy teeth, the effects of aging will cause tooth wear over time. And although we can’t prevent the aging process from occurring altogether, there are steps we can take not to accelerate the process.
Most tissues, including bone and teeth, have a growth cycle in which older cells are broken down (known as catabolism), removed and replaced by newer cells (anabolism). As we develop during childhood, the growth phase exceeds breakdown; when we reach adulthood, the two phases come into equilibrium. But as we age, breakdown will gradually overtake growth. This aging effect results in, among other outcomes, tooth wear.
“Normal” wear appears to be greatest — and most visible — along the biting surfaces of the teeth. The forces generated when we bite or chew causes enamel to erode over time. Unfortunately, you can accelerate this process through bad oral habits: clenching or grinding teeth, often times at night while you sleep, as well as habitually chewing on hard objects like nails or pencils.
Normal forces generated when we bite or chew are actually beneficial for dental health — they help stimulate bone growth. But when they exceed their normal range as when we clench or grind our teeth, they can increase tooth wear and cause other problems such as diminished function or changes in appearance, such as a shortened facial height.
To slow the rate of wear, it’s important to modify any behaviors that may be contributing to it. In many cases an occlusal night guard worn while you sleep helps prevent teeth clenching. You may also need assistance with stress management, a major trigger for these kinds of habits, through biofeedback therapy or counseling.
If you’ve already encountered excessive wear, bonding techniques using colored composite resin, veneers or crowns that attach directly to the teeth can restore lost function and rejuvenate the appearance and color of your teeth. We can perform a “smile analysis” to determine if one of these techniques is right for you to help you regain a more youthful and attractive smile.
If you would like more information on aging and tooth wear, 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 “How and Why Teeth Wear.”
Fatigue, a “foggy” mind, and irritability are all signs you’re not getting enough sleep—and neither might your sleeping partner from your continuous snoring. You might have a common form of sleep-related breathing disorder (SRBD) known as obstructive sleep apnea.
Sleep apnea occurs when the airway becomes obstructed (usually by the tongue), resulting in a lack of oxygen. The body rouses from sleep just enough to correct the obstruction. This can occur and interrupt deep sleep several times a night, causing the aforementioned problems as well as personality changes, high blood pressure or increased stomach acid reflux. If the problem persists, sleep apnea could also become a long-term factor in the development of heart disease, diabetes or other serious conditions.
Fortunately, we can do something about it. While some may require more invasive intervention, most cases of sleep apnea can be alleviated through continuous positive airway pressure (CPAP) therapy. In this therapy, an electrical pump supplies pressurized air into a face mask worn while sleeping. The increased air pressure helps to keep the airway open.
For some patients, however, CPAP can cause discomfort like claustrophobia, nasal congestion and dryness. If that’s a concern for you, you might want to consider an oral appliance provided by your dentist.
Customized to your own individual mouth contours, this appliance is usually a two-part hinged device that draws the lower jaw and the tongue forward to open the airway. Easily adjustable, these appliances are usually more comfortable to wear than a CPAP and don’t require electricity or have the attendant noise of a CPAP pump.
They do, however, have a few drawbacks: they can disrupt saliva flow, causing either too much or too little; they may result in some morning soreness; and they can stimulate unnecessary tooth or jaw movements. For most, though, these side effects are minor compared to a better night’s sleep.
If you suspect you may have some form of SRBD, you’ll need to have it confirmed through a physical examination and possibly sleep lab testing. If it is sleep apnea, your physician and dentist can work together to help you find the right therapy to regain the benefits of a good night’s sleep.
If you would like more information on sleep apnea, 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 “Sleep Disorders & Dentistry.”
Although dental disease prevention has made great strides over the last century, tooth decay and periodontal (gum) disease continue to pose a major health threat. People who’ve lost all of their teeth (edentulism) or most of them suffer the most with adverse effects on their overall health, function and appearance.
Removable dentures have been the traditional and most affordable means to treat edentulism. But even with material and construction advances in recent years, dentures can still lose their fit over time as the bone in the jaw shrinks. This happens because the bone no longer has the stimulus of natural teeth and older cells can’t be replenished at a healthy rate; the continuing compression of traditional dentures on the jaw’s bony ridges compounds the problem.
As the bone shrinks the dentures become loose and uncomfortable to wear. Among other results, this poor fit can drastically affect how you eat: studies of denture wearers have found a decrease in their diet’s nutritional value because they’re eating fewer vegetables or fibrous, “chewy” foods and more foods with refined carbohydrates and fats that are easier to eat but less nutritious.
There is an alternative, though, that might slow bone loss and provide a better long-term fit: an overdenture supported by dental implants. With this appliance, a few implants are strategically installed in the upper or lower jaw. Matched attachments securely fasten the denture to the implants. In this case, the implants not the jaw ridge and gums support the denture thereby preserving the bone.
If you’re healthy enough to undergo a tooth extraction, you should be able to handle implant surgery, a minor procedure usually performed with local anesthesia and with little to no discomfort afterward. It may even be possible to retrofit your current denture to work with the implants, but that will need to be determined during the planning stages.
Although more expensive than a traditional denture, overdentures are much more affordable than fixed restorations stabilized with implants. The difference, though, is the increase in your quality of life — for better nutrition, physical health and social confidence.
If you would like more information on treatment for teeth loss, 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 “Implant Overdentures for the Lower Jaw.”
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