Posts for: December, 2014
Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.
A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.
If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.
The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.
Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.
These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.
If you would like more information on treatments 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 “Treating Difficult Areas of Periodontal Disease.”
Enamel — that tough, outermost tooth layer — protects your teeth from all sorts of hazards, from bacterial attack to temperature extremes. But although the hardest substance in the human body, enamel has a mortal enemy — acid. High acid levels can cause the minerals in enamel to dissolve, a process called de-mineralization. And although saliva can neutralize these levels in approximately 45-60 minutes and restore some of the enamel’s lost minerals, a constant acidic environment can overwhelm this natural mechanism.
That’s why you should be careful with the amount and frequency of acidic foods and drinks like citrus fruits or coffee. You should be especially concerned about your intake of sodas, energy drinks or sports drinks. The latter in particular are designed to replace fluids and nutrients during intense exercise or sports events, but are often consumed as a regular beverage. And all these drinks mentioned are often sipped on throughout the day, resulting in a constant wash of acid in your mouth that can interrupt the protective response of saliva.
There’s one other source for high mouth acidity that comes not from outside the body but from within. GERD — Gastro Esophageal Reflux Disease — is a condition in which digestive acid refluxes (flows back) into the esophagus. While chronic acid reflux can damage the lining of the esophagus and lead to ulcers or even cancer, it may also pose a danger to teeth if the acid regularly rises into the mouth. Individuals encountering this will know it by the awful, acrid taste of vomit in their mouth.
To reduce the chances of high mouth acid due to food intake, limit the consumption of acidic foods and beverages to meal times and sports drink consumption to strenuous exercise or sporting events. Better yet, consider the greatest hydrator of all, water — with a neutral pH of 7.
If you’re experiencing chronic heartburn or other GERD symptoms, make an appointment to see your primary care doctor or a gastroenterologist as soon as possible. Many treatments are effective and will not only improve your general health but may also help preserve your tooth enamel.
If you would like more information on the effect of acid in the mouth and how to reduce it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Dentistry & Oral Health for Children” and “GERD — Gastro Esophageal Reflux Disease.”
We’re all susceptible to gum disease when we fail to practice effective daily brushing and flossing. But you may have a greater risk of gum disease (and more severe forms of it) if any of the following categories pertain to you:
Aging. Gum disease risk naturally increases with age. We can lower the risk with an effective daily hygiene regimen, along with a minimum of two office cleanings and checkups each year. Brushing and flossing removes bacterial plaque and food particles which accumulate on tooth surfaces. The longer plaque remains in contact with gum tissues, the greater the chances of infection.
Pregnancy. Although women tend to take better care of their teeth than men, they still face unique issues that increase their risk. During pregnancy, for example, certain hormone levels rise, which cause the gums to become more responsive to bacteria. Other hormonal fluctuations throughout a woman’s life, including taking certain drugs for birth control or during menopause, can cause similar situations.
Family History. You could be at higher risk if members of your immediate family have a history of gum disease. Researchers estimate that 30% of the U.S. population has a genetic predisposition to the disease; it’s also possible for family members to transfer bacteria to other family members by way of saliva contact or shared eating utensils.
Smoking. Nicotine, the active ingredient in tobacco smoke, causes changes in the blood vessels of the mouth that could inhibit the flow of antibodies (produced by the body to fight infection) in the bloodstream. As a result, smokers experience more rapid disease development and greater detachment between teeth and gums than non-smokers.
Other Inflammatory Conditions. A number of studies indicate people with other inflammatory conditions like heart disease, arthritis or diabetes have a higher risk for gum disease. Some researchers have even suggested that bacteria associated with gum disease pass into the blood stream and threaten other parts of the body — an added incentive to seek treatment and stop the disease’s advancement.
If you fall into any of these risk categories, it’s even more urgent that you practice effective daily hygiene with regular office checkups. Additionally, if you begin to notice bleeding gums, tenderness and swelling, or loose teeth, contact us as soon as possible for an evaluation.
If you would like more information on the diagnosis and treatment of 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 “Assessing Risk for Gum Disease.”
In the winter months, when the daylight hours grow few, we celebrate the season with holiday lights and good cheer. This season of hope and renewal also gives us a chance to think about the future — to take stock of where we’ve been, and even plan for some changes in the new year.
Deciding to improve your overall health is one great way to start off the year. Of course, we know many resolutions that begin with crash diets and extreme fitness programs won’t be kept up for very long. But if there were one permanent change you could make, which would both enhance your appearance and improve your health… would you do it? If you are missing teeth — or if you’re wearing dentures that aren’t working the way you’d like — then perhaps we can offer a suggestion: Consider dental implants.
Besides being an obvious blemish on your appearance, missing teeth also create problems you can’t see. For one, it’s harder to eat a proper, balanced diet if you have trouble chewing certain foods, potentially leading to serious nutritional problems. For another, when teeth are lost, the bone in your jaw that used to surround them begins to deteriorate. This can cause you to have a prematurely aged look, and make you appear unhappy even when you’re not.
Unfortunately, dentures don’t solve these problems — in fact, they tend to compound them. Many denture wearers report they have problems eating; some even say they eat better without dentures. And dentures don’t stop bone loss; in many cases, especially when they don’t fit correctly, they actually accelerate it.
But there’s really no reason you have to get by with missing teeth. Since they were introduced some three decades ago, dental implants have offered people a better way to replace lost teeth. With implants, you can eat your favorite foods again, smile with complete assurance, and stop worrying about dentures that may fit poorly or slip out at the wrong times.
Fixed solidly in your jaw in a minor surgical procedure, dental implants function just like your natural teeth. Their natural look and “feel” makes it easy to forget they aren’t the teeth you were born with. Best of all, they can last the rest of your life… unlike bridges or dentures. Because they offer a permanent solution, implants can be quite cost-effective in the long run. But the way they can restore your confidence and make you feel good about yourself isn’t something you can put a price on.
So if you have ever thought about making a New Year’s resolution that will really improve your health and well-being — consider dental implants. Just call our office to schedule a consultation. You can learn more in Dear Doctor magazine’s in-depth guide, “Dental Implants.”
Sports are an important element in human society — besides providing enjoyment they also build discipline, teamwork and character.
But sports activities, especially for children and teenagers, also carry the risk of physical injury — and your teeth and mouth aren’t immune. About 22,000 mouth injuries occur annually in individuals under the age of 18. As the degree of contact within the sport rises, so does the risk of dental injuries.
To reduce this risk, it’s important to adopt a comprehensive approach to dental injuries, beginning with protection. For any sport that involves a ball, stick, puck or physical contact with another player, athletes should incorporate two pieces of equipment to fully protect against mouth injury: headgear and a mouthguard. Both help to evenly distribute the forces generated during an impact and thus reduce the chance or severity of injury.
The design of headgear will depend on other factors involving a particular sport. Mouthguards are more singular in their purpose, and so what works in one sport should work in another. While there are a number of types like stock or “boil and bite,” the highest level of protection is a custom-fitted mouthguard created by a dentist to specifically fit the individual’s bite. Although more costly than other options, it can better reduce the chances of an even more costly mouth injury.
Because we can only reduce the risk of injury but never eliminate it, protection is only part of the approach. Individuals, parents and sports officials should have plans in place for treating dental injuries should they occur. Depending on the level of trauma, individuals should have access to a dentist as soon as possible. It’s also important to know what to do when specific injuries occur, whether they require an immediate, urgent or less urgent response. The Dear Doctor magazine article, “The Field Guide to Dental Injuries” is an excellent primer on dental injury treatment.
Sports can have a positive effect on physical, emotional and social development. Adopting a well-rounded approach to dental injury prevention and treatment will help keep the focus on those benefits.
If you would like more information on protection and treatment from sports-related dental injuries, 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 “An Introduction to Sports Injuries & Dentistry.”