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.”
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Getting a smile upgrade doesn’t necessarily require extensive dental work. You might be able to change your appearance for the better with teeth whitening.
This technique employs a bleaching solution that brightens dull enamel, the outermost layer of teeth. It isn’t a permanent fix, but if cared for properly your brighter smile could last two years or more.
Here’s what you need to know about this proven smile brightener.
Know your options. Enamel whitening is usually obtained in one of three ways: a dentist performing the procedure in-office; at home using custom trays created by a dentist; or at home with an over-the-counter whitening product. The in-office option is the most expensive—but since dentists use a stronger bleaching solution, your brighter tint may last longer and dentists can control the degree of whiteness better.
Know your preferences. That last point is important if you’re looking for a particular look. Teeth whitening can give you a dazzling “Hollywood” smile or one that’s a bit more subtle. It all depends on your lifestyle and personal preferences. Because of their advanced techniques and equipment, you may have better chances getting the look you want from your dentist rather than by doing it yourself.
Know your limitations. This type of teeth whitening won’t work if the staining originates within the teeth—for that you’ll need an invasive procedure only a dentist can perform. You’ll also want to be careful with any whitening if you have dental work like crowns, veneers or fillings: the bleaching solution won’t alter these materials’ color, which could make them stand out beside whitened natural teeth. And if you have diseased teeth and gums, those need to be treated first before any cosmetic procedures like whitening.
Teeth whitening is a great way to take years off a smile. Even if you plan to whiten your teeth at home see your dentist first for a complete examination and helpful tips on products and techniques.
If you would like more information on teeth whitening, 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 “Important Teeth Whitening Question…Answered!”
If you notice a small sore or a change in the appearance of the tissues inside your mouth, don’t panic. It’s likely a common, minor ailment that appears on a lot of skin surfaces (like the wrists or legs) besides the cheeks, gums, or tongue.
These small sores or lesions are called lichen planus, named so because their coloration and patterns (white, lacy lines) look a lot like lichen that grow on trees or rocks. They’re only similar in appearance to the algae or fungi growing in the forest — these are lesions thought to be a form of auto-immune disease. Although they can affect anyone, they’re more common in women than men and with middle-aged or older people.
Most people aren’t even aware they have the condition, although some can produce itching or mild discomfort. They’re often discovered during dental checkups, and although they’re usually benign, we’ll often consider a biopsy of them to make sure the lesion isn’t a symptom of something more serious.
There currently isn’t a cure for the condition, but it can be managed to reduce symptoms; for most people, the lesions will go away on their own. You may need to avoid spicy or acidic foods like citrus, tomatoes, hot peppers or caffeinated drinks that tend to worsen the symptoms. If chronic stress is a problem, finding ways to reduce it can also help alleviate symptoms as well as quitting tobacco and reducing your alcohol intake.
Our biggest concern is to first assure the lesion isn’t cancerous. Even after confirming it’s not, we still want to keep a close eye on the lesion, so regular monitoring is a good precaution. Just keep up with the basics — good oral hygiene and regular checkups — to ensure you have the most optimum oral health possible.
If you would like more information on lichen planus lesions, 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 “Lichen Planus: Mouth Lesions that are Usually Benign.”
If you wince in pain while eating or drinking something hot or cold, you’re not alone: tooth sensitivity afflicts one in three Americans. To understand what’s possibly going on, let’s look first at tooth anatomy.
Teeth are mainly composed of three layers: an outer protective enamel that covers the upper crown, a middle layer called dentin and an inner pulp. The dentin is composed of small tubules that transmit outer temperature and pressure sensations to nerves in the pulp.
The enamel serves as a “muffler,” damping sensations to protect the nerves from overload. In the root area, the gums and a thin material called cementum covering the roots also help muffle sensation.
But sometimes teeth can lose this muffling effect and the nerves encounter the full brunt of the sensations. The most common reason is gum recession, usually caused by periodontal (gum) disease. The gums have shrunk back or “receded,” and after a short while the cementum covering will also be lost, exposing the dentin in the root area.
Another problem is enamel erosion caused by mouth acid. Chronic high acidity, often caused by bacterial growth or acidic foods and beverages, can dissolve the enamel’s mineral content, causing decay and exposure as well of the underlying dentin.
To avoid future tooth sensitivity, it pays to prevent these two dental problems. The most important thing you can do is practice daily brushing and flossing to reduce bacterial plaque and see your dentist regularly for dental cleanings and checkups.
But if you’re already experiencing symptoms, you’ll first need an accurate diagnosis of the cause. If it’s related to gum disease, immediate treatment could help stop or even reverse any gum recession. To address enamel erosion, your dentist may be able to protect and strengthen your teeth with sealants and topical fluoride.
There are also things you and your dentist can do to reduce your symptoms. One is for you to use hygiene products with fluoride, which can take the edge off of sensitivity, or potassium, which helps reduce nerve activity. Your dentist can further reduce nerve sensitivity by blocking the tubules with sealants and bonding agents.
Tooth sensitivity is an irritating problem in itself; more importantly, though, it’s often a warning of something else seriously wrong that needs attention. If you’re feeling a little sensitive in the teeth, see your dentist as soon as possible.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.