Posts for category: Oral Health
Periodontal (gum) disease is a serious matter. Not only can it wreak havoc with your gums, it could also cause bone loss in the jaw that supports your teeth.
Gum disease is a bacterial infection that originates from a thin film of food particles on tooth surfaces called plaque. If you're not diligent about removing plaque through daily brushing and flossing, it can become a feeding ground for certain strains of bacteria that trigger gum infections. Left untreated, the disease can advance deeply into the teeth's supporting structures.
We're particularly concerned about furcations, the specific locations where multiple roots of a tooth fork or separate. When these locations become infected we call it a furcation involvement or invasion. The bone along the furcation will begin to deteriorate and dissolve, following a progression of stages (or classes) we can measure by probing the gum tissue or through x-ray evaluation:
- Class I: the furcation feels like a groove, but without any noticeable bone loss;
- Class II: a depression of about two or more millimeters develops indicating definite bone loss;
- Class III: Â bone loss now extends from one side of the root to the other, also known as “through and through.”
Treating furcation involvements can prove challenging because the infection is usually well below the gum line (sub-gingival). As with all gum disease treatment, our primary approach is to remove all plaque and calculus (hardened plaque deposits) where we find it, including around the roots. We typically use specially shaped instruments to clean the root surfaces. We can also employ an ultrasonic device that loosens plaque and calculus with high-frequency vibrations and flushed away with water.
Sometimes, we may need to surgically access involved furcations to clean them and stimulate bone growth with grafting. We can also use surgery to make the areas easier to clean — both for you and for us during your regular office cleanings — to prevent reoccurrences of infection.
Of course, preventing gum disease in the first place is your best defense against oral problems like furcation bone loss. Be sure you brush and floss every day, and visit us for thorough cleanings at least twice a year (unless we recommend more). This will help make sure not only your gums, but the bone that supports your teeth stays healthy.
If you would like more information on treating periodontal (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 “What are Furcations?”
There's a “file” on you at your dentist's office: Every visit you've made—from regular cleanings to major dental work—has been recorded, noted and preserved for posterity.
If that gives you the shivers, it's actually not as “Big Brother” as it sounds—in fact, it's critical to your continuing care. A busy dental office depends on accurate records to ensure their individual patients' treatment strategies are up to date. They also contain key information about a patient's overall health, which might overlap into their dental care.
Your records are also important if you change providers, something that ultimately happens to most of us. Your dentist may retire or relocate (or you will); or, unfortunately, you may grow dissatisfied with your care and seek out a new dentist.
Whatever your reason for changing providers, your care will be ahead of the game if your new dentist has access to your past dental records and history. Otherwise, they're starting from square one learning about your individual condition and needs, which could have an impact on your care. For example, if your new dentist detects gum disease, having your past records can inform him or her about whether to be conservative or aggressive in the treatment approach to your case.
It's a good idea then to have your records transferred to your new provider. By federal law you have a right to view them and receive a copy of them, although you may have to pay the dentist a fee to defray the costs of printing supplies and postage. And, you can't be denied access to your records even if you have an outstanding payment balance.
Rather than retrieve a copy yourself, you can ask your former provider to transfer your records to your new one. Since many records are now in digital form, it may be possible to do this electronically. And, if you're feeling awkward about asking yourself, you can sign a release with your new provider and let them handle getting your records for you.
Making sure there's a seamless transfer of your care from one provider to another will save time and treatment costs in the long-run. It will also ensure your continuing dental care doesn't miss a beat.
If you would like more information on managing your dental care, 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 “Why Your Dental Records Should Follow You.”
While wearing braces is the path to a healthier and more attractive smile, it can be a difficult journey. One of your biggest challenges will be keeping your teeth clean to avoid a higher risk of tooth decay.
Tooth decay starts with dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Daily brushing and flossing clear this accumulation. But the hardware of braces makes it difficult to access all tooth surfaces, and can even become a haven for plaque.
One sign in particular of tooth decay while wearing braces is the appearance of chalk-like spots on the teeth known as white spot lesions (WSLs). WSLs occur because the minerals in the enamel beneath them have begun to break down in response to decay. The spots can eventually cause both structural and cosmetic problems for a tooth.
The best approach to WSLs is to prevent them from developing in the first place. You'll need to be extra vigilant with daily oral hygiene while wearing braces to reduce plaque buildup. To help with the increased difficulty you might consider using a special toothbrush designed to maneuver more closely around orthodontic hardware. You may also find using a water flosser to be a lot easier than flossing thread.
Preventing tooth decay and WSLs also includes what you eat or drink to reduce the effects of enamel de-mineralization. The bacteria that cause decay thrive on sugar, so limit your intake of sweetened foods and beverages. And to avoid excessive demineralization cut back on acidic foods as well.
If despite your best preventive efforts WSLs still form, we can take steps to minimize any damage. For one, we can give your enamel a boost with fluoride applications or other remineralization substances. We can also inject a tooth-colored resin beneath the surface of a WSL that will make it less noticeable.
With any of these and other treatments, though, the sooner we can treat the WSL the better the outcome. Practicing good hygiene and dietary habits, as well as keeping an eye out for any WSL formations, will do the most to protect your new and improved smile.
If you would like more information on preventing dental disease while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
Say “bacteria,” especially in the same sentence with “disease” or “infection,” and you may trigger an immediate stampede for the hand sanitizer. The last thing most people want is to come in contact with these “menacing” microorganisms.
If that describes you, however, you’re too late. If you’re of adult age, there are already 100 trillion of these single-celled organisms in and on your body, outnumbering your own cells 10 to 1. But don’t panic: Of these 10,000-plus species only a handful can cause you harm—most are either harmless or beneficial, including in your mouth.
Thanks to recent research, we know quite a bit about the different kinds of bacteria in the mouth and what they’re doing. We’ve also learned that the mouth’s microbiome (the interactive environment of microscopic organisms in a particular location) develops over time, especially during our formative years. New mothers, for example, pass on hundreds of beneficial species of bacteria to their babies via their breast milk.
As our exposure to different bacteria grows, our immune system is also developing—not only fighting bacteria that pose a threat, but also learning to recognize benevolent species. All these factors over time result in a sophisticated, interrelated bacterial environment unique to every individual.
Of course, it isn’t all sweetness and light in this microscopic world. The few harmful oral bacteria, especially those that trigger tooth decay or periodontal (gum) disease, can cause enormous, irreparable damage to the teeth and gums. It’s our goal as dentists to treat these diseases and, when necessary, fight against harmful microorganisms with antibacterial agents and antibiotics.
But our growing knowledge of this “secret world” of bacteria is now influencing how we approach dental treatment. A generalized application of antibiotics, for example, could harm beneficial bacteria as well as harmful ones. In trying to do good we may run the risk of disrupting the mouth’s microbiome balance—with adverse results on a patient’s long-term oral health.
The treatment strategies of the future will take this into account. While stopping dental disease will remain the top priority, the treatments of the future will seek to do it without harming the delicate balance of the mouth’s microbiome.
If you would like more information on the role of bacteria in oral health, 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 “New Research Show Bacteria Essential to Health.”
Here's an alarming statistic: Nearly half of adults over 30—and 70% over 65—are affected by periodontal (gum) disease. It's sobering because if not caught and treated early, gum disease can lead to not only tooth loss but also an increased risk of heart attack or stroke.
Gum disease most often begins with dental plaque, a thin film of bacteria and food particles that builds up on tooth surfaces mainly from poor oral hygiene. Undisturbed plaque can become a breeding ground for bacteria that cause gum infections.
Daily brushing and flossing can remove most of this plaque buildup, but you also need to get professional dental cleanings at least twice a year. This is because any plaque you missed brushing and flossing can interact with saliva and harden into calculus or tartar. This hardened plaque can't be dislodged through brushing and flossing alone, but requires special instruments used by dental professionals to remove it.
You should also be aware of other risk factors you may have that increase your chances of gum disease and take action to minimize them. For instance, you may have a higher genetic propensity toward gum disease. If so, you'll need to be extra-vigilant with personal hygiene and watch for any signs of disease.
Tobacco use, especially smoking, can double your chances of gum disease as well as make it difficult to notice any signs of disease because your gums will not bleed or swell. Quitting the habit can vastly improve your odds of avoiding an infection. Your disease risk could also be high if you have a diet heavy in sugar, which feeds bacteria. Avoiding sugary foods and eating a more dental-friendly diet can lower your disease risk.
Oral hygiene and managing any other risk factors can greatly reduce your risk for gum disease, but it won't eliminate it entirely. So, be sure you seek professional dental care at the first signs of swollen, reddened or bleeding gums. The sooner you undergo treatment for a possible gum infection, the better your chances of avoiding extensive damage to your teeth, gums and supporting bone.
The risk for gum disease goes up as we get older. But by following good hygiene and lifestyle practices, you can put yourself on the healthier side of the statistics.
If you would like more information on gum disease care and treatment, 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 Gum Disease Gets Started.”