Posts for: September, 2014
Periodontal (gum) disease is a bacterial infection that can eventually lead to tooth loss if not treated. The infection typically arises from plaque, a thin film of bacteria and food particles that build up on tooth surfaces every 8-12 hours and not removed due to poor oral hygiene.
There is always an increased risk of gum disease when a person doesn’t practice effective oral hygiene. But there are certain conditions that could also heighten risk: in particular, women who are pregnant (especially during the first trimester) or taking certain types of birth control pills. During pregnancy, female hormones known as estrogens become elevated, causing changes in the gums’ blood vessels. These changes make the tissues fed by these vessels more susceptible to the effects of bacteria. This increased susceptibility even has a term — “pregnancy gingivitis.”
Gum disease during pregnancy can also affect other areas of a woman’s health, as well as the health of her baby. Recent studies have shown a possible link between pre-term low weight babies and mothers with severe gum disease, especially among those with limited dental healthcare. There’s a stronger link, however, between gum disease and diabetes; in fact, diabetes should be checked for in pregnant women who are diagnosed with gum disease.
If you’re pregnant, it’s especially important that you not neglect oral hygiene. Daily brushing and flossing is essential for removing the bacterial plaque that causes gum disease. You should also visit us for regular checkups and cleanings to remove hard to reach plaque and calculus (hardened deposits), as well as to detect any signs of periodontal disease.
You should also be aware of other factors, and take steps to minimize their effect. Smoking can cause greater plaque accumulation as well as adversely affect your immune system, which can inhibit healing in infected tissues. Stress can also affect your immune system, so be sure you’re getting enough rest.
Gum disease in any individual has the potential to cause great damage to teeth and gums. If you notice any abnormalities, particularly bleeding or swelling gums, you should see us as soon as possible for proper diagnosis. In the case of gum disease, the sooner treatment begins the better the chances of protecting both your health and your baby’s.
If you would like more information on periodontal disease and pregnancy, 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 “Pregnancy & Birth Control.”
Now that celebrities can communicate directly with their fans through social media, we’ve started to see dispatches from some surprising locations — the dental chair, for example! Take singer Kelly Clarkson, who was the first winner of American Idol, and perhaps one of the first to seek moral support via social media before having an emergency root canal procedure.
“Emergency root canal — I’ve had better days,” Kelly posted on her Facebook page, along with a photo of herself looking… well, pretty nervous. But is a root canal procedure really something to be scared about? It’s time to clear up some misconceptions about this very common dental procedure.
First of all, root canal treatment is done to save a tooth that might otherwise be lost to an infection deep inside it. So while it’s often looked upon with apprehension, it’s a very positive step to take if you want to keep your teeth as long as possible. Secondly, tooth infections can be painful — but it’s the root canal procedure that stops the pain. What, actually, is done during this tooth-saving treatment?
First, a local anesthetic is administered to keep you from feeling any pain. Then, a small opening is made through the chewing surface of the infected tooth, giving access to the central space inside, which is called the “pulp chamber.” A set of tiny instruments is used to remove the diseased pulp (nerve) tissue in the chamber, and to clean out the root canals: branching tunnel-like spaces that run from the pulp chamber through the root (or roots) of the tooth. The cleared canals are then filled and sealed.
At a later appointment, we will give you a more permanent filling or, more likely, a crown, to restore your tooth’s full function and protect it from further injury. A tooth that has had a root canal followed by a proper restoration can last as long as any other natural tooth — a very long time indeed.
If you have any questions about root canal treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “A Step by Step Guide to Root Canal Treatment.”
OK, so you've been getting orthodontic treatment for what seems like a long time, and finally, your braces are about to come off! Now you're home free, right?
Well, almost… but now comes the final part of your treatment: the retention phase. That means you'll need to wear a retainer. Most people find that a retainer is more comfortable than braces — but because it is often removable, there's the temptation to just leave it off. Don't do it! Here are the top five reasons why you should always wear your retainer as instructed:
1) A retainer helps to make your teeth stable in their new positions.
Your teeth aren't rigidly set in stone (or in bone) — instead, they are held in place by a hammock-like set of ligaments, and the bone that surrounds them is somewhat pliable. That's a good thing… because, otherwise, they would be even harder to move! But it means that it will take some time for the bone and ligament around the teeth to re-form and stabilize in its new position. A retainer holds them in position while that is happening.
2) If you don't wear it, your brand-new smile may not stay looking the way it should.
Did you know that your bone and gum tissue have some “memory?” Unfortunately, it's not the kind that could help you on a science quiz — but teeth can “remember” where they used to be located… and, if you leave them alone, they may try and go back there! A major goal of the retainer is to keep your new smile looking great! If you don't wear it, and your teeth shift back, you risk losing all the time (and money) you invested.
3) There are different types of retainers available; one of them might be just right for you.
At one time, all retainers were made of pink plastic and silvery wire, and were removable. That kind is still available, but now you may have a choice of different colors or patterns — you might even be able to customize yours! Another alternative that may be appropriate is a clear retainer that fits over your teeth, making it nearly invisible. In some cases, you can have a thin wire bonded to the inside of the teeth instead of a removable retainer. It doesn't show, and you don't have to worry about taking it out.
4) As time goes on, you'll probably need to wear your retainer less and less.
At first, you'll probably need to wear your retainer all the time, but after a while you may only have to wear it at night — a lot easier to manage! Think of it as a way of easing yourself out of orthodontic treatment — and into a brand-new smile. The retention stage also helps your teeth avoid damage by allowing the process to end slowly and gently.
5) Lots of celebrities wear them.
If we know who, we aren't telling — but let's just say that several young entertainers and a recently married British Prince have worn retainers, or are still wearing them. So, you're in good company!
If you would like more information about orthodontic retainers, 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 “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”
Without effective treatment, periodontal (gum) disease can eventually lead to tooth loss. That’s why it’s imperative to remove bacterial plaque and calculus — the main cause of the disease — from all teeth and gum surfaces. For moderate to advanced gum disease, this could require a procedure known as flap surgery to gain access to deeper infected areas.
This type of procedure involves making scalpel incisions into the gum tissue to create a flap opening. Through this opening we’re able to gain access to the deeper pockets that have formed because of the tissue detachment that occurs following bone loss. The flap opening allows for better access to the root surfaces for removal of plaque and calculus (tartar). Once we’ve finished, we then suture the flap back into place to reduce the pockets and allow the area to heal.
While effective, flap surgery is considered moderately invasive and may produce mild post-procedural discomfort. Recently, however, a specially designed laser for periodontal therapy shows promise of less invasiveness and patient discomfort than traditional flap surgery.
A laser is an intense and narrow beam of light of a single wavelength. A periodontal laser can pass without effect through healthy cell tissue (like sunlight through a window pane) but interacts and “vaporizes” the darkly pigmented bacteria in diseased tissue. The laser energy is delivered in pulses to minimize any heat-related damage to healthy cells.
The periodontal laser can precisely remove diseased tissue, even where it mingles with healthy tissue. Once it’s removed, the root surfaces can be cleaned with ultrasonic scalers and/or hand instruments. And because a medical laser seals the tissue it cuts, it doesn’t produce open incisions as with flap surgery that require suturing afterward.
Studies of post-operative recovery after laser surgery showed similar infection reduction and renewed bone and tissue growth as with traditional surgery. Patients, however, reported much less discomfort after the laser procedure. Although more research is needed, it initially appears periodontal laser treatments can effectively treat gum disease with minimal interference with healthy tissue and greater comfort for patients.
While dental implants are the preferable choice for teeth replacement, your life circumstances may cause you to postpone it or some other permanent restoration. In the meantime, you need a temporary solution for your tooth loss.
Removable partial dentures (RPDs) have met this need for many years. RPDs are traditionally made of rigid, acrylic plastic resin and fasten to existing teeth with metal clasps. While effective as temporary tooth replacements, RPDs do have their drawbacks: they can be uncomfortable, develop a loose fit and are prone to wear and staining.
Recently, though, new RPDs made of a flexible type of nylon are addressing some of these drawbacks. Because the nylon material is thermoplastic (able to change shape under high heat), it can be injected into a cast mold of a patient’s mouth to create the denture base, to which life-like replacement teeth are then attached. And rather than a metal clasp, these RPDs have thin, finger-like nylon extensions that fit snugly around existing teeth at the gum line.
The new RPDs are lightweight, resistant to fracture and offer a more comfortable, snugger fit than the older RPD. And because the nylon material can be made to closely resemble gum tissue, the base can be designed to cover receding gum tissue, which may further improve the appearance of a patient’s smile.
On the downside, these new RPDs are difficult to reline or repair if they’re damaged or the fit becomes loose. And like all RPDs, they must be regularly removed and cleaned thoroughly to prevent any accumulating bacterial biofilm that could increase the risk of gum disease or tooth decay (the attachment extensions are especially susceptible to this accumulation). They should also be removed at night, since the reduction in saliva flow while you sleep can worsen bacterial buildup.
Still, the new flexible RPD is a good choice to bridge the time gap between lost teeth and a permanent restoration. They can restore lost function and improve your smile during the transition to implants or a fixed bridge.