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Posts for tag: gum disease

By Dentistry by Design
December 05, 2018
Category: Dental Procedures
LasersCouldbetheFutureforGumDiseaseTreatment

We’ve developed a number of effective treatments for periodontal (gum) disease. Depending on how far and deep a patient’s infection has advanced, treatment can be quite invasive and even require surgery. The more invasive, the longer and more uncomfortable the healing process can be.

But using a medical laser could make that less so. Although its use for gum disease treatment is still in its infancy, the latest observations from the field seem to show patients undergoing laser treatment may have less tissue trauma and bleeding, less discomfort after the procedure and quicker healing times.

Gum disease is a bacterial infection mostly caused by dental plaque, a thin film of food particles that build up on teeth in the absence of effective oral hygiene. The infection can advance deep below the gum line, weakening gum attachment to teeth and destroying supporting bone. Ultimately the affected teeth can be lost.

Traditionally, the only way to stop the disease is to manually remove plaque buildup on teeth and gum surfaces, which is continuing to sustain the infection, with special hand instruments called scalers or ultrasonic equipment. Because it’s important to remove as much plaque and diseased tissue as possible, we may need to perform a surgical procedure called flap surgery to move some of the gum tissues out of the way to get to these deeper areas. As with any surgery, this can create tissue trauma that may cause discomfort during the healing process.

Our new alternative is to use an Nd:YAG medical laser in a procedure known as Laser Assisted New Attachment Procedure or LANAP. With light energy delivered through a small fiber no more than the width of three human hairs, the laser can pinpoint diseased tissue and destroy bacteria through intense heat. Because of the laser beam’s tiny width and pulsing action, healthy tissue is at less risk for trauma than with the traditional treatment.

Coupled with other techniques, LANAP procedures could remove as much infected tissue and plaque as traditional methods, but with less healthy tissue trauma. In the future, then, patients with advanced gum disease undergoing laser treatment could have less bleeding and discomfort and faster healing times.

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 Gum Disease with Lasers.”

By Dentistry by Design
November 25, 2018
Category: Oral Health
Tags: oral health   gum disease  
InflammationtheLinkBetweenGumDiseaseandCardiovascularDisease

Cardiovascular disease and periodontal (gum) disease are two different conditions with their own set of symptoms and outcomes. But they do share one common element: inflammation. In fact, this otherwise normal defensive response of the body might actually create a link between them.

When tissues become damaged from disease or injury, the body triggers inflammation to isolate them from the rest of the body. This allows these tissues to heal without affecting other tissues. If inflammation becomes chronic, however, it can damage rather than protect the body.

This happens with both cardiovascular disease and gum disease. In the former, low-density lipoproteins (LDL or “bad cholesterol”) in animal fat leave behind remnants that can build up within arteries. This stimulates inflammation of the vessel’s inner linings, which accelerates hardening and increases the risk of heart attack or stroke.

With gum disease, bacteria living in a thin, built-up film of food particles on the teeth called plaque infect the gum tissues, which in turn trigger inflammation. A struggle ensures between the infection and inflammation, causing the gum tissues to weaken and detach from the teeth. Coupled with erosion of the supporting bone, the risk of tooth loss dramatically increases.

Recent research now seems to indicate the inflammatory responses from these two diseases may not occur in isolation. There is evidence that gum inflammation could aggravate inflammation in the cardiovascular system, and vice-versa. The research, though, points to some possible good news: treating inflammation in either disease could have a positive effect on the other.

Making heart-friendly lifestyle changes like losing extra weight (especially around the waist), improving nutrition, and exercising regularly can help reduce LDL and lower the risk of arterial inflammation. Likewise for your gums, daily oral hygiene and visiting the dentist at least twice a year reduces the risk for gum disease. And at the first sign of a gum infection—swollen, reddened or bleeding gums—seeking immediate treatment will stop it and reduce any occurring inflammation.

Taking steps to prevent or reduce inflammation brought on by both of these diseases could improve your health and save your life.

If you would like more information on how your oral health affects your whole body, 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 “The Link between Heart & Gum Disease.”

By Dentistry by Design
October 26, 2018
Category: Dental Procedures
Tags: tooth decay   gum disease  
StopRootCavitieswithPreventionandPromptTreatment

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, 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 “Root Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”

By Dentistry by Design
September 06, 2018
Category: Oral Health
Tags: gum disease   loose tooth  
HaveYourLooseToothExaminedasSoonasPossible

A loose permanent tooth is not a good thing—and not something you should put off having examined. That’s because a loose tooth could soon become a lost tooth.

How we treat it depends on its underlying cause, which could be one of two types. One is primary occlusal trauma, meaning the affected tooth has experienced accidental trauma or higher biting forces than it normally encounters. This usually happens because of teeth grinding habits.

It could also be secondary occlusal trauma. Unlike primary trauma where the supporting gums and bone may be reasonably healthy, secondary trauma occurs because these structures have been severely damaged by periodontal (gum) disease. As the gums begin to detach from a tooth and its underlying bone deteriorates, even normal biting forces can loosen it.

If gum disease is present, our first priority is to bring it under control. We do this primarily by removing all dental plaque (a thin film of bacteria and food particles that triggers the infection and sustains it) and calculus or tartar (calcified plaque). This can take several sessions and, in the case of deep infection, may require a surgical procedure.

On the other hand, if teeth grinding is the primary cause, we’ll focus on minimizing the habit and its effects. One way is to create a custom-fitted guard worn to prevent upper and lower teeth from making solid contact. You may also need to improve your management of stress—another factor in teeth grinding—through medication, therapy or biofeedback.

In either case, improved periodontal health will help the gums naturally regain their strong attachment with help, if necessary, from gum tissue or bone grafting surgery. But this healing process can take time, so we may need to secure a loose tooth in the interim by splinting it to neighboring stable teeth. This usually requires bonding rigid material or metal across the back of all involved teeth or in a channel cut along the teeth’s biting surfaces. In this way the more stable teeth support the loose one.

Splinting may be temporary as the mouth heals from disease or trauma and the teeth regain their stability. In some cases, though, it may be permanent. Either way, dealing promptly with a loose tooth can help ensure it’ll survive—so see your dentist as soon as possible.

If you would like more information on treating loose teeth, 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 for Loose Teeth.”

YourCaseofGingivitisCouldDevelopintoSomethingMoreHarmful

That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”

Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.

ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.

Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes. We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.

We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.

It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.

If you would like more information on ANUG and other periodontal gum conditions, 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 “Painful Gums in Teens & Adults.”