Periodontal (gum) disease causes more than simple gum swelling—this bacterial infection can harm and destroy your teeth’s supporting structures, including the bone. Its aggressiveness sometimes requires equally aggressive treatment.
Gum disease usually begins with dental plaque, a thin film of bacteria and food particles on tooth and gum surfaces. Without proper oral hygiene plaque builds up with large populations of bacteria that can trigger an infection.
The growth of this disease is often “silent,” meaning it may initially show no symptoms. If it does, it will normally be reddened, swollen and/or bleeding gums, and sometimes pain. A loose tooth is often a late sign the disease has severely damaged the gum ligaments and supporting bone, making tooth loss a distinct possibility.
If you’re diagnosed with gum disease, there is one primary treatment strategy—remove all detected plaque and calculus (tartar) from tooth and gum surfaces. This can take several sessions because as the gums begin responding to treatment and are less inflamed, more plaque and calculus may be discovered.
Plaque removal can involve various techniques depending on the depth of the infection within the gums. For surfaces above or just below the gum line, we often use a technique called scaling: manually removing plaque and calculus with specialized instruments called scalers. If the infection has progressed well below the gum line we may also use root planing, a technique for “shaving” plaque from root surfaces.
Once infection reaches these deeper levels it’s often difficult to access. Getting to it may require a surgical procedure known as flap surgery. We make incisions in the gums to form what looks like the flap of an envelope. By retracting this “flap” we can then access the root area of the tooth. After thoroughly cleansing the area of infection, we can do regenerative procedures to regain lost attachment. Then we suture the flap of gum tissue back into place.
Whatever its stage of development, it’s important to begin treatment of gum disease as soon as it’s detected. The earlier we can arrest its spread, the less likely we’ll need to employ these more invasive procedures. If you see any signs of gum disease as mentioned before, contact us as soon as possible for a full examination.
If you would like more information on preventing and 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.”
Dental work isn’t performed in a vacuum — the state of your general health can have an impact on procedures and vice-versa. This is especially true if you’re taking certain medications like blood thinners.
Blood thinners such as Warfarin or Clopidogrel are used for a number of medical conditions as an anti-coagulant (inhibiting blood from clotting). They’re commonly part of a stroke or heart attack prevention strategy in patients with cardiovascular disease, or those with tendencies for thrombosis (blood clot formation within blood vessels) or pulmonary embolisms (blood clots within the lungs). They’re also used with patients with artificial heart valves or on a temporary basis with patients who’ve recently undergone knee replacement or similar surgical procedures.
In most cases, dental work won’t be affected by your use of a blood thinner. An issue might arise, however, if an invasive procedure has the potential to cause bleeding, like a tooth extraction or gum surgery. Because the blood doesn’t clot normally it may be difficult to stop the bleeding during such procedures.
To avoid undue complications, it’s always best to let your dentist or oral surgeon know what medications you’re taking, especially blood thinners (this includes low-dose aspirin, a common over-the-counter drug that’s often prescribed as a mild blood thinner). Depending on the procedure and your dosage, they may consult with your prescribing doctor to see if temporarily stopping the medication or reducing the dosage is an acceptable precautionary measure for your dental treatment. Your dentist may also take precautions during the procedure to help reduce bleeding such as using haemostatic agents around the wound site to help stabilize blood clotting, while carefully suturing the wound to avoid disrupting smaller blood vessels (capillaries) that easily bleed.
If your dosage has been temporarily stopped or reduced, you’ll usually be able to resume blood thinners immediately after the dental procedure. Working together, your dentist and doctor will help ensure that your health won’t be at risk and your dental procedure will occur without undue complications.
If you would like more information on dental work precautions with medications, 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 “Oral Surgery & Blood Thinners.”
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Halloween means loads of fun for kids everywhere: a chance to put on fanciful costumes and have some safe, spooky enjoyment. But the reward for all that trick-or-treating — bags full of sugary candy — can create monstrous problems for young smiles, in the form of tooth decay. Short of taking all those treats away, are there any ways to lessen the impact on your children’s teeth?
According to the American Dental Association (ADA), the answer is: Yes!
As long as kids are brushing twice and flossing once a day, it’s okay for them to enjoy a few sweet treats on Halloween. But starting that same night, or the next day, you can help protect them from cavities. Here’s how:
Sort It Out:
Some treats are potentially more damaging to teeth than others. For example, candy that’s sticky and clings to teeth — like gummy bears and taffy — takes longer to get cleared away by saliva. Lengthier contact with the teeth increases the risk of tooth decay. The same is true for sweets that stay in the mouth for a long time, like hard candy. Sour candy is often acidic, and that acid can weaken the hard enamel coating of teeth, making them more prone to decay. But there’s some good news: Chocolate, a favorite treat, washes off the teeth relatively quickly — and dark chocolate has less sugar than milk chocolate.
Give It Away:
You can always give away some or all of your candy stash to people who will appreciate it: first responders or troops serving overseas, for example. Some organizations sponsor donation (or even buyback) programs. Try searching the web for programs like “Operation Gratitude,” among others.
Timing Is Everything:
If you do allow candy, limit it to mealtimes. That’s when saliva production is at its peak — and saliva helps neutralize acids and wash away food residue that can cause cavities. Whatever you do, don’t let kids snack on sweet treats from the candy dish throughout the day: This never gives your mouth a chance to bounce back from the sugary saturation.
Get Healthy Hydration:
For quenching thirst, water is the best choice. It helps your body stay properly hydrated and is needed for healthful saliva production. Sugary or acidic beverages like sodas (regular or diet), so-called “sports” or “energy” drinks, and even fruit juices can harm teeth. Fluoridated water (like most municipal tap water) has been shown to help prevent tooth decay. If you drink bottled water, look for a fluoridated variety.
Following these tips — and making sure your kids maintain good oral health with brushing, flossing, and routine dental office visits — will help keep them safe from cavities, not only at Halloween but all year long. If you have questions about cavity prevention or oral hygiene, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Tooth Decay — How to Assess Your Risk” and “How to Help Your Child Develop the Best Habits for Oral Health.”
October is National Dental Hygiene Month. It’s a great time to talk about your first line of dental defense: your toothbrush.
Are you getting the most out of your tooth-brushing routine at home? Your toothbrush is the primary tool to maintain oral health on a daily basis, so here are some tips to keep in mind:
- Brush gently twice a day, every day, for two minutes each time using a soft toothbrush. Scrubbing with too much force or with hard bristles can damage gums and tooth enamel.
- Use fluoride toothpaste to prevent tooth decay. Fluoride is a mineral that builds tooth enamel to prevent tooth decay.
- Replace your toothbrush every 3 to 4 months or when the bristles start to look frayed, curled, or worn.
- Rinse out your mouth thoroughly after brushing to get rid of bacteria and food debris that you worked loose from your teeth.
- Also rinse your toothbrush well after each use to wash away the debris and bacteria you just brushed from your teeth.
- Let your toothbrush dry out between uses. A toothbrush that is stored in a closed container can become a breeding ground for bacteria.
- Keep your toothbrush to yourself. Sharing toothbrushes is a way to share disease-causing germs as well.
Follow these pointers and come in for regular dental visits to help ensure healthy teeth and a bright smile. If you have any questions about your dental hygiene routine, be sure to ask us.
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