Posts for category: Oral Health
It often begins without you realizing it—spreading ever deeper into the gums and damaging tissue attachments, teeth and supporting bone in its way. In the end, it could cause you to lose your teeth.
This is periodontal (gum) disease, a bacterial infection caused by dental plaque, a thin biofilm that accumulates on tooth surfaces. It in turn triggers chronic inflammation, which can cause the gum attachments to teeth to weaken. Detaching gum ligaments may then produce diseased voids—periodontal pockets—that can widen the gap between the teeth and the gums down to the roots.
There is one primary treatment objective for gum disease: uncover and remove any and all plaque and tartar (hardened plaque). If the infection has advanced no further than surface gum tissues, it may simply be a matter of removing plaque at or just below the gum line with hand instruments called scalers or ultrasonic equipment.
The disease, however, is often discovered in more advanced stages: The initial signs of swollen, reddened or bleeding gums might have been ignored or simply didn't appear. Even so, the objective of plaque and tartar removal remains the same, albeit the procedures may be more invasive.
For example, we may need to surgically access areas deep below the gum line. This involves a procedure called flap surgery, which creates an opening in the gum tissues resembling the flap of an envelope. Once the root or bone is exposed, we can then remove any plaque and/or tartar deposits and perform other actions to boost healing.
Antibiotics or other antibacterial substances might also be needed for stopping an infection in advanced stages. Some like the antibiotic tetracycline can be applied topically to the affected areas to directly stop inflammation and infection; others like mouthrinses with chlorhexidine might be used to fight bacteria for an extended period.
Although effective, treatment for advanced gum disease may need to continue indefinitely. The better approach is to focus on preventing a gum infection through daily brushing and flossing and regular dental cleanings. And at the first sign of problems with your teeth and gums, see us as soon as possible—the earlier in the disease progression that we can begin treatment, the better the outcome.
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.”
If you think periodontal (gum) disease is something that only happens to the other guy (or gal), you might want to reconsider. Roughly half of adults over age 30—and nearly three-quarters over 65—have had some form of gum disease.
Gum disease isn't some minor inconvenience: If not treated early, a gum infection could lead to bone and tooth loss. Because it's inflammatory in nature, it may also impact the rest of your health, making you more susceptible to diabetes, heart disease or stroke.
Gum disease mainly begins with dental plaque, a thin film of food particles on tooth surfaces. Plaque's most notable feature, though, is as a haven for oral bacteria that can infect the gums. These bacteria use plaque as a food source, which in turn fuels their multiplication. So, the greater the plaque buildup, the higher your risk for a gum infection.
The best way to lower that risk is to reduce the population of bacteria that cause gum disease. You can do this by keeping plaque from building up by brushing and flossing every day. It's important for this to be a daily habit—missing a few days of brushing and flossing is enough for an infection to occur.
You can further reduce your disease risk by having us clean your teeth regularly. Even if you're highly proficient with daily hygiene, it's still possible to miss some plaque deposits, which can calcify over time and turn into a hardened form called tartar (or calculus). Tartar is nearly impossible to remove with brushing and flossing, but can be with special dental tools and techniques.
Even with the most diligent care, there's still a minimal risk for gum disease, especially as you get older. So, always be on the lookout for red, swollen or bleeding gums. If you see anything abnormal like this, see us as soon as possible. The sooner we diagnose and begin treating a gum infection, the better your chances it won't ultimately harm your dental health.
If you would like more information on the prevention and treatment of 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 “How Gum Disease Gets Started.”
Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.
One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.
But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.
But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.
There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.
A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.
If you would like more information on tongue ties and other oral abnormalities in children, 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 “Tongue Ties, Lip Ties and Breastfeeding.”
Life has changed dramatically over the centuries. But although our ancient forebears wouldn't recognize much of our modern world, they would be well acquainted with one particular oral habit that still persists. There's some evidence from archeological dental examinations that our ancestors also clenched or ground their teeth.
This habit of involuntarily gnashing, clenching or grinding the teeth together is most prevalent among children, although not considered a major problem at these younger ages. But it can continue into adulthood, as it does for one in ten people, and lead to an array of problems from worn teeth to jaw joint pain.
As to why adult teeth grinding occurs, researchers have proposed a number of possibilities. Some believe it may be related to the arousal response that occurs when a person passes through various stages of sleep. It also appears that certain psychoactive drugs can trigger it. But at the top of the cause list, teeth grinding is believed to be a physical outlet for stress.
Because of the possibility of multiple causes, there is no one method for treatment—instead, it's better to tailor treatments to the individual. Universally, though, patients who use drugs, alcohol or tobacco, all of which are considered contributing factors, may reduce grinding episodes by restricting their use of these substances.
It's also possible to reduce the incidence of teeth grinding through better stress management. People can learn and use individual relaxation techniques like meditation, mindfulness or biofeedback. For sleep-related teeth grinding it may also be helpful to forgo use of electronic devices before bedtime for a better night's sleep.
Dental treatments like an occlusal guard worn mainly during sleep can minimize the effects of nocturnal teeth grinding. This custom-made appliance prevents teeth from coming fully into contact with each other, thus lowering the intensity of the biting forces generated and preventing cumulative damage to teeth and dental work.
If you have symptoms like sore teeth and jaws, reports from your family hearing you grind your teeth, or catching yourself during the day clenching your teeth, make an appointment for a full examination. From there, we'll help you find the right combination of solutions to keep this old habit from complicating your oral health.
If you would like more information on teeth grinding, 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 “Teeth Grinding.”
Knowing what to do—and what not to do—when your child is sick can greatly affect their health and well-being. That's especially true with dental problems.
Here then are some Dos and Don'ts for 3 common problems children experience with their teeth and gums.
Teething. An infant's first teeth breaking through the gums is a normal but often unpleasant experience. Fortunately, teething episodes only last a few days. And, there's usually no need to see the dentist unless they have a fever or diarrhea while teething. In the meantime:
- Do: provide them chilled (not frozen) cloth or plastic items to bite and gnaw, and massage their gums to relieve painful pressure. You can also give them an age-appropriate dose of a mild pain reliever.
- Don't: rub any medication on their gums, which can irritate them and other soft tissues. Never use alcohol or aspirin to alleviate teething discomfort. And avoid using anything with benzocaine, a numbing agent which can be hazardous to young children.
Toothache. Whether a momentary sensitivity to hot or cold or a sharp, throbbing pain, a child's toothache often signals tooth decay, a bacterial disease which could eventually lead to tooth loss.
- Do: make a dental appointment at your child's first complaint of a toothache. Ease the pain with a warm-water rinse, a cold compress to the outside of the jaw, or a mild pain reliever.
- Don't: rub medication on the teeth or gums (for similar reasons as with teething). Don't apply ice or heat directly to the affected tooth or gums, which can burn them.
Bleeding gums. Gum bleeding from normal brushing or flossing, along with red or swollen gums, may indicate periodontal (gum) disease. Although rare in children, it can still happen—and it can put an affected tooth in danger.
- Do: see your dentist if bleeding continues for a few days. Continue to brush gently with a soft-bristled toothbrush around the gums to remove plaque, a thin-biofilm most responsible for gum infection.
- Don't: brush aggressively or more than twice a day, which could unnecessarily irritate and damage the gums. And don't stop brushing—it's important to remove plaque buildup daily to lessen the gum infection.