There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.
As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.
Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.
There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.
Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.
If you would like more information on surgical procedures for 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 “Periodontal Surgery: Where Art Meets Science.”
The various structures in your mouth — your teeth and gums, of course, as well as periodontal tissues that hold teeth in place within the jaw — all function together to create your smile. This includes muscles like the frenum, a fold of muscle tissue that connects the gums to the upper lip, which helps pull the lip upward when you smile.
Unfortunately, an overly large frenum could contribute to an unattractive space between your two upper front teeth. The problem occurs when the frenum grows beyond its normal range and runs between the front teeth to connect with the gums behind them at the forefront of the roof of your mouth. The resulting space that may develop can be closed with orthodontics, but unless the excess frenum tissue is addressed the space may eventually reopen.
The frenum is just one cause among many for a noticeably wide space, including bite problems (malocclusions), finger-sucking habits or missing teeth. We would, therefore, need to examine your mouth to determine the exact cause before beginning any treatment. If indeed the frenum is the source of the problem, it will be necessary to ultimately remove the excess portion through a procedure known as a frenectomy.
A frenectomy is a minor surgical procedure performed by a periodontist, oral surgeon or a general dentist with surgical training. After numbing the area with local anesthesia, the tissue behind the teeth is dissected or reduced in size with a small scalpel or a surgical laser. The wound is then closed with a few stitches; any post-surgical discomfort is usually minimal and managed with non-steroidal anti-inflammatory pain medication. The wound will completely heal within a few weeks.
Most frenectomies are performed after orthodontics to close the space. Removing it prior to tooth movement may result in scar tissue that prevents the space from closing. It’s also easier for the surgeon to gauge how much tissue to remove after space closure to avoid removing too much, which can leave a “black” triangular hole where gum tissue should normally be.
Treating an abnormally large frenum isn’t difficult, but it needs to be coordinated with orthodontic treatment for the best outcome. The end result is a smile that’s both healthy and attractive.
If you would like more information on teeth spacing problems, 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 “Space between Front Teeth.”
As is the case with most celebs today, Beyonce is no stranger to sharing on social media… but she really got our attention with a video she recently posted on instagram. The clip shows the superstar songstress — along with her adorable three-year old daughter Blue Ivy — flossing their teeth! In the background, a vocalist (sounding remarkably like her husband Jay-Z) repeats the phrase “flossin’…flossin’…” as mom and daughter appear to take care of their dental hygiene in time with the beat: https://instagram.com/p/073CF1vw07/?taken-by=beyonce
We’re happy that this clip highlights the importance of helping kids get an early start on good oral hygiene. And, according to authorities like the American Dental Association and the American Academy of Pediatric Dentistry, age 3 is about the right time for kids to begin getting involved in the care of their own teeth.
Of course, parents should start paying attention to their kids’ oral hygiene long before age three. In fact, as soon as baby’s tiny teeth make their first appearance, the teeth and gums can be cleaned with a soft brush or cloth and a smear of fluoride toothpaste, about the size of a grain of rice. Around age 3, kids will develop the ability to spit out toothpaste. That’s when you can increase the amount of toothpaste a little, and start explaining to them how you clean all around the teeth on the top and bottom of the mouth. Depending on your child’s dexterity, age 3 might be a good time to let them have a try at brushing by themselves.
Ready to help your kids take the first steps to a lifetime of good dental checkups? Place a pea-sized dab of fluoride toothpaste on a soft-bristled brush, and gently guide them as they clean in front, in back, on all surfaces of each tooth. At first, it’s a good idea to take turns brushing. That way, you can be sure they’re learning the right techniques and keeping their teeth plaque-free, while making the experience challenging and fun.
Most kids will need parental supervision and help with brushing until around age 6. As they develop better hand-eye coordination and the ability to follow through with the cleaning regimen, they can be left on their own more. But even the best may need some “brushing up” on their tooth-cleaning techniques from time to time.
What about flossing? While it’s an essential part of good oral hygiene, it does take a little more dexterity to do it properly. Flossing the gaps between teeth should be started when the teeth begin growing close to one another. Depending on how a child’s teeth are spaced, perhaps only the back ones will need to be flossed at first. Even after they learn to brush, kids may still need help flossing — but a floss holder (like the one Beyonce is using in the clip) can make the job a lot easier.
If you would like more information about maintaining your children’s oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”
A focus on dental care in senior citizens is just as important as it is for children. Indeed, oral health in your later years can be a major factor in your quality of life.
For one, aging effects on other parts of the body can make dental care more challenging. Some hygiene tasks once performed easily become harder — arthritis, for example, or loss of muscle strength may make it difficult to hold a toothbrush or floss. In such cases, you may need to find new ways to make the task easier: a power toothbrush with a larger handle; pre-loaded floss holders or a water flosser; or adaptations to a manual brush to make it easier to hold, like attaching a tennis ball or bike handle.
Other age-related conditions — and their treatments — can negatively impact oral health. Less saliva production, which is a consequence of aging or certain drugs, increases the risk of tooth decay or periodontal (gum) disease. Older adults often develop gastric reflux problems that can introduce tooth enamel-eroding stomach acid into the mouth. And medications called bisphosphonates, often prescribed to treat osteoporosis, may interfere in rare cases with bone healing after tooth extraction or similar procedures.
Prior dental work can also prove challenging to treating dental disease. It becomes more difficult to preserve teeth threatened with decay if there are significant restorations or appliances to work around. Pain perception can also diminish with age, so that dental disease may not be noticed until later stages when significant damage has already occurred.
Oral care requires more attention as we grow older, or as we care for older family members. Your best defense against disease is to continue regular six-month visits with us. In addition to normal cleanings and checkups, we’ll also screen for oral cancer (a more prevalent occurrence in older adults), review your prescriptions or other supplements and medications for any possible side effects to oral health, check the fit of any dentures or other restorations and evaluate the effectiveness of your hygiene.
While other age-related conditions may capture the majority of your attention, you shouldn’t allow that to neglect your dental care. With your continued efforts, along with our support and your family’s, you can continue to enjoy good oral health throughout your lifetime.
Tooth sensitivity can be disheartening: you’re always on your guard with what you eat or drink, and perhaps you’ve even given up on favorite foods or beverages.
The most common cause for this painful sensitivity is dentin exposure caused by receding gums. Dentin contains tiny open structures called tubules that transmit changes in temperature or pressure to the nerves in the pulp, which in turn signal pain to the brain. The enamel that covers the dentin, along with the gum tissues, creates a barrier between the environment and dentin to prevent it from becoming over-stimulated.
Due to such causes as aggressive over-brushing or periodontal (gum) disease, the gum tissues can recede from the teeth. This exposes portions of the dentin not covered by enamel to the effects of hot or cold. The result is an over-stimulation of the dentin when encountering normal environmental conditions.
So, what can be done to relieve painful tooth sensitivity? Here are 3 ways to stop or minimize the symptoms.
Change your brushing habits. As mentioned, brushing too hard and/or too often can contribute to gum recession. The whole purpose of brushing (and flossing) is to remove bacterial plaque that’s built up on tooth surfaces; a gentle action with a soft brush is sufficient. Anything more than two brushings a day is usually too much — you should also avoid brushing just after consuming acidic foods or liquids to give saliva time to neutralize acid and restore minerals to the enamel.
Include fluoride in your dental care. Fluoride has been proven to strengthen enamel. Be sure, then, to use toothpastes and other hygiene products that contain fluoride. With severe sensitivity you may also benefit from a fluoride varnish applied by a dentist to your teeth that not only strengthens enamel but also provides a barrier to exposed dentin.
Seek treatment for dental disease. Tooth sensitivity is often linked to tooth decay or periodontal (gum) disease. Treating dental disease may include plaque removal, gum surgery to restore receded gums, a filling to remove decay or root canal therapy when the decay gets to the tooth pulp. These treatments could all have an effect on reducing or ending your tooth sensitivity.
If you would like more information on the causes and treatments for sensitive 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 “Tooth Sensitivity.”
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