Posts for: May, 2019
Your gums not only help hold your teeth securely in place, they also help protect them. They're also part of your smile — when healthy and proportionally sized, they provide a beautiful frame for your teeth.
But if they become weakened by periodontal (gum) disease, they can detach and begin to shrink back or recede from the teeth. Not only will your smile be less attractive, but you could eventually lose teeth and some of the underlying bone.
Treating gum recession begins with treating the gum disease that caused it. The primary goal is to remove the source of the disease, a thin film of food particles and bacteria called dental plaque, from all tooth and gum surfaces. This may take several sessions, but eventually the infected gums should begin showing signs of health.
If the recession has been severe, however, we may have to assist their healing by grafting donor tissue to the recession site. Not only does this provide cover for exposed tooth surfaces, it also provides a “scaffold” for new tissue growth to build upon.
There are two basic surgical approaches to gum tissue grafting. One is called free gingival grafting in which we first completely remove a thin layer of surface skin from the mouth palate or a similar site with tissue similar to the gums. We then attach the removed skin to the recession site where it and the donor site will usually heal in a predictable manner.
The other approach is called connective tissue grafting and is often necessary when there's extensive root exposure. The tissue is usually taken from below the surface of the patient's own palate and then attached to the recession site where it's covered by the surrounding adjacent tissue. Called a pedicle or flap, this covering of tissue provides a blood supply that will continue to nourish the graft.
Both of these techniques, but especially the latter, require extensive training and micro-surgical experience. The end result is nothing less than stunning — the tissues further rejuvenate and re-attach to the teeth. The teeth regain their protection and health — and you'll regain your beautiful smile.
If you would like more information on treating gum recession, 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 Plastic Surgery.”
There's a lot of emphasis — well-placed, of course — on preventing and treating tooth decay. But there's another dental disease just as dangerous to your oral health and nearly half of U.S. adults have it. It's actually a group of diseases known collectively as periodontal (gum) disease.
Gum disease is similar to tooth decay in one respect: they're both triggered by bacteria. These microorganisms thrive in a thin film of food particles called plaque that collects on tooth surfaces.
Certain bacteria can infect gum tissues and trigger inflammation, a response from the body's immune system to fight it. As the battle rages, bone loss can occur and the gums weaken and begin to detach from the teeth. Without treatment, you could eventually lose affected teeth.
Like tooth decay, the best approach with gum disease is to prevent it, and by using the same techniques of daily brushing and flossing. These actions loosen and remove plaque built up since your last brushing. It's also important you visit us at least twice a year for cleanings that remove hard to reach plaque and calculus (hardened plaque deposits).
If despite your best efforts you do contract gum disease, the sooner you see us for treatment the lower the long-term impact on your health. The treatment aim is the same as your daily hygiene: to remove plaque and calculus. We use specialized hand instruments or ultrasound equipment to mechanically remove plaque; more advanced cases may require the skills of a periodontist who specializes in caring for structures like the gums that support teeth.
So, defend yourself against gum disease by brushing and flossing daily, and visiting us regularly for dental cleanings and checkups. If you notice bleeding, swollen or painful gums, see us as soon as possible for diagnosis and treatment. Don't let tooth decay's evil twin ruin your oral health or your smile.
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 “When to See a Periodontist.”
As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.
Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb). It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.
It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.
We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.
Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.
At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.
If you would like more information on diagnosing and treating root resorption, 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 Resorption: An Unusual Phenomenon.”