Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.
To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.
Â While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.
The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter.Â It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.
Â Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.
Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.
If you would like more information on your treatment options 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.
Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.
Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.
A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.
The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.
The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.
We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.
The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.
A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.
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 “What are Furcations?”
At this time of year, hearts are everywhere you look, so it's fitting that February is American Heart Month, a time to focus on cardiovascular health. Cardiovascular disease, which includes heart disease and stroke, is the number one cause of death around the world. But did you know that there's a link between the health of your heart and the health of your mouth?
People with advanced gum disease have a higher risk of having a heart attack, stroke or other cardiovascular event, but what is the connection? For one, oral bacteria found in gum disease can enter the bloodstream, where it has been found in artery-clogging plaque. In addition, untreated gum disease has been determined to worsen high blood pressure, a major contributor to heart attack, stroke and heart failure. One study reported that when gum disease was treated, high blood pressure fell by up to 13 points. But perhaps the most significant common denominator between gum disease and heart disease is inflammation, according to many researchers.
Gum disease is the most common inflammatory disease, affecting nearly 50% of US adults over 30, and 70% of those aged 65 and older, according to the U.S. Centers for Disease Control. The body's inflammation response is a key weapon in fighting infection. However, when there is chronic low-level inflammation such as occurs with untreated periodontal (gum) disease, many adverse health effects can result. In one Harvard University study, chronic inflammation was found to triple the risk of heart attack and double the risk of stroke.
The relationship between gum disease and heart disease is still not completely understood, but there's no denying that a connection exists between the two, so it's worth doing what you can to take care of both your gums and your cardiovascular health. Here are some tips:
As you think about what you can do to take care of your heart health and overall health, don't forget your gums. If you have questions about how to improve your oral health, call us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Good Oral Health Leads to Better Health Overall” and “Carbohydrates Linked to Gum Disease.”
Like other aspects of our lives, aging can take a toll on our smile. Over a lifetime the effects of disease, teeth wearing and the foods we eat can cause our teeth and gums to look unattractive.
Here are 3 of the most common age-related dental problems and how we can help you "turn back the clock" on each one.
Discoloration. Teeth can dull and grow darker over time. And not just from what we eat or drink—age-related structural changes in the tooth can also cause discoloration. We can often alleviate external staining temporarily with teeth whitening. If the staining is heavy or it originates inside the tooth, then we can install life-like porcelain veneers or crowns to cover the discoloration. We can also use composite dental materials to alter the color of one darkened tooth so that it doesn't stand out from the rest of your teeth.
Wearing. Our teeth naturally wear down over time. If the wearing is excessive, though, teeth can look shorter and less youthful. Again, we can use veneers or crowns to change a tooth's outward appearance and make them look longer. We can also employ enamel contouring and reshaping that smoothes out sharper edges caused by wearing to give your teeth a softer, more youthful look.
Receding gums. On the other end of the spectrum, gums that have shrunk back or receded from the teeth can make them look much larger and unattractive. Our first step is to treat any gum disease present—the most common cause of recession—which often helps the tissues to regenerate. If your case is more advanced, though, you may also need grafting surgery to restore lost gum tissue. Using in-depth microsurgical techniques, surgeons attach grafted gum tissue at the recession site. Over time new tissue will grow, restoring adequate gum coverage.
You can also improve your appearance at any age with orthodontics. Besides a more attractive smile, properly aligned teeth tend to wear more slowly and evenly. This and proper daily oral hygiene and regular dental care can keep your teeth looking younger even in your later years.
If you would like more information on gaining a more youthful smile, 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 Your Dentist can help you Look Younger.”
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.”