Posts for tag: gum disease
If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.
That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.
Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.
During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.
Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.
If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.
Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.
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 article “Understanding Periodontal Pockets.”
Treating advanced periodontal (gum) disease takes time. If you have this destructive disease, it wouldn’t be uncommon for you to undergo several cleaning sessions to remove plaque from tooth and gum surfaces. This built-up film of bacteria and food particles is primarily responsible for triggering and fueling gum disease.
These cleaning sessions, which might also involve surgery and other advanced techniques to access deep pockets of infection, are necessary not only to heal your gums but to preserve the teeth they support. With these intense efforts, however, we can help rescue your teeth and return your reddened and swollen gums to a healthy, pink hue.
But what then — is your gum disease a thing of the past?
The hard reality is that once you’ve experienced gum disease your risk of another occurrence remains. From now on, you must remain vigilant and disciplined with your oral hygiene regimen to minimize the chances of another infection. You can’t afford to slack in this area.
Besides daily brushing and flossing as often as your dentist directs, you should also visit your dentist for periodontal maintenance (PM) on a regular basis. For people who’ve experienced gum disease, PM visits are more than a routine teeth cleaning. For one, your dentist may recommend more than the typical two visits a year: depending on the severity of your disease or your genetic vulnerability, you may need to increase the frequency of maintenance appointments by visiting the dentist every two to three months.
Besides plaque and calculus (tartar) removal, these visits could include applications of topical antibiotics or other anti-bacterial substances to curb the growth of disease-causing bacteria in your mouth. You may also need to undergo surgical procedures to make particular areas prone to plaque buildup easier to clean.
The main point, though, is that although you’ve won your battle with gum disease, the war isn’t over. But with your own daily hygiene maintenance coupled with your dentist’s professional attention, you’ll have a much better chance of avoiding a future infection.
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 “Periodontal Cleanings.”
Gum disease is a bigger problem than you might think. More than half of all adults over age 30 have it, and that figure jumps to 70% of adults over 65. If left untreated, gum (periodontal) disease can eventually loosen teeth and cause them to fall out. It can also cause health issues outside of the mouth, including an increased risk of heart disease and other systemic health conditions.
But the good news is that gum disease can be treated—and even better, prevented! Since September is National Gum Care Month, it’s a good time to answer some frequently asked questions about gum disease:
What causes gum disease?
Gum disease is caused by certain types of harmful oral bacteria that live in a sticky film called dental plaque that collects on teeth both above and below the gum line. If this film is not cleaned effectively each day, it can eventually harden into a substance called tartar that can only be removed by a dental professional. As your body tries to fight the bacteria and the toxins they produce, your gums can become inflamed and may start to pull away from the teeth. Eventually, bone beneath the gums can start to break down and with continued bone loss, the teeth could be lost.
How do I know if I have it?
Gum disease doesn’t always produce symptoms—especially in smokers. Smoking hides the symptoms of gum disease because nicotine reduces blood flow to the area. However, there are things you should look out for. Gingivitis, a mild form of gum disease, can produce red and/or puffy gums that bleed when you brush or floss. Signs of periodontitis, a more serious form of the disease, include gum recession, bad mouth odors or tastes, and tooth looseness. But the only way to truly know if you have gum disease is to come in for an exam.
What can I do about it?
If you have gingivitis, a professional teeth cleaning and a renewed commitment to oral hygiene at home—including daily flossing and rinsing with antibacterial mouthwash—may be all you need to turn the situation around. Periodontitis may require a variety of treatments, ranging from special cleaning procedures of the tooth root surfaces to gum surgery. The first step toward controlling gum disease is visiting the dental office for an exam.
How can I prevent it?
Regular professional teeth cleanings and meticulous oral hygiene at home are your best defenses against gum disease. Avoid sugary drinks and snacks—which feed the disease-causing bacteria in your mouth—and tobacco in all forms. If you have diabetes, do your best to manage it well because uncontrolled diabetes can worsen periodontal disease.
A loose permanent tooth is not a good thing—and not something you should put off having examined. That’s because a loose tooth could soon become a lost tooth.
How we treat it depends on its underlying cause, which could be one of two types. One is primary occlusal trauma, meaning the affected tooth has experienced accidental trauma or higher biting forces than it normally encounters. This usually happens because of teeth grinding habits.
It could also be secondary occlusal trauma. Unlike primary trauma where the supporting gums and bone may be reasonably healthy, secondary trauma occurs because these structures have been severely damaged by periodontal (gum) disease. As the gums begin to detach from a tooth and its underlying bone deteriorates, even normal biting forces can loosen it.
If gum disease is present, our first priority is to bring it under control. We do this primarily by removing all dental plaque (a thin film of bacteria and food particles that triggers the infection and sustains it) and calculus or tartar (calcified plaque). This can take several sessions and, in the case of deep infection, may require a surgical procedure.
On the other hand, if teeth grinding is the primary cause, we’ll focus on minimizing the habit and its effects. One way is to create a custom-fitted guard worn to prevent upper and lower teeth from making solid contact. You may also need to improve your management of stress—another factor in teeth grinding—through medication, therapy or biofeedback.
In either case, improved periodontal health will help the gums naturally regain their strong attachment with help, if necessary, from gum tissue or bone grafting surgery. But this healing process can take time, so we may need to secure a loose tooth in the interim by splinting it to neighboring stable teeth. This usually requires bonding rigid material or metal across the back of all involved teeth or in a channel cut along the teeth’s biting surfaces. In this way the more stable teeth support the loose one.
Splinting may be temporary as the mouth heals from disease or trauma and the teeth regain their stability. In some cases, though, it may be permanent. Either way, dealing promptly with a loose tooth can help ensure it’ll survive—so see your dentist as soon as possible.
If you would like more information on treating loose 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 “Treatment for Loose Teeth.”
Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.
One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.
Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.
Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.
The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.
Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.
The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.
Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.
If you would like more information on loose teeth and 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 “Treatment for Loose Teeth.”