Posts for: February, 2018
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.”
Your teeth were meant to shine! Tooth enamel’s polished translucence, framed by the dentin layer beneath it, has a way of vibrantly catching the light when you smile. But tooth wear and structural changes as you age can dim that shine. Add to that staining caused by foods and beverages or disease and your smile could further lose its luster.
On your supermarket or pharmacy oral hygiene aisle you’ll find dozens of products promising to restore that lost luster, including toothpastes, whitening kits or even chewing gum. While such products work to some degree, our dental office may have the right solution for you: a safe and effective treatment for whitening teeth.
Why see us for teeth whitening? For one, professional whitening solutions contain a higher concentration of bleaching agent (usually 35-45% hydrogen peroxide) than home kits. We usually apply it in a gel form directly to the teeth while using barrier devices like dams to protect the lips and other soft tissue from irritation. We may then apply heat or light to the applied gel to enhance the release of peroxide into your enamel.
This professional procedure can often give you a brighter smile in fewer sessions than a home whitening kit — and it may last longer. What’s more, we can control the level of brightness to produce only a subtle change or a dazzling “Hollywood” smile — whatever your preference.
Like a home kit, this procedure bleaches staining on the outer surface of enamel, known as extrinsic staining. But you can also have discoloration deep within a tooth, known as intrinsic staining, caused by a variety of reasons like tetracycline use early in life or complications from a root canal treatment. Home kits or even the professional treatment described above can’t whiten intrinsic staining.
For intrinsic staining you’ll need a special procedure that places a bleaching agent inside the tooth. Depending on the extent of staining the procedure could require more than one session.
To find out what kind of discoloration you have, visit us for a full examination. We’ll then be able to give you your options for putting the shine back in your smile.
If you would like more information on teeth whitening, 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 Whitening.”
Due to financial circumstances, people often have a lost tooth restored with a removable partial denture, an effective appliance that restores function and a degree of aesthetic appearance. Later, though, they may want to improve both function and appearance with a dental implant.
If this describes you, you’re making a great choice. Dental implants are the closest technology we have to a natural tooth. But there may be a roadblock to your implant, especially if a long time has passed since your tooth loss—there may not be enough bone at the site to place an implant.
The heart of an implant is a titanium metal post surgically imbedded in the jawbone. The titanium naturally attracts bone cells, which grow and adhere to it to form a solid hold that can support a porcelain crown or other restorations like bridges or dentures. But to achieve a natural appearance it’s important that the implant is placed in the right location. To achieve that requires adequate bone.
But there may not be adequate bone if the tooth has been missing for a while. The forces generated when we chew travel through the teeth to the jawbone, which stimulates bone growth. If that stimulus is absent because of a missing tooth, new bone cells may not replace older ones at a healthy rate and the total bone volume begins to diminish. A denture can’t compensate and, in fact, accelerates bone loss.
But there may be a solution: bone grafting. With this procedure we place a donor bone graft into the area of bone deficiency some time before implant surgery. The graft serves as a scaffold for new bone cells to grow upon. Hopefully, this will produce enough healthy bone to support an implant. If the bone deficiency is minor, we may place the implant and the bone graft at the same time.
If you have experienced bone loss, we must first determine the amount of bone at the missing tooth site and whether grafting is a viable option. Bone grafting postpones your implant, but the delay will be worth the wait if we’re successful. With increased bone volume you’ll be able to obtain a new tooth that’s superior to your current restoration.