Posts for: April, 2015
At some point in every person's life, they will experience bleeding gums or gingivitis, a mild inflammation of the gingiva (gums), which is the first stage of periodontal (gum) disease. For example, when was the last time you were brushing or flossing your teeth and noticed that your gums were bleeding or that when you spit and rinsed there was some blood? When this occurs, it is a sign that you have gum disease, as healthy gum tissues do not bleed. And no, it is highly unlikely that your bleeding is from brushing too hard. You would have to use extreme force to make healthy gum tissues bleed. However, this is exactly how most people discount or ignore this warning sign.
If this sounds like you or another member of your family, here's what you can expect when you see us for treatment. Depending on the severity of your periodontal disease, all of these treatment options may not be necessary.
Behavior change: We will collect a thorough medical history to obtain facts about your oral hygiene, eating and other personal habits such as alcohol and tobacco use to determine their impact on your periodontal disease. Proper brushing and flossing techniques are necessary for everyone, whether you have early or late stage gum disease; however, you must commit to a good daily oral health routine if you want to achieve success and thus keep you mouth and teeth healthy.
Calculus (tartar) removal: Cleaning is not just your responsibility. We'll clean and polish your teeth to remove calculus (tartar), the calcified deposits of bacterial products that become glued to the teeth and roots that you canÃ¢Â€Â™t remove. In fact, routine visits to see us for a thorough cleaning will help ensure that all the unhealthy calculus (tartar) is removed from your teeth.
Evaluation: Usually after three or four weeks, we will want to see you to evaluate your progress and to see the response of your gingival tissues to the treatment thus far. And depending on the severity of your gum disease, we may need another follow-up exam to decide the best maintenance and monitoring regimen necessary to keep your mouth healthy.
Occlusal or Bite Therapy: This treatment, if necessary, usually occurs once your gum tissues have been stabilized and the inflammation and infection have been controlled. It is during this phase that we will address loose teeth or teeth that have shifted or drifted in position.
Surgical Therapy: For more severe cases of gum disease, you may need periodontal plastic surgery to repair and regenerate gum and bone tissue and their attachment to the teeth. It may also be necessary to replace missing teeth with dental implants.
If you are ready to talk to us about the current state of your mouth (or the mouth of another member of your family), contact us today to schedule an appointment. The first step towards achieving optimal oral health could start with this simple call. Or, you can learn more by reading, “Understanding Gum Disease.”
Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.
“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”
That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.
Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!
The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.
If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”
Since boxers first began using them a century ago, athletic mouthguards are now standard safety equipment for most contact sports. Without them, dental injuries would skyrocket.
But a recent study in the peer-reviewed journal, General Dentistry, indicates there’s another important reason to wear a mouthguard for contact sports or exercise: you may be able to significantly reduce your risk for a mild traumatic brain injury (MTBI), better known as a concussion. It’s believed the mouthguard absorbs some of the force generated during contact, resulting in less pressure to the brain. That reduction is even more significant if your mouth-guard has been custom-made by a dentist.
That last finding is important, because not all mouthguards on the market are equal. There are three basic categories of mouthguards — stock, “boil and bite,” and custom. Stock mouthguards come in limited sizes; they’re relatively inexpensive, but they provide the least level of protection. “Boil and bite” can be customized after purchase to the wearer’s bite, but they don’t always provide complete coverage of back teeth. Custom mouthguards are designed and fashioned by a dentist; they’re relatively expensive (running in the hundreds of dollars), but there’s ample evidence they provide the highest level of protection from mouth injuries.
The General Dentistry study also corroborates custom mouthguards’ effectiveness in preventing concussions. The study followed approximately 400 football players from six different high school teams. While all the players wore the same type of helmet, half of them wore custom-made mouthguards and the other half wore stock guards. 8.3% of the athletes wearing stock guards experienced a concussion injury; by contrast only 3.6% of those with custom guards sustained an injury — greater than half fewer occurrences.
The study also highlights the need not to rely solely on helmets or other protective headgear for concussion prevention. It’s important to include mouthguards along with other athletic protective gear to lower injury risk as much as possible.
So when considering how you can provide the optimum injury protection for you or your child, be sure to include an athletic mouthguard, preferably one that’s custom-made. We’ll be happy to advise you further on what you need to know to prevent traumatic dental injuries, as well as concussions.
If you would like more information on custom-fit mouthguards, 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 “Mouthguards.”
We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).
The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.
What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.
Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.
There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.
If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”