We all benefit from regular dental care, regardless of our state of oral health. But if you've experienced periodontal (gum) disease, those regular dental visits are even more important in making sure your healed gums stay that way.
Gum disease is a bacterial infection caused by dental plaque, a thin film of bacteria and food particles accumulating on tooth surfaces. The infection triggers inflammation in the gums that quickly becomes chronic. That's why people with gum disease have reddened and swollen gums that bleed easily.
The infection can aggressively spread deeper below the gum line, eventually affecting the bone. The combination of weakened gum detachment from the teeth and bone loss may ultimately cause tooth loss. But we can stop the infection by thoroughly removing all plaque and tartar (hardened plaque) from the teeth and gums. As the plaque is removed, the gums respond and begin to heal.
It's possible then even with advanced gum disease to restore health to your teeth and gums. But although the infection has been arrested, it can occur again. In fact, once you've had gum disease, your susceptibility for another infection is much greater. To stay on top of this, you may need to visit the dentist more frequently.
These upgraded visits known as periodontal maintenance (PM) are actually a continuation of your treatment. Depending on the extensiveness of your gum disease, we may need to see you more than the standard twice-a-year visits: Some periodontal patients, for example, may need a visit every two to three months. Again, the state of your gum health will determine how often.
In addition to standard dental cleanings and checkups, PM visits will also include more thorough examination of the teeth and gums, particularly the health of the tooth roots. We'll also check how well you're doing with daily plaque removal and if there are any signs of gum infection. We may also prescribe medication, rinses or topical antibiotics to help control your mouth's levels of bacteria.
A patient's periodontal “maintenance schedule” will depend on their individual condition and needs. The key, though, is to closely monitor gum health for any indications that another infection has set in. By staying alert through dedicated PM, we can stop a new infection before it harms your dental health.
If you would like more information on 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.”
Despite momentous strides in recent years in the fight against cancer, treatments can still disrupt normal life. Both radiation and chemotherapy have side effects that can cause problems in other areas of health—particularly the teeth and gums.
If you or a loved one are undergoing cancer treatment, it's important to get ahead of any potential side effects it may have on dental health. Here are 4 things that can help protect teeth and gums while undergoing cancer treatment.
Get a preliminary dental exam. Before beginning treatment, patients should have their dentist examine their teeth and gums to establish a baseline for current dental health and to treat any problems that may already exist. However, patients should only undergo dental procedures in which the recovery time can be completed before starting radiation or chemotherapy.
Be meticulous about oral hygiene. Undergoing cancer treatment can increase the risks for developing tooth decay or gum disease. That's why it's important that patients thoroughly brush and floss everyday to reduce bacterial plaque buildup that causes disease. Patients should also reduce sugar in their diets, a prime food source for bacteria, and eat “teeth-friendly” foods filled with minerals like calcium and phosphorous to keep teeth strong.
Keep up regular dental visits. The physical toll that results from cancer treatment often makes it difficult to carry on routine activities. Even so, patients should try to keep up regular dental visits during their treatment. Besides the extra disease prevention offered by dental cleanings, the dentist can also monitor for any changes in oral health and provide treatment if appropriate.
Minimize dry mouth. Undergoing cancer treatment can interfere with saliva production and flow. This can lead to chronic dry mouth and, without the full protection of saliva against dental disease, could increase the risk of tooth decay or gum disease. Patients can minimize dry mouth by drinking more water, using saliva boosters and discussing medication alternatives with their doctor.
It may not be possible to fully avoid harm to your oral health during cancer treatment, and some form of dental restoration may be necessary later. But following these guidelines could minimize the damage and make it easier to regain your dental health afterward.
If you would like more information on dental care during cancer treatment, 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 “Oral Health During Cancer Treatment.”
Dental implants are a reliable way to replace teeth. More than 95% of implants survive ten years after their installation, and many of these could conceivably continue for decades.
But that still leaves a tiny few that don't reach the ten-year mark. Some fail early because the implant didn't integrate fully with the bone to create a durable hold. But others fail later—usually for one of two major causes.
Some failures occur due to over-stressing of the implant from abnormally high biting forces, usually because of teeth grinding. People who have this involuntary habit generate excessive force as they grind their teeth, which can damage implants (as well as natural teeth). To reduce this force, a patient's dentist can fit them with a biteguard they wear in the mouth to prevent teeth from making solid contact with each other during a grinding episode.
Fortunately, teeth grinding isn't that prevalent among adults—but that can't be said about the other major cause for implant failure: periodontal (gum) disease. This is a bacterial infection caused by dental plaque, a thin, bacterial film that accumulates on teeth. The implant itself isn't affected by the infection, but the gums and underlying bone supporting the implant can be.
Implants are most in peril from a form of gum disease called Peri-implantitis, which spreads deeper into the gum tissues around implants faster than infections around natural teeth. That's because implants lack the gum attachment of real teeth, which supply a collagen barrier that slows the spread of infection. Peri-implantitis can quickly infect the supporting bone and eventually weaken its connection with the implant.
Because of its aggressiveness and speed, we must diagnose and treat peri-implantitis as soon as possible to limit any damage to the support structures around an implant. If you notice any swollen, reddened or bleeding gums, you should call your dentist as soon as possible for an examination.
And in light of this potential danger to your implants, you should also strive to prevent gum disease through daily oral hygiene. Brushing and flossing your teeth, including around your implants, removes harmful plaque buildup. This daily habit and regular dental cleanings will help you avoid a costly gum infection and ensure your implants are there for years to come.
If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method That Rarely Fails.”
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Daily oral hygiene and regular dental cleanings help keep your natural teeth and gums healthy and disease-free. But they're also a priority with dental implants. Here's why.
Unlike other restorations, an implant replaces both a tooth's crown and root, the latter by way of a titanium metal post imbedded into the jawbone. Bone cells grow and adhere to the metal surface, forming a secure and lasting hold.
But although quite durable, this hold differs significantly from natural teeth, which are actually held in place by a tough, elastic tissue called the periodontal ligament. The attachment of the ligament's tiny fibers to both tooth and bone secure the tooth in place, as well as supply it and the surrounding gums with nutrients and defensive antibodies to fight infection.
Implants don't have this relationship with the periodontal ligament. The tissues around an implant are thus susceptible to an aggressive form of periodontal (gum) disease called peri-implantitis. This kind of gum infection can progress rapidly, leading eventually to bone loss and possible failure of the implant.
Daily brushing and flossing of both natural and implant-supported teeth lowers the risk of gum disease, particularly peri-implantitis. It's also imperative that you undergo regular cleanings, at least every six months, with your dentist or dental hygienist.
These, however, won't be the typical cleanings performed on natural teeth. Hygienists don't use metal cleaning implements to remove plaque and tartar deposits because they can scratch the metal materials of the implant and crown. These microscopic scratches can then attract bacteria that trigger gum infections. Instead, they'll use instruments made of plastics or resins.
Hygienists also rely heavily on ultrasonic equipment that vibrates plaque loose on or around implants, which are then flushed away with water. The tips used with these instruments are also typically made of nylon or plastic sheathing.
Even with the extra hygiene care needed, implants still enjoy a 95% or higher survival rate after ten years. You can ensure your implants achieve that level of durability by keeping them clean and seeing your dentist at the first sign of a gum infection.
If you would like more information on maintaining dental implants, 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 “Dental Implant Maintenance.”
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