Posts for tag: gum disease
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
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? Branching Tooth Roots can be Periodontal Nightmares.”
Your gums’ primary role is to protect your teeth and keep them firmly in place. But periodontal (gum) disease can damage your gums to such an extent you could ultimately lose your teeth.
Gum disease is a progressive infection caused by bacterial plaque built up on tooth surfaces from poor oral hygiene. The initial infection triggers inflammation, a defensive response of the body characterized by swelling, redness and bleeding of the gums. An initial form of the disease known as gingivitis occurs in most people after just a few days without brushing or flossing.
Resuming hygienic activities to remove daily plaque, along with regular dental cleanings, may be enough to stop gingivitis and restore healthy gums. If the disease is allowed to advance, however, the infected gum tissues will begin to detach from the teeth, turning the slight normal gaps between teeth and gums into wider voids known as periodontal pockets that fill with bacteria leading to infection. Your hygiene efforts will not be enough to cope with this advanced form of periodontal disease.
At this point professional techniques are required to adequately remove plaque and calculus (hardened plaque deposits), depending on the depth and location of the periodontal pockets. The most basic of these is scaling using specialized hand instruments or ultrasonic equipment to remove plaque and calculus in pockets at or just below the gum line. If plaque and calculus have extended to the roots we may then need to employ root planing, in which we “shave” offending material from root surfaces. In some cases this may require accessing the area surgically beneath the gum tissue.
As plaque removal progresses, inflammation will begin to subside and the gum tissues heal. If, however, swelling, bleeding or pus formation persists, this may indicate bacterial levels remain too high. To decrease these levels we may need to administer antibiotics, or through mouthrinses containing chlorhexidine.
Once under control, it’s crucial from then on for you to maintain a strict daily regimen of brushing and flossing to keep plaque from building up on tooth surfaces. You'll also need to visit us regularly (two or more times a year) for professional cleaning and checkups. Keeping a close eye will help prevent a reoccurrence of this serious disease and prolong the life of your teeth.
If you would like more information on treating periodontal (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 “Treating Difficult Areas of Periodontal Disease.”
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
Archeologists can tell us quite a bit about our primitive ancestors. For example, because of their coarse, abrasive diet and a primitive understanding of oral hygiene, their teeth had a rough go of it. They simply wore out faster — a contributing factor, no doubt, to their short life spans of thirty or forty years.
But thanks to improvements in lifestyle, healthcare and diet, people live much longer today. And so do their teeth, thanks to advances in dental care and disease prevention. While teeth still wear to some degree as we age, if we care for them properly with daily oral hygiene and regular dental visits, we can keep that wear to a minimum. Teeth truly can last a lifetime.
Unfortunately, it's still all too common for people to lose their teeth prematurely. The main reason: the two most prevalent dental diseases, tooth decay and periodontal (gum) disease. Tooth decay arises from high concentrations of mouth acid that erode enamel, teeth's irreplaceable protective shell. Gum disease is an infection that damages the bone supporting tissues as it infiltrates deep below the visible gum line.
While they occur by different mechanisms, the two diseases have some commonalities. They both, of course, can lead to tooth loss. And, they're both triggered by oral bacteria found in dental plaque, a thin film of food particles built up on tooth and gum surfaces. Multiplying bacteria feed on plaque and produce acid as a by-product. And certain bacterial strains infect gum tissues.
Both of these diseases can be treated successfully, especially if detected early. But the better approach is to prevent them in the first place. This introduces another commonality — they share the same prevention strategy of daily, comprehensive brushing and flossing for plaque removal, regular dental cleanings and checkups, and a sharp eye for any signs of disease like bleeding gums or tooth pain.
With diligent dental care and close attention to your oral health, you increase your chances of avoiding the full threat of these diseases.Â And with healthy teeth, you have a better chance of living a long and healthy life.
If you would like more information on minimizing tooth wear, 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 and Why Teeth Wear.”
Many people learn they have periodontal (gum) disease after noticing gum swelling, soreness or bleeding. But what you can see or feel may be only the tip of the iceberg — the damage may extend much deeper.
Gum disease is caused mainly by dental plaque, a thin film of bacteria and food particles built up on teeth due to ineffective brushing and flossing. Infection of the visible gums is only the beginning — left untreated, it can advance well below the gum line and even infect supporting bone.
One critical concern in this regard is the areas where the roots of a tooth separate from each other, known as furcations. Here an infection known as a furcation invasion can cause the bone to weaken and dissolve.
This usually occurs in stages (or classes) we can detect through manual probing and/or with x-rays. In the earliest stage, Class I, we might only notice a slight pocket in the gums with no significant bone loss. In Class II, though, the pocket between the roots has become a horizontal opening of two or more millimeters, indicating definite bone loss with increased pocket depth getting “under” the crown of the tooth. Class III, the last and most serious stage, describes an opening we can probe under the crown all the way to the other side of the tooth; the bone loss now extends “through and through” the furcation.
The basic goal of gum disease treatment is to remove plaque and calculus (tartar) from all tooth and gum surfaces. But removing plaque below the gum line, especially “into” the furcations, can be challenging. We will need instruments called scalers to clean root surfaces, assisted sometimes by ultrasonic equipment to vibrate plaque loose. With furcations we may also need to employ surgery to aid gum or bone tissue regeneration or to make the area easier to access for future cleaning.
Of course, the best way to protect against furcation invasions is to prevent gum disease in the first place. Be sure to brush and floss daily and visit us for thorough dental cleanings and checkups at least every six months.
And don’t delay contacting us if you see any signs of teeth or gum problems. The sooner we can identify gum disease, the more likely we’ll be able to prevent it from doing serious damage to your gums, bone and teeth.
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?”