Posts for: September, 2014

By Dentistry For Children & Adults
September 29, 2014
Category: Oral Health
Tags: gum disease   loose teeth  
DeterminingtheCauseofToothLoosenessKeytoEffectiveTreatment

A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.

Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.

Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.

Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.

In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.

If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.

If you would like more information on 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 “Loose Teeth.”


By Dentistry For Children & Adults
September 26, 2014
Category: Oral Health
AWake-UpCallinMajorLeagueBaseball

What would it take to get you to give up tobacco? For major league baseball player Addison Reed, it took the death of his former coach, Tony Gwynn. Gwynn, a Hall-of-Famer who played for the San Diego Padres in addition to coaching at San Diego State, was just 54 years old when he died of oral cancer. As soon as Reed heard the sad news, the Arizona Diamondbacks’ relief pitcher says he knew what he needed to do: He took every can of smokeless tobacco he owned and dumped them all in the trash.

“It’s just become a habit, a really bad habit,” Reed told an interviewer at MLB.com. “It was something I always told myself I would quit.” But quitting took him many years — in fact, Reed admitted that he first started using smokeless tobacco as a junior in high school.

People begin using tobacco — in the form of cigarettes, cigars, pipes, or smokeless types (snuff, chewing tobacco, or dip) — for a variety of reasons. One major draw is that they see others doing it. And, while smoking is prohibited in most all Major League venues, the use of smokeless tobacco has remained fairly widespread.

Smokeless tobacco isn’t a safe alternative to cigarettes. According to the National Cancer Institute, it contains 28 carcinogenic agents. It increases the risk not only for oral and pancreatic cancer, but also for heart disease, gum disease, and many other oral problems. It’s also addictive, containing anywhere from 3.4 to 39.7 milligrams of nicotine per gram of tobacco — and its use has been on the rise among young adults.

But now the tide may be turning. After Addison Reed’s announcement, his former college teammate Stephen Strasburg (now a pitcher for the Washington Nationals) resolved that he, too, would give up tobacco. “[The] bottom line is, I want to be around for my family,” said Strasburg. Mets left-hander Josh Edgin has vowed to try quitting as well. It’s even possible that Major League Baseball will further restrict the use of smokeless tobacco at games.

What does this mean for you? It may just be the opportunity you’ve been waiting for… to stop using tobacco. Dentists have seen how quickly oral cancer can do its devastating work — and we can help you when you’re ready to quit. The next time you come in for a checkup, ask us how. Your teeth and gums will thank you — and your family will too.


By Dentistry For Children & Adults
September 18, 2014
Category: Oral Health
Tags: gum disease  
RemovingBacterialPlaqueisCriticaltoHaltingAdvancingGumDisease

Treating periodontal (gum) disease is rather straightforward: remove the bacterial plaque that causes the disease. The techniques to accomplish this are varied, depending on how far the disease has advanced with an individual patient.

Plaque is a thin film of bacteria and food particles that build up on tooth surfaces due to inadequate oral hygiene. The bacteria that grow there can cause an infection that inflames and damages the gum and supporting bone tissues to the point they begin to lose their attachment to the teeth and form spaces known as periodontal pockets. In time, plaque becomes calcified due to the minerals in saliva, forming calculus or tartar. As the disease advances, it can ultimately cause tooth loss.

The most common technique for interrupting this progression of disease is known as scaling. Using hand instruments and/or an ultrasonic device, we remove as much plaque and calculus as we can detect on the outer surfaces of the teeth and gum tissues. Scaling, however, won’t address the plaque and calculus that has accumulated at the tooth root level, especially where pocket formation has taken place. This is where root planing may be necessary.

As the name implies, we use this procedure to literally “plane” plaque and calculus from the roots, a similar concept to removing thin layers of wood from a board. If necessary, we will first numb the affected area so that we can perform the procedure in a meticulous manner without causing discomfort. It’s essential we remove every bit of plaque and calculus that we can, especially where it has become lodged deep at the base of the pockets.

It’s common to start with ultrasonic therapy, using vibration to loosen the plaque while flushing the pockets with water. We then switch to delicate hand instruments known as curettes to physically remove any remaining plaque and calculus. An experienced touch helps us determine when the root surfaces have been properly cleaned; we can also “read the gum tissues,” as they will slightly change color as the offending plaque and calculus deposits are removed. As the gum tissues heal and become less inflamed, they return to a healthy pink color and the pocket depths generally become smaller as the inflammation leaves the area.

While a good portion of the treatment requires our professional skills, equipment and expertise, the bedrock for renewed periodontal health is effective daily oral hygiene on your part. Working together we can preserve the progress already made, while continuing to progress in restoring your oral health.

If you would like more information on root planing and other periodontal disease treatments, 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 “Root Planing.”


By Dentistry For Children & Adults
September 10, 2014
Category: Oral Health
Tags: gum disease  
BeExtraVigilantforSignsofGumDiseaseDuringPregnancy

Periodontal (gum) disease is a bacterial infection that can eventually lead to tooth loss if not treated. The infection typically arises from plaque, a thin film of bacteria and food particles that build up on tooth surfaces every 8-12 hours and not removed due to poor oral hygiene.

There is always an increased risk of gum disease when a person doesn’t practice effective oral hygiene. But there are certain conditions that could also heighten risk: in particular, women who are pregnant (especially during the first trimester) or taking certain types of birth control pills. During pregnancy, female hormones known as estrogens become elevated, causing changes in the gums’ blood vessels. These changes make the tissues fed by these vessels more susceptible to the effects of bacteria. This increased susceptibility even has a term — “pregnancy gingivitis.”

Gum disease during pregnancy can also affect other areas of a woman’s health, as well as the health of her baby. Recent studies have shown a possible link between pre-term low weight babies and mothers with severe gum disease, especially among those with limited dental healthcare. There’s a stronger link, however, between gum disease and diabetes; in fact, diabetes should be checked for in pregnant women who are diagnosed with gum disease.

If you’re pregnant, it’s especially important that you not neglect oral hygiene. Daily brushing and flossing is essential for removing the bacterial plaque that causes gum disease. You should also visit us for regular checkups and cleanings to remove hard to reach plaque and calculus (hardened deposits), as well as to detect any signs of periodontal disease.

You should also be aware of other factors, and take steps to minimize their effect. Smoking can cause greater plaque accumulation as well as adversely affect your immune system, which can inhibit healing in infected tissues. Stress can also affect your immune system, so be sure you’re getting enough rest.

Gum disease in any individual has the potential to cause great damage to teeth and gums. If you notice any abnormalities, particularly bleeding or swelling gums, you should see us as soon as possible for proper diagnosis. In the case of gum disease, the sooner treatment begins the better the chances of protecting both your health and your baby’s.

If you would like more information on periodontal disease and pregnancy, 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 “Pregnancy & Birth Control.”


By Dentistry For Children & Adults
September 02, 2014
Category: Oral Health
SavingaBabyToothistheBestOptionforPermanentToothDevelopment

Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.

Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.

Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.

There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.

If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.

In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.

If you would like more information on the importance of baby teeth, please contact us or schedule an appointment for a consultation.