Periodontal (gum) disease is a serious matter. Not only can it wreak havoc with your gums, it could also cause bone loss in the jaw that supports your teeth.
Gum disease is a bacterial infection that originates from a thin film of food particles on tooth surfaces called plaque. If you're not diligent about removing plaque through daily brushing and flossing, it can become a feeding ground for certain strains of bacteria that trigger gum infections. Left untreated, the disease can advance deeply into the teeth's supporting structures.
We're particularly concerned about furcations, the specific locations where multiple roots of a tooth fork or separate. When these locations become infected we call it a furcation involvement or invasion. The bone along the furcation will begin to deteriorate and dissolve, following a progression of stages (or classes) we can measure by probing the gum tissue or through x-ray evaluation:
- Class I: the furcation feels like a groove, but without any noticeable bone loss;
- Class II: a depression of about two or more millimeters develops indicating definite bone loss;
- Class III: Â bone loss now extends from one side of the root to the other, also known as “through and through.”
Treating furcation involvements can prove challenging because the infection is usually well below the gum line (sub-gingival). As with all gum disease treatment, our primary approach is to remove all plaque and calculus (hardened plaque deposits) where we find it, including around the roots. We typically use specially shaped instruments to clean the root surfaces. We can also employ an ultrasonic device that loosens plaque and calculus with high-frequency vibrations and flushed away with water.
Sometimes, we may need to surgically access involved furcations to clean them and stimulate bone growth with grafting. We can also use surgery to make the areas easier to clean — both for you and for us during your regular office cleanings — to prevent reoccurrences of infection.
Of course, preventing gum disease in the first place is your best defense against oral problems like furcation bone loss. Be sure you brush and floss every day, and visit us for thorough cleanings at least twice a year (unless we recommend more). This will help make sure not only your gums, but the bone that supports your teeth stays healthy.
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 “What are Furcations?”
You might see your teeth and gums as separate parts of your mouth. But we dentists see them as a unified biological system, each of them contributing to your mouth's various functions: eating, speaking and, of course, smiling.
The teeth-gum-mouth relationship is also a factor when things aren't going well. Tooth decay, for example, doesn't suddenly appear — conditions have to be present in the mouth to cause it. The same can be said for periodontal (gum) disease or bite problems.
So the best approach in dental care is to consider the whole — to first learn all we can about your mouth. We need to understand not only your current problems but also your health history and the unique features of your mouth. With this deeper understanding we can formulate a long-term plan that addresses all your individual needs.
We specifically want to identify your individual oral health risks, from your genetic makeup to any past problems with dental disease or the bite. We then want to assess your current state of health: do you have any presence of dental disease? Is any past dental work failing or in need of updating? Are there any biomechanical issues with the bite or bone loss that need to be addressed?
With this more complete picture, we can then prioritize your care and treatment. Some things like gum disease require immediate attention. Other areas such as bite problems or cosmetic issues may require planning and time to fully address. Our aim, though, is to eventually bring you to as high a level of health as your individual situation will permit.
Once we've achieved an acceptable level of health, our aim is to then maintain that level. This includes monitoring for changes in your oral health and intervening when necessary.
As you can see, establishing a care strategy is only the beginning — and care will always be ongoing. In fact, we'll need to modify your care as new issues arise or you experience the effects of aging. Our end goal, however, always remains the same — to help you achieve and keep the most healthy and attractive mouth possible.
If you would like more information on getting the most from your dental care, 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 “Successful Dental Treatment: Getting the Best Possible Results.”
They seemingly pop up out of the blue inside your mouth: tiny sores that are sometimes painful — and always annoying. Then, in about a week to ten days these small, irritating lesions are gone.
They're known as canker sores: the most common break out in the linings of the mouth, including the cheeks, lips, under the tongue or even the back of the throat. Medically known as aphthous ulcers, you'll recognize these round lesions by their yellow-gray center surrounded by a red “halo.”
You might feel a tingling sensation a couple of days before an outbreak. Once they appear they usually last a week to ten days; during that time they can cause discomfort especially while eating or drinking.
We don't know fully what causes canker sores, but it's believed they're related to abnormalities in the immune system, the processes in the body that fight infection and disease. High stress or anxiety and certain acidic or spicy foods like citrus fruit or tomato sauce also seem to trigger them.
Most people experience canker sores that range in intensity from slight discomfort to sometimes severe pain. But about 20-25% of people, mostly women, have an acute form known as recurrent aphthous stomatitis (RAS). Thought to be hereditary, RAS produces clusters of ulcers that are almost always painful, and which come and go on a regular basis.
Our main treatment goal with canker sores is to decrease discomfort while the outbreak runs its course and promote rapid healing. There are over-the-counter ointments that often prove effective. For more resistant symptoms we can also prescribe topical or injectable steroids or other medications.
Canker sores are rarely concerning as a significant health issue. You should, however, take an outbreak seriously if it hasn't healed within two weeks, if the outbreaks seem to be increasing in frequency or severity, or you're never without a sore in your mouth. In these cases, we may need to take a tissue sample of the lesion to biopsy for signs of cancer, pre-cancer or some other skin disease.
More than likely, though, the canker sore will be benign albeit annoying. With effective treatment, though, you can get through the outbreak with only a minimal amount of discomfort.
If you would like more information on treating canker sores, 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 “Mouth Sores.”
Mention “bacteria” and people begin looking for the germicide. The truth is, though, only a few strains cause disease — the rest are benign or even play a beneficial role.
This may shock you, but your body both inside and out is home to around 100 trillion single-celled organisms, exceeding the number of your native cells by 10 to 1. You won't notice them, though: bacteria are so small they only make up 1 to 3% of your total body mass. And each of us has a unique “microbiome” of micro-organisms: they influence a variety of processes like digestion and metabolism, and some even “teach” our immune systems to distinguish between helpful and harmful bacteria.
Of the 10,000 or more species of bacteria that inhabit the body, perhaps the most studied and understood are in the mouth. We even have a database that catalogs the gene sequences of oral bacteria. And what we've learned has enlarged our understanding of dental disease and how to prevent or treat it.
This new knowledge, for example, confirms that many of our modern lifestyle habits adversely affect oral health. For example, researchers have found higher concentrations of Streptococcus mutans, the bacteria most responsible for tooth decay, in current samples of biofilm than in those from preindustrial eras. The culprit seems to be the modern diet rich with carbohydrates like sugar that bacteria eat. Cigarette smoking can also make the mouth friendlier to disease-causing bacteria.
On the bright side, our growing knowledge of oral bacteria is helping us devise better prevention and treatment strategies. One example is the use of antibiotics to reduce the populations of disease-causing oral bacteria.
The broad, traditional approach kills not only malevolent bacteria, but beneficial strains as well. The approach may also be helping bad bacteria become resistant to common antibiotics. A newer approach targets specific bacteria with custom-designed antibiotics that won't kill other bacteria. There's also increased focus on ways to re-balance a person's normal microbiome if it's become skewed.
As we come to understand bacteria better — both good and bad species — these and other dental care efforts will benefit. With our increasing knowledge of these microorganisms that surround us the future looks bright for better oral health.
If you would like more information on the role of bacteria in oral health, 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 “New Research Shows Bacteria Essential to Health.”
From the time they're born, you do everything you can to help your children develop a healthy body. That should include their teeth and gums. It's not over-dramatizing to say that what you do now may set the pattern for a healthy mouth for the rest of their life.
Here, then, are 4 things you should be doing for your children's oral health before they begin school.
Train them to brush and floss. Good hygiene habits have one primary purpose — remove dental plaque, a thin film of bacteria and food particles that builds up on tooth surfaces. Plaque is the number one cause of tooth decay and periodontal (gum) disease, so focus on brushing and later flossing as soon as their first teeth appear in the mouth, gradually training them to perform the tasks themselves. You can also teach them to test their efforts with a rub of the tongue — if it feels smooth and “squeaky,” their teeth are clean!
Keep your own oral bacteria to yourself. Children aren't born with decay-producing bacteria — it's passed on to them through physical contact from parents and caregivers. To limit their exposure to these “bad” bacteria, avoid kissing infants on the lips, don't share eating utensils and don't lick a pacifier to clean it off.
Eat healthy — and watch those sweets. Building up healthy teeth with strong enamel is as important to decay prevention as daily hygiene. Be sure they're getting the nutrients they need through a healthy diet of fresh fruits and vegetables, protein and dairy (and set a good example by eating nutritiously too). Sugar is a prime food source for bacteria that cause tooth decay, so avoid sugary snacks if possible and limit consumption to mealtimes.
Wean them off pacifiers and thumb sucking. It's quite normal for children to suck pacifiers and their thumbs as infants and young toddlers. It becomes a problem for bite development, though, if these habits continue into later childhood. As a rule of thumb, begin encouraging your children to stop sucking pacifiers or their thumbs by age 3.
If you would like more information on promoting your child's dental health, 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 “Help your Child Develop the Best Habits for Oral Health.”
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