Posts for tag: gum disease

PeriodontalSurgerymaybeNeededtoHaltGumDiseaseandEncourageHealing

There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.

As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.

Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.

There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.

Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.

If you would like more information on surgical procedures for 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 Surgery: Where Art Meets Science.”

By Arnold Cutler, D.D.S.
March 24, 2020
Category: Dental Procedures
DontLetGumDiseaseCutShortYourImplantsServiceLife

Among dental restorations, implants are the closest prosthetic we have to real teeth. They not only replace the visible crown, but the titanium post imbedded in the jawbone adequately substitutes for the tooth root. Because of their unique design, implants are not only life-like, they’re highly durable and could potentially last for decades.

But while their success rate is remarkably high (more than 95% exceed the ten-year mark), they can fail. Ironically, one possible cause for implant failure is periodontal (gum) disease. Although an implant’s materials are themselves impervious to disease, the tissues and underlying bone that support the implant aren’t. If these natural tissues become infected, the secure hold the implant has can weaken and fail.

A gum infection usually begins with dental plaque, a thin biofilm of bacteria and food particles that builds up on tooth surfaces. Certain strains of bacteria within plaque can infect the gums. One particular form of the disease known as peri-implantitis starts as an initial infection and ensuing inflammation of gum tissues around an implant. The disease can quickly spread down to the bone and destroy the integration between the bone and the implant that helps keep the implant in place.

That’s why it’s important for you to keep the implant and the tissues around it clean of plaque, just as you would the rest of your natural teeth. This requires daily brushing and flossing around the implant and other teeth, and visiting your dentist regularly for more thorough dental cleanings.

You should also be alert to any signs of disease, especially around implants: gum redness, swelling, bleeding or pus formation. Because of the rapidity with which peri-implantitis can spread, you should see your dentist as soon as possible if you notice any of these signs.

Preventing gum disease, and treating it promptly if it occurs, is a key part of implant longevity. Preserving your overall dental health will help make sure your implant doesn’t become a loss statistic.

If you would like more information on caring for your dental implants, please contact us or schedule an appointment for a consultation.

By Arnold Cutler, D.D.S.
February 08, 2019
Category: Dental Procedures
3Age-RelatedDentalProblemsandwhatyoucandoAboutThem

Like other aspects of our lives, aging can take a toll on our smile. Over a lifetime the effects of disease, teeth wearing and the foods we eat can cause our teeth and gums to look unattractive.

Here are 3 of the most common age-related dental problems and how we can help you "turn back the clock" on each one.

Discoloration. Teeth can dull and grow darker over time. And not just from what we eat or drink—age-related structural changes in the tooth can also cause discoloration. We can often alleviate external staining temporarily with teeth whitening. If the staining is heavy or it originates inside the tooth, then we can install life-like porcelain veneers or crowns to cover the discoloration. We can also use composite dental materials to alter the color of one darkened tooth so that it doesn't stand out from the rest of your teeth.

Wearing. Our teeth naturally wear down over time. If the wearing is excessive, though, teeth can look shorter and less youthful. Again, we can use veneers or crowns to change a tooth's outward appearance and make them look longer. We can also employ enamel contouring and reshaping that smoothes out sharper edges caused by wearing to give your teeth a softer, more youthful look.

Receding gums. On the other end of the spectrum, gums that have shrunk back or receded from the teeth can make them look much larger and unattractive. Our first step is to treat any gum disease present—the most common cause of recession—which often helps the tissues to regenerate. If your case is more advanced, though, you may also need grafting surgery to restore lost gum tissue. Using in-depth microsurgical techniques, surgeons attach grafted gum tissue at the recession site. Over time new tissue will grow, restoring adequate gum coverage.

You can also improve your appearance at any age with orthodontics. Besides a more attractive smile, properly aligned teeth tend to wear more slowly and evenly. This and proper daily oral hygiene and regular dental care can keep your teeth looking younger even in your later years.

If you would like more information on gaining a more youthful smile, 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 Your Dentist can help you Look Younger.”

By Arnold Cutler, D.D.S.
November 30, 2018
Category: Dental Procedures
LasersCouldbetheFutureforGumDiseaseTreatment

We’ve developed a number of effective treatments for periodontal (gum) disease. Depending on how far and deep a patient’s infection has advanced, treatment can be quite invasive and even require surgery. The more invasive, the longer and more uncomfortable the healing process can be.

But using a medical laser could make that less so. Although its use for gum disease treatment is still in its infancy, the latest observations from the field seem to show patients undergoing laser treatment may have less tissue trauma and bleeding, less discomfort after the procedure and quicker healing times.

Gum disease is a bacterial infection mostly caused by dental plaque, a thin film of food particles that build up on teeth in the absence of effective oral hygiene. The infection can advance deep below the gum line, weakening gum attachment to teeth and destroying supporting bone. Ultimately the affected teeth can be lost.

Traditionally, the only way to stop the disease is to manually remove plaque buildup on teeth and gum surfaces, which is continuing to sustain the infection, with special hand instruments called scalers or ultrasonic equipment. Because it’s important to remove as much plaque and diseased tissue as possible, we may need to perform a surgical procedure called flap surgery to move some of the gum tissues out of the way to get to these deeper areas. As with any surgery, this can create tissue trauma that may cause discomfort during the healing process.

Our new alternative is to use an Nd:YAG medical laser in a procedure known as Laser Assisted New Attachment Procedure or LANAP. With light energy delivered through a small fiber no more than the width of three human hairs, the laser can pinpoint diseased tissue and destroy bacteria through intense heat. Because of the laser beam’s tiny width and pulsing action, healthy tissue is at less risk for trauma than with the traditional treatment.

Coupled with other techniques, LANAP procedures could remove as much infected tissue and plaque as traditional methods, but with less healthy tissue trauma. In the future, then, patients with advanced gum disease undergoing laser treatment could have less bleeding and discomfort and faster healing times.

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 “Treating Gum Disease with Lasers.”

By Arnold Cutler, D.D.S.
September 21, 2018
Category: Oral Health
Tags: gum disease   oral hygiene  
StopGumDiseaseBeforeitGetsStartedwithDailyOralHygiene

While tooth decay seems to get most of the “media attention,” there’s another oral infection just as common and destructive: periodontal (gum) disease. In fact, nearly half of adults over 30 have some form of it.

And like tooth decay, it begins with bacteria: while most are benign or even beneficial, a few strains of these micro-organisms can cause gum disease. They thrive and multiply in a thin, sticky film of food particles on tooth surfaces called plaque. Though not always apparent early on, you may notice symptoms like swollen, reddened or bleeding gums.

The real threat, though, is that untreated gum disease will advance deeper below the gum line, infecting the connective gum tissues, tooth roots and supporting bone. If it’s not stopped, affected teeth can lose support from these structures and become loose or out of position. Ultimately, you could lose them.

We can stop this disease by removing accumulated plaque and calculus (calcified plaque, also known as tartar) from the teeth, which continues to feed the infection. To reach plaque deposits deep below the gum line, we may need to surgically access them through the gums. Even without surgery, it may still take several cleaning sessions to remove all of the plaque and calculus found.

These treatments are effective for stopping gum disease and allowing the gums to heal. But there’s a better way: preventing gum disease before it begins through daily oral hygiene. In most cases, plaque builds up due to a lack of brushing and flossing. It takes only a few days without practicing these important hygiene tasks for early gingivitis to set in.

You should also visit the dentist at least twice a year for professional cleanings and checkups. A dental cleaning removes plaque and calculus from difficult to reach places. Your dentist also uses the visit to evaluate how well you’re doing with your hygiene efforts, and offer advice on how you can improve.

Like tooth decay, gum disease can rob you of your dental health. But it can be stopped—both you and your dentist can keep this infection from ruining your smile.

If you would like more information on preventing and treating gum disease, please contact us or schedule an appointment for a consultation.



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