Posts for tag: gum disease
In the fight against dental disease and other conditions your general dentist is your first line of defense for prevention strategies and treatment. Sometimes, however, your condition may require the services of a dental specialist to restore health to your mouth.
A good example of this is an advanced case of periodontal (gum) disease. While your dentist and hygienist are quite skilled at removing plaque and calculus, there may be extenuating circumstances that may benefit from the knowledge and expertise of a specialist. In the case of gum-related issues that would be a periodontist, a dentist who specializes in the diagnosis and treatment of diseases or disorders related to the gums and bone that support teeth.
There are a number of reasons why you may be referred to a periodontist regarding your gum health. Besides advanced stages of the disease (loose teeth, periodontal pocketing or bone loss) that require surgery or other invasive techniques you may have a particular form that requires advanced treatment, or a secondary condition, like pregnancy or diabetes, which could impact your periodontal condition. There may also be a need for a periodontist’s consultation if you’re preparing for cosmetic restoration, most notably dental implants, that could have a bearing on your gum and bone health.
As your primary oral health “gatekeeper,” your general dentist is largely responsible for determining what you need to achieve optimal health. Likewise, your periodontist or other specialists for other problems will be equally committed to providing you the right care for your situation. Your general dentist and other specialists will work together to ensure that your condition will be cared for, and that you’ll continue to enjoy the highest level of oral health possible.
If you would like more information on the role of periodontics and other dental specialties 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 “Referral to a Dental Specialist.”
We’re all susceptible to gum disease when we fail to practice effective daily brushing and flossing. But you may have a greater risk of gum disease (and more severe forms of it) if any of the following categories pertain to you:
Aging. Gum disease risk naturally increases with age. We can lower the risk with an effective daily hygiene regimen, along with a minimum of two office cleanings and checkups each year. Brushing and flossing removes bacterial plaque and food particles which accumulate on tooth surfaces. The longer plaque remains in contact with gum tissues, the greater the chances of infection.
Pregnancy. Although women tend to take better care of their teeth than men, they still face unique issues that increase their risk. During pregnancy, for example, certain hormone levels rise, which cause the gums to become more responsive to bacteria. Other hormonal fluctuations throughout a woman’s life, including taking certain drugs for birth control or during menopause, can cause similar situations.
Family History. You could be at higher risk if members of your immediate family have a history of gum disease. Researchers estimate that 30% of the U.S. population has a genetic predisposition to the disease; it’s also possible for family members to transfer bacteria to other family members by way of saliva contact or shared eating utensils.
Smoking. Nicotine, the active ingredient in tobacco smoke, causes changes in the blood vessels of the mouth that could inhibit the flow of antibodies (produced by the body to fight infection) in the bloodstream. As a result, smokers experience more rapid disease development and greater detachment between teeth and gums than non-smokers.
Other Inflammatory Conditions. A number of studies indicate people with other inflammatory conditions like heart disease, arthritis or diabetes have a higher risk for gum disease. Some researchers have even suggested that bacteria associated with gum disease pass into the blood stream and threaten other parts of the body — an added incentive to seek treatment and stop the disease’s advancement.
If you fall into any of these risk categories, it’s even more urgent that you practice effective daily hygiene with regular office checkups. Additionally, if you begin to notice bleeding gums, tenderness and swelling, or loose teeth, contact us as soon as possible for an evaluation.
If you would like more information on the diagnosis and treatment of 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 “Assessing Risk for Gum Disease.”
Surgical treatment for periodontal (gum) disease can go a long way toward restoring your mouth to good health; however, it does not change your susceptibility to the disease. That’s why we recommend that you come in regularly for periodontal cleanings after your treatment. Here are some frequently asked questions about keeping your mouth healthy after gum disease treatment.
How often do I have to come in for periodontal cleanings?
There’s no “one-size-fits-all” answer to that question: It really depends on your individual situation. For example, some individuals may have a more aggressive form of periodontal disease that requires more frequent periodontal maintenance (PM) treatments to maintain control. Others may have greater success controlling the buildup of disease-causing plaque with at-home oral hygiene measures, and therefore need PM less often. However, for people with a history of periodontal disease, getting PM treatments at a three-month interval may be a good starting point.
What happens at a periodontal maintenance appointment?
A thorough cleaning of the crown and root surfaces of the teeth, aimed at removing sticky plaque and hardened dental calculus (tartar), is a big part of PM treatments — but there’s much more. You’ll also receive a thorough clinical examination (including oral cancer screening), a review of your medical history, and x-rays or other diagnostic tests if needed. The status of any ongoing periodontal disease will be carefully monitored, as will your success at maintaining good oral hygiene. Decisions about further treatment will be based on the results of this examination.
What else can I do to keep gum disease at bay?
Keeping your oral hygiene in top-notch condition — which includes effective brushing and flossing every day — can go a long way toward controlling gum disease.Â In addition, you can reduce risk factors by quitting tobacco use and eating a more balanced diet. And since inflammatory conditions like diabetes, arthritis and cardiovascular disease can make periodontal disease worse (and vice versa), keeping these conditions under control will greatly benefit both your oral health and your overall health.
Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.
One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.
It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.
We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).
Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.
Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.
If you have periodontal (gum) disease, you’ve no doubt experienced red and swollen gums. If, however, you notice an especially inflamed area next to a tooth, you may have developed a gum abscess.
An abscess is a pus-filled sac that develops as a result of chronic (long-standing) gum disease, an infection caused by bacterial plaque that’s built up on tooth surfaces from inadequate oral hygiene or from a foreign body (food debris) getting stuck below the gums. The abscess, which typically develops between the tooth and gums, may be accompanied by pain but not always (the affected tooth may also be tender to bite on). Abscesses may grow larger, precipitated by stress or by a general infection like a common cold, and then abate for a time.
As with other abscesses in the body, a gum abscess is treated by relieving the pressure (after numbing the area with local anesthesia) and allowing it to drain. This is often followed by cleaning any infected root surfaces of bacterial plaque and then irrigating the area with a saline and/or antibacterial solution. We may also prescribe antibiotics afterward and some form of pain control (usually a non-steroidal anti-inflammatory drug like ibuprofen) to help with discomfort.
Although the results of this procedure can be dramatic, it’s just the first step in treating the overall gum disease. After a few days of healing, we continue with a complete examination and recommend further treatment, usually starting with removing bacterial plaque and calculus (hardened plaque deposits), the underlying cause for the infection and inflammation, from all tooth and gum surfaces. This may take several sessions before we begin seeing the gum tissues return to a healthier state.
The key to preventing an abscess recurrence (or any symptom of gum disease) is to remove plaque everyday through proper brushing and flossing, and visiting us twice a year (or more if you’ve developed chronic gum disease) for cleanings and checkups. Doing so will raise your chances of avoiding an uncomfortable and often painful gum abscess in the future.
If you would like more information on gum abscesses, 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 (Gum) Abscesses.”