Preserving Baby Teeth Crucial to Future Dental Health

It's easy to view your child's primary ("baby") teeth as less important than the permanent teeth replacing them. They're temporary - the last of them will give way around ages 10 to 13 - so why go to extraordinary lengths to save them if they're decayed?

Although relatively short in life, primary teeth are indeed important. They, of course, provide young children a means to speak and eat. But they're also pivotal to your child's mouth and facial development. A primary tooth lost early can lead to adverse effects in the permanent teeth and bite later.

A primary tooth holds open the space in the jaw for the permanent tooth as it develops below the gums. When it's ready to come in, the roots of the primary tooth dissolves (resorbs), allowing it to be lost. If they are lost too early, though, it can disrupt this spacing, especially for a back tooth. If this happens, adjacent teeth can move or "drift" naturally into the open space, greatly increasing the chances of a bad bite (malocclusion). The permanent tooth may then come in the wrong position or perhaps not at all, setting up the need for costly future orthodontic treatment.

That's why it's better to save the tooth if we can, even employing a modified root canal treatment for deep decay if necessary. If, however, the primary tooth is lost prematurely due to disease or trauma, we can still attempt to preserve the space left behind. One way is to install a "space maintainer," a metal orthodontic device that prevents adjacent teeth from moving into the space. This will still require constant monitoring and extra care to prevent the device from dislodging.

The best strategy for preserving primary teeth is, of course, prevention. By establishing daily brushing when the first teeth appear in the mouth, coupled with regular dental cleanings and checkups twice a year and a diet low in sugar-added foods, you can reduce the risk of dental disease. Further prevention with sealants or topical fluoride can also strengthen young teeth.

Keeping primary teeth healthy will help ensure they'll continue until they've served their purpose. In the end they'll set the stage for a lifetime of healthy teeth.

If you would like more information on caring for your child's primary teeth, please visit our website at www.myparkdental.com, or contact us here, or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Importance of Baby Teeth."

Smoking Increases Your Risk for Dental Implant Failure

There are definite links between smoking tobacco and several major health problems. While we're all familiar with its relationship to cancer or heart disease, smoking can also adversely affect your dental health, particularly the long-term survival of dental implants.

Smoking can affect your mouth in two ways: first, the inhaled smoke can slowly "cook" gum tissue to form a thickened top layer of cells and damage salivary glands, which reduces saliva flow causing mouth dryness. Second, the nicotine in tobacco may cause the mouth's blood vessels to constrict and inhibit blood flow, which can weaken the body's defenses and healing ability.

Put all these outcomes together and you increase your risk of periodontal (gum) disease that can cause the loss of supporting gum tissue and bone. Bone loss especially can have an adverse effect on implant stability, which relies on adequate bone for anchorage.

Slower mouth healing caused by smoking also lowers the chances of a successful outcome to implant surgery. Over time, bone in the jaw grows and attaches to the imbedded titanium implant, which will increase the implant's strength and durability. With a weakened healing mechanism, however, this process known as osseo-integration may fail to develop fully. As a result, the implant won't be as strong and stable as it could be and may fail when it encounters normal biting forces.

This scenario is borne out in a number of research studies. Although dental implants have a very high success rate, about 5% fail. Twice as many of those failures occurred in smokers compared to non-smokers. Although an implant isn't destined to fail if you're a smoker, your risks are much higher.

You can reduce that risk by trying to quit smoking a few weeks before implant surgery, or at the very least try not smoking a week before and two weeks after the procedure, and follow good oral hygiene practices to prevent gum disease. And, be sure to see us on a regular basis for checkups and implant maintenance.

Dental implants are a highly successful tooth replacement option that can give you decades of service. Don't allow smoking to short-circuit that success.

If you would like more information on the impact of smoking and other lifestyle issues on dental implants, please visit our website at www.myparkdental.com, or contact us here, or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Dental Implants & Smoking."

Aggressive Forms of Gum Disease May Require Invasive Measures

Although aggressive and potentially devastating, periodontal (gum) disease can be brought under control with proven methods. For most patients removing the underlying cause, bacterial plaque built up on tooth surfaces, is enough to restore the gums to good health.

For some patients, though, scaling (manual plaque and calculus (tartar) removal using specialized hand instruments) may not be enough. The disease may have progressed deep below the gum line, to inhabit gaps that have developed between the teeth and gums known as periodontal pockets or in furcations, branching points in teeth with multiple roots. Either of these is difficult if not impossible to reach through scaling - without more invasive techniques these patients' teeth are at a heightened risk for loss.

The infected areas in these cases may require surgical access to clean and disinfect them. One of the more common procedures is gum flap surgery, where the surgeon creates a small opening on three sides of the gum tissue - resembling the "flap" of a letter envelope - to access the roots for disinfection. The procedure can be performed with local anesthesia and the flap closed with self-absorbing sutures.

Antibacterial therapy may also be appropriate for more aggressive forms of bacteria to inhibit re-infection after removing plaque and calculus (hardened plaque deposits). These antibacterial agents, usually tetracycline, are applied topically during treatment or in follow-up cleanings. They can help stop inflammation and promote healing, and can be more effective in penetrating difficult areas than hand instruments.

But one caveat with antibiotics: they will eventually kill good bacteria, and give rise to resistant strains that can make future antibiotic use ineffective. For these reasons, they're best used for short, isolated attacks on aggressive bacteria and not long-term unless absolutely necessary.

Whether you will need a surgical or antibiotic approach will depend on your individual case. Regardless, as soon as we've diagnosed gum disease you should begin appropriate treatment - the sooner we bring this damaging infection under control, the better your chances of bringing your teeth and gums back to good health.

If you would like more information on the causes and treatment of gum disease, please contact us here, 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."

Lasers for Gum Disease Treatment are Just as Effective as Conventional Surgery

When fighting periodontal (gum) disease, it's often necessary to go deep into "enemy" territory - below the gum line - to remove bacterial plaque, a thin film of built up food remnant that fuels the infection. This often requires gum surgery to access these deep areas of infection.

As gum disease advances, the slight natural gap between the gums and teeth can widen to form voids called periodontal pockets that can fill with infection. Pockets that extend more than 4 millimeters below the gum line can't be reached effectively with oral hygiene techniques like brushing and flossing. As the pockets become deeper, even dentists and hygienists have difficulty with conventional hand instruments called scalers to effectively remove plaque and calculus (hardened plaque deposits).

As the pockets deepen, surgical procedures are often needed to reach these areas. That allows the dentist to remove all of the plaque and calculus as well as smoothing the root surface free of contaminants. Then, the gums are placed closer to the bone so that gum tissue pockets are removed and become easier to clean.

Surgical lasers offer a new alternative to scalpel surgery. The laser's narrow beam of light only removes diseased gum tissue without incisions and with minimal disruption of healthy tissue. Because of the color of its light, the laser energy passes through normal gum tissue like sunlight through a glass pane, but heats and vaporizes the much darker diseased cells. Scalers are then used in the open space it creates to remove plaque from the tooth surface.

Besides precisely targeting and destroying diseased tissue, the laser's pulsating energy also limits excessive heat buildup that can also damage healthy tissue. The laser also limits bleeding by cauterizing the area as it passes through. As a result, there's less tissue disruption and damage, less bleeding and no need for suturing afterward.

But is it as effective as the conventional procedure? A number of studies have indicated similar success rates as with conventional surgery. And, patients with laser treatment indicate less pain and discomfort afterward with quicker recovery times.

While this treatment is still new, recent findings are encouraging. Lasers may soon become the standard and with fewer complications for patients dealing with this aggressive and debilitating condition.

If you would like more information on treating gum disease including with lasers, please contact us here, 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."