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."

4 Tips for Instilling Good Family Hygiene Habits

Long-term dental health is built on a foundation of good hygiene habits instilled at an early age. Consistent, daily hygiene not only makes for healthy teeth and gums but an attractive smile too.

Here are 4 tips for encouraging your child to develop effective oral hygiene habits.

Begin teaching them to brush and floss on their own around age 6. Brushing and flossing are the primary ways to remove bacterial plaque from teeth, the main cause for dental disease. You should begin brushing your child' teeth when they first appear; around age 6 you can begin encouraging them to brush for themselves and learn to floss.

Promote healthy eating and snacking habits. A nutritious diet is also important for maintaining healthy teeth and gums. Make sure your child is eating a varied, balanced diet of whole foods in appropriate portions. You should limit sugar and other carbohydrates (which accelerate growth of decay-causing bacteria) to mealtimes; offer limited, non-sugary snacks between meals.

Warn older children and teens about practices that are unhealthy for the mouth. As children enter their teen years, they're under increased pressure from peers to try unhealthy practices. Oral piercings like tongue and lip bolts can increase tooth damage - chipping and wear - and gum recession, infection and bone loss. Tobacco use, both smoke and smokeless, can also cause tooth staining, increase the risk of decay, gum disease and oral cancer. Begin stressing the dangers these practices pose to their general and oral health before they reach puberty.

Practice what you teach.  Modeling healthy behavior you want your child to learn is just as important as instructing them how to do it. When they're very young, brushing teeth should be a family affair - allow them to see how you brush your teeth as you help them brush theirs. And, if you're not sure if your hygiene techniques are worthy of emulation, we'll be glad to help you improve your effectiveness to pass on to the next generation.

If you would like more information on developing life-long dental habits with your child, please visit us at www.myparkdental.com. If you would like to send us a message, you can 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 "How to Help Your Child Develop the Best Habits for Oral Health."

Gingivitis Could Become a More Serious Form of Gum Disease

People with poor hygiene habits can develop a chronic form of periodontal (gum) disease known as gingivitis. Characterized by inflamed and bleeding gums, gingivitis is caused by an infection triggered by bacterial plaque, a thin film of food remnant built up on tooth surfaces.

This chronic form of gingivitis, though, can quickly escalate into more serious forms of gum disease that may lead to tooth and bone loss. One such condition is Acute Necrotizing Ulcerative Gingivitis (ANUG), also known as "trench mouth." ANUG is a painful condition that can appear suddenly and result in extensive tissue damage and ulcerations, particularly in the papillae, the small, triangular bits of tissue between teeth. Persons with ANUG may also develop a foul breath and taste.

Gingivitis often develops into ANUG when certain mouth conditions exist: poor diet, smoking, which can dry the mouth and disrupt healthy bacterial flora, and increased stress or anxiety. If caught early, though, ANUG is highly treatable and reversible.

After determining you have ANUG and not another condition, our first step is to relieve the symptoms with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to manage pain and reduce swelling. We also prescribe a regimen of antibiotics like Amoxicillin (a proven antibiotic against the specific bacteria that cause ANUG). This should decrease the symptoms within 24 to 48 hours.

As the inflammation subsides we want to continue treatment by removing any plaque or calculus (hardened plaque deposits), especially in hard to reach places. This involves a technique known as scaling in which we used specialized hand tools or ultrasonic equipment to manually remove and flush away plaque and calculus.

The final step depends on you. To prevent reoccurrence, it' important for you to consistently practice effective oral hygiene to remove plaque - brushing twice and flossing once each day, and visiting us at least twice a year for cleanings and checkups. Quitting tobacco and improving your diet will also reduce your risk for ANUG.

ANUG and any other form of gum disease can cause a lot of damage. But taking steps to care for your teeth will help keep this acute form of gingivitis from arising in the first place.

If you would like more information on gingivitis and other forms of gum disease, please visit us at www.myparkdental.com. If you would like to send us a message, you can 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 "Painful Gums in Teens & Adults."

Dental Magic Transforms Smiles

Magician Michel Grandinetti can levitate a 500-pound motorcycle, melt into a 7-foot-tall wall of solid steel, and make borrowed rings vanish and reappear baked inside bread. Yet the master illusionist admits to being in awe of the magic that dentists perform when it comes to transforming smiles. In fact, he told an interviewer that it' "way more important magic than walking through a steel wall because you're affecting people' health... people' confidence, and you're really allowing people to... feel good about themselves."

Michael speaks from experience. As a teenager, his own smile was enhanced through orthodontic treatment. Considering the career path he chose for himself - performing for multitudes both live and on TV - he calls wearing an orthodontic device (braces) to align his crooked teeth "life-changing." He relies on his welcoming, slightly mischievous smile to welcome audiences and make the initial human connection.

A beautiful smile is definitely an asset regardless of whether you're performing for thousands, passing another individual on a sidewalk or even, research suggests, interviewing for a job. Like Michael, however, some of us need a little help creating ours. If something about your teeth or gums is making you self-conscious and preventing you from smiling as broadly as you could be, we have plenty of solutions up our sleeve. Some of the most popular include:

• Tooth Whitening. Professional whitening in the dental office achieves faster results than doing it yourself at home, but either approach can noticeably brighten your smile.
• Bonding. A tooth-colored composite resin can be bonded to a tooth to replace missing tooth structure, such a chip.
• Veneers. This is a hard, thin shell of tooth-colored material bonded to the front surface of a tooth to change its color, shape, size and/or length; mask dental imperfections like stains, cracks, or chips, and compensating for excessive gum tissue.
• Crowns. Sometimes too much of a tooth is lost due to decay or trauma to support a veneer. Instead, capping it with a natural-looking porcelain crown can achieve the same types of improvements. A crown covers the entire tooth replacing more of its natural structure than a veneer does.

If you would like more information about ways in which you can transform your smile, please visit us at www.myparkdental.com. If you would like to send us a message, you can contact us here, or schedule an appointment for a consultation. You can also learn more about the techniques mentioned above by reading the Dear Doctor magazine articles "Teeth Whitening," "Repairing Chipped Teeth," and "Porcelain Crowns & Veneers."