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."

Look at the Long-Term Costs When Considering Dental Implants

You've probably heard a lot of great things about dental implants as a replacement for missing teeth. But there' one aspect about implants that may cause you hesitation about choosing them: the cost. If you have multiple teeth to be replaced, the expense of implants may seem even further beyond your means.

But before you decide against what' widely considered the premier tooth replacement option, it would be beneficial for you to look at their cost from a long-term perspective. You may find implants are actually a cost-effective investment in both your oral health and your smile.

So, what sets the dental implant apart from other options? One of its most important attributes is its life-like appearance. Not only does the visible crown resemble the color, shape and texture of natural teeth, the implant' placement can so precisely mimic the appearance of natural teeth emerging from the gums, it' indistinguishable from the real thing.

They're not just attractive, but also durable. This is due in large part to titanium, the most common metal used in implants, which has the unique quality of being osseophilic, or "bone-loving." Bone cells naturally attract to titanium and over time will grow and adhere to the implant in a process known as osseointegration. As a result, the implant' attachment in the jaw becomes strong and secure.

This durability gives implants a greater longevity on average than most other replacement options. If you thus compare the total costs for an implant (including maintenance) over its projected life with the costs of other options like dentures or fixed bridges, you'll find implants may actually cost less over time.

That may sound affordable for one or two missing teeth - but what about several? Replacing multiple teeth individually with implants can be quite high; but implants are also versatile - just a few strategically placed implants can support a fixed bridge or overdenture. This "hybrid" solution combines the affordability of these other options with the stability of implants.

Before weighing your options, you should first undergo a complete dental examination to see if you're a candidate for implants. From there we can help you decide whether implants are the right investment for your health and your smile.

If you would like more information on dental implants, 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 "Dental Implants 101."

Chrissy Teigen's Teeth-Grinding Troubles

It might seem that supermodels have a fairly easy life - except for the fact that they are expected to look perfect whenever they're in front of a camera. Sometimes that's easy - but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.

As she recounted in an interview, "I was... like, 'Oh my god, is my tooth going to fall out on camera?' This is going to be horrible." Yet despite the mishap, Teigen managed to finish the scene - and to keep looking flawless. What caused her dental dilemma? "I had chipped my front tooth so I had temporaries in," she explained. "I'm a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand."

Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you're trying to cope with a stressful situation. Other times, it can occur at night - even while you're asleep, so you retain no memory of it in the morning. Either way, it's a behavior that can seriously damage your teeth.

When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down - even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.

You may not be aware of your own teeth-grinding behavior - but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you're a "bruxer." So what can you do about teeth clenching and grinding?

We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that's needed to start controlling the habit. Finding healthy ways to relieve stress - meditation, relaxation, a warm bath and a soothing environment - may also help. If nighttime grinding keeps occurring, an "occlusal guard" (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.

Teeth grinding at night can damage your smile - but you don't have to take it lying down! If you have questions about bruxism, please contact us here or call us at (239) 206-1500, or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles "Stress & Tooth Habits" and "When Children Grind Their Teeth."