Posts for: May, 2020
Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.
Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.
Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.
A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.
The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.
The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.
We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.
The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.
A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.
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 “What are Furcations?”
Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.
Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.
Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.
The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.
Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.
Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.
Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.
If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”
Straightening your smile doesn't happen overnight—it can involve months or even years of orthodontic treatment. And although the end result is well worth it, the long process can make it difficult to keep your gums healthy, especially while wearing braces.
Gum swelling in particular is a common problem for braces wearers with two potential sources. First, orthodontic hardware makes it difficult to keep teeth clean of dental plaque, a thin bacterial film that can cause gum disease. Plaque and its hardened counterpart tartar can trigger a gum infection, which in turn triggers inflammation. As a result, affected gums appear swollen and red, and can easily bleed.
Gum tissues may also react to braces pressing against them and develop hypertrophy (or hyperplasia), an increase in individual tissue cell growth. If this overgrowth occurs, it may not get resolved until after your braces have been removed.
As long as the hypertrophy doesn't appear to have weakened gum attachment with the teeth, it's usually not a big concern. But what is a concern is that hypertrophy could increase a braces wearer's difficulties with oral hygiene and give rise to a true gum infection that could endanger dental attachment. Advanced cases could require surgical correction or removal of the braces altogether to adequately treat the infection.
The best way to avoid a worst case scenario is to be as diligent as possible with daily brushing and flossing. Fortunately, there are several tools that can make it easier with braces. Interproximal brushes, tiny brushes that can fit into the narrow spaces between the teeth and the braces, can be used in conjunction with your regular toothbrush.
Flossing is also easier if you use a floss threader or a water flosser. The latter utilizes a pump to emit a pulsating jet of water to break loose plaque between teeth and flush it away. Clinical studies have shown the effectiveness of water flossers for removing plaque in braces wearers as opposed to not flossing at all.
A faithful daily hygiene practice and twice-a-year cleanings and checkups with your regular dentist can help minimize your chances of gum swelling. Doing so will help ensure you'll complete your orthodontic treatment on the way to healthier and more attractive smile.
If you would like more information on teeth and gum care while wearing braces, 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 “Gum Swelling During Orthodontics.”