Posts for: October, 2012
Since the dawn of man, periodontal (gum) disease has impacted humans. And while dental health has dramatically improved over the generations, the facts are still clear Ã¢Â€Â” millions of Americans are suffering from gum disease and probably do not even know that they have a problem. This is because periodontal disease most often starts without any symptoms or ones that most people tend to discount or ignore.
Stage 1: Gingivitis. The first stage of gum disease is inflammation of the gingiva (gums) without bone loss. While nearly all people will develop gingivitis in the absence of good oral hygiene, only 10 to 15% of them will go on to develop more advanced stages of the disease.
Stage 2: Early periodontitis. With this stage, gingivitis progresses into the deeper periodontal structures — the tissues that attach the teeth to the bone resulting in early or beginning bone loss. About 10% of the population develops full-blown periodontitis with progressive bone loss.
Stage 3: Moderate periodontitis. The third stage of gum disease results in moderate bone loss (20 to 50%) of root surfaces of the teeth due to continued destruction of the surrounding tissues and bone. Periodontal disease is “cyclical” — it goes in cycles with bursts of activity, followed by a period in which the body tries to recover. This is called chronic inflammation, or frustrated healing.
Stage 4: Advanced periodontitis. With the final stage of gum disease, there is severe bone loss (50 to 85%) from the tooth's root. This stage includes looseness of teeth, moving teeth, abscess formation with red, swollen and painful gums. The end results — eating and even smiling is difficult and uncomfortable, and you could lose all your teeth.
You can learn more about gum disease in the Dear Doctor article, “Understanding Gum Disease.”
Have We Described Your Mouth?
If any of the above stages sounds like we are talking about your mouth, contact us today to schedule a consultation, discuss your questions and receive a thorough exam. If addressed promptly and with commitment to following your treatment plan, your mouth can return to good oral health.
We pride ourselves on educating our patients regarding oral health and dental treatment. This is why we are providing you with these frequently asked questions (FAQs) regarding root canals. Our belief is that by being informed about this important dental treatment, you will be more comfortable should you ever require a root canal.
Exactly what is root canal treatment?
A root canal treatment is an endodontic procedure (“endo” – inside: “dont” – tooth) in which the living pulp tissues are housed, including the nerves. When a severely decayed or damaged tooth begins to hurt, it is because the pulpal tissues are inflamed or infected, and the response of the nerves is varying degrees of pain — letting you know something is wrong. If the pulp is dead or dying it must be removed and the root canal of the tooth is filled and sealed to stop infection and to save the tooth.
Who typically performs them?
Endodontics is a specialty within dentistry that specifically deals with the diagnosis and treatment of diseases and disorders of root canal issues affecting a tooth's root or nerve. While endodontists are dentists who specialize in root canal treatment, general dentists may also perform root canal treatment and are usually the dentists you will consult with when you first have tooth pain and who will refer you to an endodontist if necessary.
What are the symptoms of a root canal infection?
Root canal symptoms and the character of the pain may vary depending on the cause. For example, symptoms may be:
- Sharp, acute pain that is difficult to pinpoint
- Intense pain that occurs when biting down on the tooth or food
- Lingering pain after eating either hot or cold foods
- Dull ache and pressure
- Tenderness accompanied by swelling in the nearby gums
Does root canal treatment hurt?
A common misconception is that a root canal treatment is painful when, in actuality, it is quite the opposite. The pain associated with a root canal occurs prior to treatment and is relieved by it — not visa versa.
If you have tooth pain, you may or may not need a root canal treatment. Contact us today (before your symptoms get worse) and schedule an appointment to find out what's causing the problem. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “Common Concerns About Root Canal Treatment.”
When you begin a smile makeover in our office, you are embarking on an exciting partnership with my laboratory technician and me. You should be full of excitement and anticipation — if you have been dissatisfied with your current smile, and you have great expectations for the results of this project. You will really like what you see in your mirror.
Being completely satisfied with your new look depends upon successful communication — between you and me and also between my dental lab technician and me. As you might expect, your perceptions of how your teeth appear are different from a dentist's perceptions. My education leads me to think of factors that untrained individuals probably won't consider, such as crown (tooth) length, midlines (how the teeth line up with other facial features) and the distance from gum to lip.
It is helpful to be able to describe what you like and don't like about your current smile, and what changes you would like to see. Using visual aids is a good idea. Bring photos and magazine illustrations to show what you have in mind. (Remember that we cannot make you look exactly like a celebrity or anyone else. The pictures are guidelines.)
Things to think about:
- The color, size, shape, alignment and spacing of your teeth.
- How much of your teeth and gum tissues show when your lips are relaxed and when you smile.
- Tooth color: bright “Hollywood” white or more natural looking off-white.
Your makeover is more likely to meet your expectations if you get an advanced view of the results. Computer imaging is one way to do this. Another is for us to make a mock-up of the proposed dental work in tooth-colored wax on models of your mouth.
Finally, a “Provisional Restoration” can be used as a test to make sure that what I envision is also what you, the patient, want to see. A provisional restoration, made from temporary materials, gives you a chance to test out the changes and make sure they work for you — that they not only look good, but they are also functional in terms of biting, chewing, speech, and gum health.
If the provisional restoration works, it is used as a blueprint to make durable and long lasting porcelains in the same design. We will take impressions of the provisional restoration and communicate the relevant information to a dental laboratory technician, who will make the final porcelain tooth replicas for your new smile.
Competent communication and a provisional restoration will put you on track to meet your expectations and obtain the most aesthetic and functional result in your Smile Makeover.
Contact us today to schedule an appointment to discuss your questions about Smile Makeovers. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”
Gum recession is a common problem affecting millions of Americans to some degree. If you have it, you will notice that the pink gum tissue surrounding one or more of your teeth has shrunk or receded and left the tooth-root surfaces exposed. How does this happen? And does it require treatment? The answers to both of these questions will vary from person to person. The good news is that treatment is available for those who need it.
The way you care for your teeth can be a major factor in gum recession. If you do not effectively remove plaque (bacterial biofilm) from your teeth daily, you may develop gum inflammation, gum disease and/or recession. Conversely, if you brush or floss too hard or for too long, you can also damage your gums. Please remember that it doesn't take a lot of pressure to remove biofilm; you just need to make sure you get to each tooth, right down to the gum line.
Other causes of gum recession include: mal-positioned and/or prominent teeth that are not fully encased in supporting bone; muscle attachments (frenums) pulling at the gum line; habits such as holding foreign objects (nails, pins) between the teeth that press on the gum tissues; and badly fitting oral appliances such as dentures, braces Ã¢Â€Â“ even tongue bolts and lip piercings.
Besides not looking too great, gum recession can lead to anything from minor tooth sensitivity to tooth loss in the most severe cases. If you are experiencing any discomfort from a loss of gum (also called “gingival”) tissue, we'd certainly like to know about it. We would be happy to examine your condition and make recommendations.
There are surgical procedures that are very effective in treating these problems. Procedures such as gingival grafting or periodontal plastic surgery (“peri” – around; “odont” – tooth), often involve taking a small piece of healthy gingival tissue from the roof of your mouth and grafting it to the area where it is needed. Ultrafine sutures hold the graft in place until it “takes.” Laboratory-processed donor tissue can also be used. In either case, the procedure has a terrific success rate.
If you have any questions about gum recession, please contact us or schedule an appointment for a consultation. To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Periodontal Plastic Surgery.”