Posts for: January, 2014
While periodontal disease can take on a variety of forms, most are caused by a thin layer of bacterial plaque called biofilm. This layer of plaque will form every 8-12 hours and sticks like glue to your teeth near the gum line. With time, tartar formation occurs at and below the gum line.
If left unchecked, biofilm can give rise to a very unhealthy progression. It first triggers an infection that leads to painful inflammation, progressive bone loss and the gum tissue losing attachment with a tooth. Void spaces (or pockets) form where the gum and bone tissue once adhered; infectious plaque and tartar moves into these pockets and advances deeper to the root. Overcome by disease, the tooth is in danger of being lost.
It's imperative then to remove as much of this entrenched plaque and tartar as possible. Renewed oral hygiene is not enough — removing plaque and tartar from the root surfaces requires a treatment known as root planing.
Root planing is a meticulous, labor-intensive process. We first clear away larger portions of plaque around the teeth and gums with hand instruments or an ultrasonic device and then flush out the pockets with water. After administering a local anesthetic for pain, we would then turn to a number of small hand instruments known as curettes to probe and scrape away as much remaining plaque below the gum line as we can get to.
Root planing requires experience and a good sense of touch to work in areas that can't be clearly seen. Observing the gum line, though, can give us a good indication of progress as these tissues will actually change color once the biofilm and tartar deposits have been removed.
Being so deeply entrenched, not all the deposits might be removed during one session. However, as plaque and tartar are removed, the gum tissues will begin to heal and become less inflamed. This will make it easier to remove plaque in subsequent sessions.
Root planing takes time, but the effort is well worth it. In the short term you'll notice less inflammation and pain around your teeth and gums. In the long-term, it just may save your teeth.
If you would like more information on root planing and periodontal 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 “Root Planing.”
The world is full of options to improve your appearance. But if you really want a dramatic change for the better, don't overlook one of the more prominent features of your face — your smile. The field of cosmetic dentistry has developed a vast array of procedures, techniques and materials to work this transformation.
First, though, it's important to undergo a smile analysis. During this review, we examine the major components of your current smile: the condition of your teeth and their alignment; their natural color and hue; your gum health; and the relationship between your upper and lower jaws. We then analyze these findings in context with the shape of your face, your eyes and your skin. Any changes we propose to make to your smile must fit with this bigger picture.
Of course, nothing is more foundational to a beautiful smile than good, basic hygiene. Besides a daily regimen, regular visits to our office for cleaning and polishing not only remove entrenched decay-causing plaque or tartar, but also staining that can spoil your appearance. Whitening procedures, at home or in our office, can also brighten up an otherwise drab smile.
But what if you have chipped or broken teeth, or some other abnormality? That's where our artistry as a cosmetic dentist can truly make a difference. In some cases, using bonding materials, tooth-colored restorations or veneers may be the best option, if enough of the tooth structure is still intact. If not, porcelain crowns may be in order.
Nor are we limited to those options. Your particular situation may call for a more integrated approach to smile enhancement. Orthodontics to realign teeth and treat for malocclusion (where the teeth on the upper and lower jaws do not meet properly) could be part of that approach, as well as replacing missing teeth with dental implants that replicate the teeth they replace.
The key is to devise the best approach that couples reality with your expectations. It will change not only your smile, but also your life.
If you would like more information on cosmetic dentistry, 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 “Cosmetic Dentistry: A Time for Change..”
Many people suffer from problems with the temporomandibular joint (TMJ); this can result in chronic pain and severely limit the function of the jaw. Yet exactly what causes the problems, how best to treat them… and even the precise number of people affected (estimates range from 10 million to 36 million) are hotly debated topics.
There are, however, a few common threads that have emerged from a recent survey of people who suffer from temporomandibular joint disorders (TMJD). Some of them are surprising: For example, most sufferers are women of childbearing age. And two-thirds of those surveyed say they experienced three or more associated health problems along with TMJD; these include fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, rheumatoid arthritis, chronic headaches, depression, and sleep disturbances. The links between these threads aren’t yet clear.
The survey also revealed some interesting facts about treating TMJD. One of the most conservative treatments — thermal therapy (hot or cold compresses) — was found by 91% to offer the most effective relief of symptoms. By contrast, the most invasive treatmentâ??surgeryâ??was a mixed bag: A slightly higher percentage reported that surgery actually made the condition worse compared to those who said it made them better.
So what should you do if you think you may have TMJD? For starters, it’s certainly a good idea to see a dentist to rule out other conditions with similar symptoms. If you do have TMJD, treatment should always begin with some conservative therapies: moist heat or cold packs, along with over-the-counter anti-inflammatory medications if you can tolerate them. Eating a softer diet, temporarily, may also help. If you’re considering more invasive treatments, however, be sure you understand all the pros and cons — and the alternatives — before you act. And be sure to get a second opinion before surgery.
If you would like more information about temporomandibular joint disorders (TMJD), call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Chronic Jaw Pain And Associated Conditions” and “Seeking Relief from TMD.”
There’s no doubt dental implants are an effective choice for restoring both the form and function of missing teeth. But although they aren’t susceptible to tooth decay as with natural teeth, the bone and gum tissues that surround them are. Implants, therefore, require the same cleaning and maintenance as natural teeth.
A dental implant is actually a root replacement, a titanium post surgically imbedded in the jawbone. Because titanium is osteophilic (“bone-loving”), bone will naturally grow around it, making the implant more secure over time. Atop the implant is an abutment to which an artificial crown, the visible portion of the implant, is attached. The abutment is surrounded and supported by connective fibers within the gum tissue that hold the tissue against the implant surface.
This attachment differs significantly from natural teeth’s attachment to the jawbone, which attach to a tooth’s root through the periodontal ligament. The tiny fibers of the ligament hold teeth in place; its elasticity allows for tiny adjustments in a tooth’s position in response to changes in other teeth and bone. The ligament is also rich in blood supply that enriches the area with nutrients and provides resources to fight and resist infection.
An implant doesn’t have this same degree of defense against infection. Without proper hygiene, a layer of bacterial plaque known as biofilm can develop on the crown surface of both natural teeth and restorations. In addition, an infectious condition specific to implants known as peri-implantitis can set in the gum tissues surrounding the implant. This can lead to bone loss (sometimes very rapid) and eventual loss of the implant.
Although your daily hygiene won’t require special toothbrushes or other devices for implant cleaning, your professional cleanings will. The metal instruments (known as curettes) used to clean natural teeth could damage implant surfaces. The hygienist will use devices made of plastic or resin rather than metal, and nylon or plastic sheaths or tips on ultrasonic equipment that are specially designed for implant cleaning.
While maintaining dental implants requires diligence on both your part and ours, implants remain an effective, long-term choice for dental restoration. In fact, some studies indicate upwards of 95% success rate. Proper hygiene will greatly increase your chances for many years of service from your implants.
If you would like more information on properly maintaining your dental implants, 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 “Dental Implant Maintenance.”