Posts for tag: gum disease
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
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? Branching Tooth Roots can be Periodontal Nightmares.”
Your child has had braces for a few months and making good progress with correcting a poor bite (malocclusion), but you’ve also noticed something else: his gums are becoming red and swollen.
These are symptoms of gingivitis, a periodontal (gum) disease. It’s an infection that arises when plaque, a thin film of bacteria and food particles, isn’t adequately removed from teeth with daily brushing and flossing. The braces increase the risk for gingivitis.
This is because the hardware — metal or plastic brackets cemented to the teeth and joined together by metal bands — makes it more difficult to reach many areas of the teeth with a brush or floss string. The plaque left behind can trigger an infection that causes inflammation (swelling) and bleeding.
To exacerbate the situation, gums don’t always take well to braces and can react by overgrowing. Wearing braces may also coincide with a teenager’s surge in hormones that can accelerate the infection. Untreated, gingivitis can develop into advanced stages of disease that may eventually cause tooth loss. The effect is also heightened as we’re orthodontically putting stress on teeth to move them.
You can stay ahead of gingivitis through extra diligence with daily hygiene, especially taking a little more time to adequately get to all tooth surfaces with your brush and floss. It may also help to switch to a motorized brush or one designed to work around braces. You can make flossing easier by using special threaders to get around the wires or a water flosser that removes plaque with a pulsating water stream.
And don’t forget regular dental visits while wearing braces: we can monitor and treat overgrowth, perform thorough dental cleanings and treat occurrences of gingivitis. In some cases you may need to visit a periodontist, a specialist in gums and supporting teeth structures, for more advanced treatment. And if the disease becomes extensive, the braces may need to be removed temporarily to treat the gums and allow them to heal.
Orthodontic treatment is important for not only creating a new smile but also improving your teeth’s function. Keeping a close eye out for gum disease will make sure it doesn’t sidetrack your efforts in gaining straighter teeth.
If you would like more information on dental care during orthodontics, 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.”
In 2016, voters in three states—California, Massachusetts and Nevada—joined Alaska, Colorado, Oregon, Washington and the District of Columbia in legalizing the use of recreational marijuana. These referenda moved the country closer to what may soon be a monumental political showdown between the states and the federal government, which still categorizes marijuana as a controlled substance.
But there’s another angle to this story often overshadowed by the political jousting: is increased marijuana use a good thing for your health and overall physical well-being?
When it comes to your dental health, the answer might be no. The Journal of Periodontology recently published a study that included frequent marijuana users showing increased signs of periodontal (gum) disease. This harmful bacterial infection triggered by plaque buildup can cause weakening of gum attachment to teeth and create the formation of large voids between teeth and gums called periodontal pockets. Left untreated, the disease can also cause supporting bone loss and eventually tooth loss.
The study looked at the dental treatment data of over 1,900 adults of which around one-quarter used marijuana once a month for at least a year. Marijuana users in the study on average had 24.5% of pocket sites around their teeth with depths of at least eight millimeters (an indication of advanced gum disease). In contrast, non-users averaged around 18.9% sites.
To be sure, there are several risk factors for gum disease like genetics, oral hygiene (or lack thereof), structural problems like poor tooth position or even systemic conditions elsewhere in the body. This published study only poses the possibility that marijuana use could be a risk factor for gum disease that should be taken seriously. It’s worth asking the question of whether using marijuana may not be good for your teeth and gums.
Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.
One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.
It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.
We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).
Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.
Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.