We’ve developed a number of effective treatments for periodontal (gum) disease. Depending on how far and deep a patient’s infection has advanced, treatment can be quite invasive and even require surgery. The more invasive, the longer and more uncomfortable the healing process can be.
But using a medical laser could make that less so. Although its use for gum disease treatment is still in its infancy, the latest observations from the field seem to show patients undergoing laser treatment may have less tissue trauma and bleeding, less discomfort after the procedure and quicker healing times.
Gum disease is a bacterial infection mostly caused by dental plaque, a thin film of food particles that build up on teeth in the absence of effective oral hygiene. The infection can advance deep below the gum line, weakening gum attachment to teeth and destroying supporting bone. Ultimately the affected teeth can be lost.
Traditionally, the only way to stop the disease is to manually remove plaque buildup on teeth and gum surfaces, which is continuing to sustain the infection, with special hand instruments called scalers or ultrasonic equipment. Because it’s important to remove as much plaque and diseased tissue as possible, we may need to perform a surgical procedure called flap surgery to move some of the gum tissues out of the way to get to these deeper areas. As with any surgery, this can create tissue trauma that may cause discomfort during the healing process.
Our new alternative is to use an Nd:YAG medical laser in a procedure known as Laser Assisted New Attachment Procedure or LANAP. With light energy delivered through a small fiber no more than the width of three human hairs, the laser can pinpoint diseased tissue and destroy bacteria through intense heat. Because of the laser beam’s tiny width and pulsing action, healthy tissue is at less risk for trauma than with the traditional treatment.
Coupled with other techniques, LANAP procedures could remove as much infected tissue and plaque as traditional methods, but with less healthy tissue trauma. In the future, then, patients with advanced gum disease undergoing laser treatment could have less bleeding and discomfort and faster healing times.
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 “Treating Gum Disease with Lasers.”
During pregnancy, your body isn’t the only part of your life that changes. Instead of “me,” you’re now thinking about “us”—you and the new person growing inside you. Because of this change in focus you may be re-examining your current habits to see if any could adversely affect your baby.
If you’re concerned your regular dental visits might be one of these, don’t be. Both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) recommend continuing regular dental exams and cleanings even during pregnancy.
In fact, professional dental care is often more important during pregnancy. Because of hormonal changes, you may develop food cravings for more carbohydrates like sugar. Unfortunately, eating more sugar could increase your risk for dental diseases like tooth decay and periodontal (gum) disease.
These same hormonal changes can also make you more prone to gum disease. There’s even a specific form of it known as pregnancy gingivitis that often occurs in expectant mothers. You may also experience “pregnancy tumors,” large, reddened areas of swelling on the gums.
To decrease your risk of pregnancy-related dental disease, you should certainly keep up your regular dental visits—and more if you begin to notice signs like swollen or bleeding gums. And although it’s usually best to postpone elective procedures like cosmetic dental work, you should be able to safely undergo any essential treatment for disease even if it requires local anesthesia. But do discuss any proposed dental work with both your dentist and obstetrician to be sure.
There are also things you can do for yourself during pregnancy that support your dental health. Be sure you’re practicing good oral hygiene habits like daily brushing and flossing. And by all means eat a well-balanced diet and restrict your sugar intake if at all possible. Taking care of these things will help you avoid dental problems and help make this memorable time in your life as joyous as possible.
If you would like more information on caring for your teeth during pregnancy, 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 Care During Pregnancy.”
Helping your infant or toddler develop good dental habits is one of the best head starts you can give them toward optimum oral health. But even after they’ve matured enough to handle hygiene tasks without you, they still need your guidance.
This is especially true in the “tween” and teen years. Although they’re beginning to flex their independence muscles, they’re still vulnerable at this age to peer pressure urging them to try things that, among other outcomes, could hurt their oral health.
Here are 3 areas where your input and guidance could save your older children and teens from oral health problems.
Sports activities. As children mature, they may also become involved with various physical activities, including contact sports. Years of diligent hygiene and dental care can be undone with one traumatic blow to the mouth. You can help avoid this by urging your child to wear a mouth guard during sports activity. While there are some good choices on the retail market, the most effective mouth guards are custom-created by a dentist to precisely fit your child’s mouth.
Oral piercings. While expressions of solidarity among young people are popular and often harmless, some like oral piercings and their hardware could potentially damage teeth and gums. You should especially discourage your child from obtaining tongue bolts or other types of lip or mouth hardware, which can cause tooth wear or fracture. Instead, encourage them to take up safer forms of self-expression.
Bad habits and addictions. A young person “spreading their wings” may be tempted to dabble in habit-forming or addictive activities. In addition to their effect on the rest of the body, tobacco, alcohol and drugs can have severe long-term consequences for oral health. Unsafe sexual practices could lead to the contraction of the human papilloma virus, which has been linked to oral cancer in young adults. Be sure your teen understands the dangers of these habits to both their oral and general health—and don’t hesitate to seek professional help when a habit becomes an addiction.
If you would like more information on helping your child develop great oral habits, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.
In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.
This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.
For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.
Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.
If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”
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