Understanding Periodontal Disease

Did you know that more adults loose teeth due to periodontal disease that they do to tooth decay? Periodontal disease is a chronic inflammatory process of the gum tissue, bone and ligaments that surround the teeth. Millions of Americans have evidence of periodontal disease, leading to inflamed gum tissue, bone loss around the teeth and eventually the loss of the teeth. The good news is that affordable treatment is available to assist in bringing the tissues back to health and controlling the life long disease. You may have periodontal disease without noticing any symptoms. There are three main stages to the disease. Early detection and treatment can help periodontal disease from progressing. Gingivitis: Bacteria and plaque have caused the gums to become inflamed and bleed easily. Plaque gets in the space between the gums and the tooth, causing the tissue to swell and remain irritated. Good home care and a professional cleaning on a regular basis are normally enough to restore the healthy gums. Often medications or systemic disease can lead to gingivitis as well. This why it is so important to report any changes in your medications or to your health to your dental team so that your condition can be properly evaluated.

Periodontitis: High levels of bacteria initiate a release of tissue destroying enzymes. These enzymes start a process that results in deeper pockets and bone loss. Re-treatment is aimed at stopping further damage and reversing the progress of the disease. Advanced Periodontitis: Bacteria and enzymes have caused surrounding tissue and bone to degrade further. At this stage, tooth loss is possible. It is critical to avoid this outcome.

Adult Periodontal Treatments: With regular professional dental cleanings and proper home care, periodontal disease can be diagnosed early and treated.

Treatment includes scaling and root planing, enzyme suppression, antibacterial therapy, and sometimes surgery. For the best results, you may have a combination of these treatments Scaling and Root Planing: This is a special type of professional service provided under local anesthesia, by a dentist or dental hygienist. It is usually done in several appointments. The procedure is designed to meticulously remove plaque and calculus (tartar) and toxins imbedded in the root surfaces as well as the diseased root surface. The roots are smoothed to a glass like finish making it more difficult for plaque to attach in the future.

Enzyme Suppression: Suppression therapy is performed in conjunction with scaling and root planing, and includes oral medication that helps stop enzymes from attacking the gums and the surrounding bone.

Antibiotic Therapy: This treatment includes oral medication, topically applied antibiotics and rinses that can help fight the bacteria that caused periodontal disease. Surgery: Surgical treatment is used in the most advanced cases of periodontal disease. Surgery may be done on the soft tissue, the bone or on the roots of the teeth. The purpose of the surgery is to either correct defects or to make the area more cleansable for the patient . Thus reducing the bacteria in the effected area.

On-Going Periodontal Therapy: Following the initial periodontal treatment, it is most important that the patient receives a periodontal maintenance procedure from a dental hygienist every 12 –16 weeks. This procedure replaces the standard dental cleaning, with a more thorough session of periodontal scaling, and spot root planing where needed. Because periodontal disease is a chronic disease that can not be cured, the periodontal maintenance procedure will be necessary 3-4 times a year for the rest of the patients life. Timely on-going periodontal therapy and good oral home care are the only possible way of controlling this disease and preventing future tooth loss.

You and Your Bite

Isn’t it ironic how some of us sleep our recommended eight hours and still wake up in the morning fatigued, tired and with muscle strain? Do you ever feel neck, shoulder or back pain as soon as you sit up from bed? Most of us probably think it’s time for a new mattress; however, the answer to your restless sleep could be something you may not be aware is a problem. These pains could be symptoms of an uneven occlusion (bite) or of improperly aligned teeth. Occlusion problems cause clenching and grinding (bruxism), jaw clicking, headaches, ear aches and sore jaw muscles. Continuous grinding can also lead to a more severe problem, Temporomandibular Joint Disorder. This is a disorder that affects one or both of the joints in the jaw which work together to control chewing, speaking and swallowing. Repeated trauma to the joints will wear down the fibrocartilage, leaving your joint with no choice but to have bone on bone contact. As some of you know, this can be extremely painful and in severe cases surgery is the only treatment that can remedy it. But before reaching this point, there is a preventable tool that may aid in taking care of all these symptoms.

The solution may be splint therapy. A splint is made out of acrylic and provides a temporary perfect bite for the mouth. Splint therapy is implementing this device to correct your occlusion. Once your splint is constructed to your individual bite, there is a series of adjustments the dentist makes to the splint over a period of time until the bite is ideal and the symptoms once present are gone. The final step is to equilibrate the occlusion. In other words, now that the jaw has reached the perfect bite, adjustments will now be made to the teeth to achieve the same occlusion. The goal is to eliminate interferences in order to give that perfect bite once felt with the splint, but without the splint present and therefore, prevent any future problems.

Not addressing the issue can lead to more expensive treatment such as, repairing chipped teeth, replacing broken crowns, erosion and much of the bridgework adults encounter. You may not be aware of the clenching and grinding that goes on at night but your dentist will definitely see the evidence in your mouth. This is why not only regular hygiene visits are essential, but also comprehensive oral exams with the dentist. According to the Pankey Institute, a world renowned center for dental education, “your doctor knows that looking into the future means providing you with all the information about what’s happening today that will impact your teeth five, ten, twenty and more years from now.” This makes it possible for patients to be able to make informed decisions and therefore, have a healthier mouth, more restful sleep and fewer problems in the future.

Your Best Investmen in 2009: YOUR HEALTH

Grim news about the global financial crisis dominates headlines daily. Consumer confidence is at its lowest point in history. Even if your monthly income has not recently changed, you are probably looking at your household budget, trying to decide where you can cut back in personal expenses. It only makes sense to prioritize spending and cut back on the things that just are not necessary right now.

Personal Reflection: All of us have ongoing expenses that we can certainly reduce or perhaps go without. We want the item or service, but do we really need it? On the other hand, there are things that we need but we don’t really want. In these hard times, it is certainly easy to rationalize that you can’t afford something you actually need if it isn’t something that is high on your emotional priority list. Often, health care falls into that category. You need it but you don’t necessarily want it, and it is moved down the priority list when it comes to monthly spending.

Making Good Choices: Making the decision to reduce or eliminate health care in the short term during lean financial times can have long term repercussions. There are very few procedures in dentistry that are preventive (or elective) or that can be delayed. Often the public has considered regular hygiene visits (professional teeth cleaning), resin sealants, examinations and x rays as procedures that are preventive in nature and not totally necessary. Nothing could be further from the truth. Delaying any needed procedure, including a hygiene visit, will lead to more dental disease. A delay in needed therapy will result in dental treatment that is more extensive, more expensive, and with a poorer prognosis. Often, it leads to the loss of the tooth entirely. 90% of the dental diseases that we diagnose have no symptoms for the patient. The decision to not treat the disease until you feel it can be a costly mistake. Taking care of it now will be the most conservative treatment option, with the least expense and the best prognosis.

The doctor and your hygienist will make a recommendation for the frequency of your professional dental cleanings based on your level of periodontal disease and your ability to control the bacterial levels in your mouth, as well as your medical conditions. This is necessary to control or eliminate the dental disease process. Every patient is different; therefore, every patient’s frequency rate for professional cleaning and examination will vary.

The decision to spread out your regular dental visits for the sake of saving money in the monthly household budget may not be a wise choice. It would be the equivalent of a diabetic deciding to take insulin every other day, or a high blood pressure patient deciding to skip their medications twice a week for the sake of saving money. Could that decision create an unstable medical condition for the patient? You bet! The decision to delay or skip regular dental visits or needed treatment will create an unstable dental situation as well.

We Want To Help: We are dedicated to assisting our patients in achieving and maintaining excellent oral and systemic health. We know that means not only providing the services necessary but also the information and education necessary for our patients to make good decision about their care. We know that also means working with each patient individually to find a way to comfortably afford treatment. Let us help you with your questions and considerations during this unusual economy.
Invest In Yourself: The troubled financial times leave few places for an individual to securely invest their time and money. While Wall Street is seemingly in a state of disarray, the financial institutions are lacking credibility and real estate investments have become unpredictable, your continued good health becomes your best investment. We look forward to serving you in that endeavor.

Chewing Gum-the dental benefits

The benefits of chewing gum extend beyond oral gratification, fresh breath and a way to expel nervous energy. While people may chew for many reasons, scientific research has shown that chewing gum can make a positive contribution to oral health in general and the teeth specifically. Chewing gum stimulates one of the most powerful defense mechanisms from the body-saliva. The partnership between chewing gum and saliva stimulation creates a powerful force that contributes to good dental health for the following areas:

What are the oral benefits?

• Alleviates dry mouth discomfort


• Freshens breath


• Neutralizes acids formed from in the mouth by bacteria


• Re-mineralizes enamel to strengthen teeth


• Cleans the mouth of food debris


• Whitens teeth by reducing stains and preventing stains from accumulating


• Reduces plaque


• Helps fight cavities


• Reduces gingivitis to maintain healthy gums


• Kills the germs that cause bad breath

Perhaps future benefits? Healthy Mouth/Healthy Body

New Research suggests that inflammation from the body could be a factor associated with disease like heart disease and dieabetes. This inflammation may be realted to the bacteria you find in the mouth. Research is currently being conducted to explore the role chewing gum might play in reducing inflammation causing bacteria in the mouth and therefore its contribution to the overall health of the body.

What does chewing gum do?

The physical act of chewing increases the flow of saliva in your mouth. If you chew after eating, the increased salivary flow can help neutralize and wash away the acids that are produced when food is broken down by the bacteria in plaque on your teeth. Over time, the acid can break down tooth enamel, creating the conditions for decay. Increased saliva flow also carries with it more calcium and phosphate to help strengthen tooth enamel. Clinical studies have shown that chewing sugarless gum for 20 minutes following meals can help prevent tooth decay. Newly on the market are chewing gums also containing a variety of therapeutic agents (such as xylitol) that could also enhance the gum's ability to re-mineralize teeth and reduce decay, or enabel gum to reduce plaque and gingivitis.

Does chewing gum replace brushing and flossing?

Chewing gum is an adjunct to brushing and flossing, but not a substitute for either. We continue to recommend brushing twice a day with a flouridated toothpaste and cleaning plaque from between your teeth once a day with dental floss or other interproximinal dental cleaners.

The bottom line

Using chewing gum after meals to increase the flow of saliva in the mouth will aid in the reduction of acid concentration in the mouth helping to reduce cavity developement and periodontal disease.

Why a Comprehensive Dental Exam

The Comprehensive Dental Examination, is a service that is provided for all new patients and for our adult patients of record every 2 years. Similar to a complete medical examination with your physician, this examination process is considered the current Standard of Care with the American Dental Association. During this examination we are able to document and compare the findings that are significant to your oral health. Being able to compare these findings at a two year interval allows us to detect changes in your dental health that may be subtle to the human eye, resulting in early detection and correction of oral problems. Of course, we will continue to provide updated examinations at the time of your periodontal maintenance visit in between your comprehensive dental evaluations.

The Comprehensive Examination and Evaluation consists of six areas of your oral health:

• Head and neck oral cancer examination
• Temporal mandibular joint (TMJ) evaluation
• Evaluation of your occlusion( how your upper and lower teeth relate to each other in function)
• Periodontal examination and evaluation of the supporting bone and tissue around the teeth
• Evaluation of current dental restorations, detection of new decay and fractured teeth
• Esthetic evaluation of your smile

We will take time to listen to your concerns, considerations and desires when it comes to the correction of your oral health problems. Treatment plan options will be developed and discussed as a result of our clinical findings, our professional judgment and your wants and needs. At the end of your examination, our treatment coordinator will provide you with your examination results, including a copy of your treatment plan, your periodontal charting, your dental photographs and any support brochures that we felt would help you better understand our discussion. We invite you to visit our web site for further information concerning the dental procedures as well as information about our practice . We feel open communication is vital to the patient/professional relationship. If you ever have had any questions or concerns about your examination visit, the treatment discussed, the fees presented your estimated insurance benefits or our practice procedures, please call and ask for assistance. Our mission is to assist you in obtaining optimum oral health. We know that this mission is dependant on a team of people (including you the patient) working toward a common goal. We look forward to continuing to assist you in your mission toward optimum oral health.

Maintaining Your Pearly Whites

From the time your first tooth poked its way through your tender gums, those pearly whites have played an enormous role in your life. Not only do the 32 teeth in your mouth help you talk and chew, they can make or break your appearance. Although aesthetics are important, tooth and gum health is essential. In the last few years, researchers have uncovered a link between periodontal (gum) disease and an increased risk of heart disease. One study found that men with periodontal disease had a whopping 72 percent greater risk of developing coronary disease than those with healthy gums. To keep your teeth in tip-top shape, we've come up with the following tips that go far beyond just brushing, flossing and your regular visits to see the doctor or hygienist.

Go on a white-teeth diet. What goes in, shows up on your teeth. So if you're drinking red wines and black tea, or smoking cigarettes or cigars, expect the results to show up as not-so-pearly whites. Other culprits to blame for dingy teeth include colas, gravies, and dark juices. Bottom line: If it's dark before you put it in your mouth, it will probably stain your teeth:

Step 1: Brush your teeth immediately after eating or drinking foods that stain teeth.

Step 2: Be conscious of the foods and drinks in your diet that can stain your teeth, and eat only when a toothbrush is around. If there isn't one, eat an apple for dessert -- it will provide some teeth-cleaning action, or rinse with water.

Change your toothbrush, or the head of your electric toothbrush at least every two to three months.

Use alcohol-free mouthwash to rinse away bacteria. Most over-the-counter mouthwashes have too much alcohol, which can dry out the tissues in your mouth, making them more susceptible to bacterial growth and bad breath.

Clean your tongue with a tongue scraper every morning to remove tongue plaque and freshen your breath. One major cause of bad breath is the buildup of bacteria on the tongue, which a daily tongue scraping will help remove.

Avoid sugary foods. Sugar plus bacteria equals oral plaque. Plaque, then, leads to bleeding gums, and tooth decay. Plus, the acid in refined sugars and carbonated beverages dissolves tooth enamel.

Senior Dental Care

Dental care for those patients over the age of 65 involves unique considerations. Seniors are more likely to suffer from a host of oral issues resulting from the natural aging process, difficulty in receiving proper oral health care due to financial constraints (fixed income, lack of dental insurance), or their inability to provide adequate oral home care for themselves. We know that seniors are often on softer diets, which affects the self-cleaning/natural food deflection action of the chewing process. They may have systemic diseases that affect the health of the oral cavity such as, diabetes and heart disease. They may be on many medications, which affect the saliva production. Dry mouth makes people more prone to developing cavities. In addition, there may be reduced manual dexterity; therefore, home care efforts are not as effective as they once were.

Our concerns for you: Seniors are more prone to periodontal (gum) disease, resulting from improper dental hygiene practices, poor diet, ill-fitting dentures or partials, disease, or a predisposition due to genetics. In many cases, the supporting bone structure for the teeth, including the jaw, may shift, which can play havoc with a patient's occlusion (bite). This may contribute to tooth decay, further periodontal disease and/or increased joint pain in the jaw.

Seniors are prone to decay and tooth sensitivity due to the loss of enamel and dentin, or root deterioration caused by gum recession and gum disease. More frequent dental visits may be necessary to help stop the progression of further dental disease. Old restorations, such as crowns and fillings, may need to be replaced, medications may need to be applied directly to the tooth surface, or products may be prescribed for home care. Seniors are also more likely to suffer inflammation of the gum tissue, dry mouth syndrome or oral thrush, these need to be checked and monitored on a regular basis as well.