Posts for: January, 2018
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.
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Twice a year dental cleanings are an important aspect of optimal oral health. But if you’re not brushing and flossing every day, your dental visits could change from regular maintenance to teeth rescue missions.
These two hygiene tasks don’t take long—a single trip with floss around each tooth and a couple of minutes of brushing at least twice a day—but you’ll need to perform them effectively to get the most out of them. Not to worry, though: with a little practice and helpful advice from us, this small investment in time and effort could save your teeth—and your money.
The first thing to know, though, is the reason behind brushing and flossing: to remove disease-causing bacterial plaque that can build up daily on teeth. Bacteria produce acid, which at elevated levels can erode enamel and lead to decay; and some bacterial strains can cause periodontal (gum) disease. These infections could ultimately lead to gum recession, bone deterioration and tooth loss.
Daily brushing and flossing lowers your risk of this occurring. It’s your preference in what order you do them, but for now let’s start with flossing.
There are a number of techniques—and tools—for effective flossing. If you’re using thread floss, simply cut off about 18 inches and wrap each end around the middle finger from each hand. Use the remaining fingers to create a small amount of floss between the two best fingers for a particular area of the mouth and gently pull the floss in between the tooth gap. Form a “C” shape around one of the tooth sides and rub up and down until you hear a squeak (which you’ll only hear if you use un-waxed floss). Now, repeat the action with the adjacent tooth, then move to the next and each succeeding gap and do the same until you’ve cleaned each side of each tooth.
When brushing, hold your toothbrush gently like a paintbrush or pencil at about a 45-degree angle with just a small amount of toothpaste on the end bristles. All it takes is a gentle scrubbing or wiggling motion and the abrasives and detergents in the toothpaste will do the rest. Just make sure you fully brush all your teeth and gum surfaces, which should take about two minutes.
Along with regular dental visits and a low-sugar diet to discourage bacterial growth, brushing and flossing will help you avoid disease and enjoy the best oral health possible.
If you would like more information on keeping your teeth and gums clean, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”