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Posts for tag: gum disease

By Richard Hamaty
October 10, 2018
Category: Dental Procedures
Tags: tooth decay   gum disease  
StopRootCavitieswithPreventionandPromptTreatment

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, 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 Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”

By Richard Hamaty
May 22, 2018
Category: Oral Health
Tags: gum disease  
StopGumDiseaseBeforeitBecomesaMajorHealthIssue

If you think gum disease only happens to the other guy (or gal), think again. If you’re over 30 you have a 50-50 chance for an infection. After 65 the risk climbs to 70 percent.

Fortunately, we can effectively treat most cases of gum disease. But depending on its severity, treatment can involve numerous intensive sessions and possible surgery to bring the disease under control. So, why not prevent gum disease before it happens?

First, though, let’s look at how gum disease most often begins—with dental plaque, a thin film of bacteria and food particles built up on teeth and gum surfaces. If plaque isn’t consistently removed through daily brushing and flossing, it doesn’t take long—just a few days—for the bacteria to infect the gums.

While it’s not always easy to detect gum disease early on, there are signs to look for like red, swollen and tender gums that bleed easily when you brush or floss, and bad breath or taste. The infection is usually more advanced if you notice pus-filled areas around your gums or loose teeth. If you see any of these (especially advanced signs like loose teeth) you should contact us as soon as possible.

Obviously, the name of the game with prevention is stopping plaque buildup, mainly through daily brushing and flossing. Technique is the key to effectiveness, especially with brushing: you should gently but thoroughly scrub all tooth surfaces and around the gum line, coupled with flossing between teeth.

To find out how well you’re doing, you can rub your tongue along your teeth after you brush and floss—you should feel a smooth, almost squeaky sensation. You can also use plaque-disclosing agents that dye bacterial plaque a particular color so you can easily see surface areas you’ve missed. You can also ask us for a “report card” on how well you’re doing during your next dental visit.

Dental visits, of course, are the other essential part of gum disease prevention—at least every six months (or more, if we recommend) for cleaning and checkups. Not only will we be able to remove hard-to-reach plaque and tartar, we’ll also give your gums a thorough assessment. By following this prevention regimen you’ll increase your chances of not becoming a gum disease statistic.

If you would like more information on recognizing and 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 “How Gum Disease Gets Started.”

By Richard Hamaty
February 18, 2018
Category: Oral Health
Tags: gum disease  
PeriodontalProbingIncreasesAccuracyinDiagnosingGumDisease

If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.

That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.

Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.

During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.

Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.

If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.

Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.

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 article “Understanding Periodontal Pockets.”

By Richard Hamaty
September 28, 2017
Category: Oral Health
Tags: oral hygiene   gum disease  
TakeCareofYourGums

It’s National Gum Care Month. Let’s a moment to talk about why it’s so important to take care of your gums.

Gum disease affects almost half of adults over age 30 and approximately 70 percent of adults over age 65. The first stage of gum disease is called gingivitis, an inflammation of the gums. With gingivitis, gums can be red and puffy, and bleed easily when brushing or flossing. If gingivitis is not treated, it can progress to periodontitis, where the structures supporting the teeth, including the bone, begin to break down and be lost. Advanced stages of gum disease can lead to tooth loss and general health problems.

The good news is that gum disease is treatable — and early gum disease is even reversible. So what can you do to take care of your gums?

  • Be diligent about your oral hygiene routine at home: Your first line of defense is your oral hygiene routine at home. Brush your teeth gently morning and night, using a soft toothbrush and fluoride toothpaste. Brushing too vigorously can harm your gums and cause them to recede. It is also important to floss every day to dislodge plaque that can build up between the teeth and around the gum line.
  • Come in for professional dental cleanings and exams: Schedule regular professional cleanings to remove the plaque that is hard to reach. If plaque is not removed, it can harden to form tartar (or “calculus”). Only professional cleanings with special dental tools can remove tartar. When plaque and tartar form below the gum line, your bone that supports the teeth may be at risk. We can examine your mouth above and below the gum line to detect and monitor any signs of gum disease and recommend appropriate treatments.

We are always happy to talk with you about how to maintain the health of your gums. Remember that early gum disease is very treatable, so take care of your gums, and they’ll take care of you!

You can learn more about gum health in the Dear Doctor magazine article “Daily Oral Hygiene.”

GumInfectionAroundToothRootsCallsforImmediateAction

Many people learn they have periodontal (gum) disease after noticing gum swelling, soreness or bleeding. But what you can see or feel may be only the tip of the iceberg — the damage may extend much deeper.

Gum disease is caused mainly by dental plaque, a thin film of bacteria and food particles built up on teeth due to ineffective brushing and flossing. Infection of the visible gums is only the beginning — left untreated, it can advance well below the gum line and even infect supporting bone.

One critical concern in this regard is the areas where the roots of a tooth separate from each other, known as furcations. Here an infection known as a furcation invasion can cause the bone to weaken and dissolve.

This usually occurs in stages (or classes) we can detect through manual probing and/or with x-rays. In the earliest stage, Class I, we might only notice a slight pocket in the gums with no significant bone loss. In Class II, though, the pocket between the roots has become a horizontal opening of two or more millimeters, indicating definite bone loss with increased pocket depth getting “under” the crown of the tooth. Class III, the last and most serious stage, describes an opening we can probe under the crown all the way to the other side of the tooth; the bone loss now extends “through and through” the furcation.

The basic goal of gum disease treatment is to remove plaque and calculus (tartar) from all tooth and gum surfaces. But removing plaque below the gum line, especially “into” the furcations, can be challenging. We will need instruments called scalers to clean root surfaces, assisted sometimes by ultrasonic equipment to vibrate plaque loose. With furcations we may also need to employ surgery to aid gum or bone tissue regeneration or to make the area easier to access for future cleaning.

Of course, the best way to protect against furcation invasions is to prevent gum disease in the first place. Be sure to brush and floss daily and visit us for thorough dental cleanings and checkups at least every six months.

And don’t delay contacting us if you see any signs of teeth or gum problems. The sooner we can identify gum disease, the more likely we’ll be able to prevent it from doing serious damage to your gums, bone and teeth.

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?