Posts for: November, 2019
Over a lifetime, teeth can endure temperatures ranging from freezing to near boiling, biting forces of as much as 150 pounds per square inch and a hostile environment teeming with bacteria. Yet they can still remain healthy for decades.
But while they’re rugged, they’re not indestructible — they can incur serious damage from tooth decay or periodontal (gum) disease, two of the most prevalent oral infections. If that happens, you could be faced with the choice of removing the tooth or trying to save it.
Because today’s restorations like dental implants are quite durable and amazingly life-like, it might seem the decision is a no-brainer — just rid your mouth of the troubled tooth and replace it. But from a long-term health perspective, it’s usually better for your gums, other teeth and mouth structures to try to save it.
How we do that depends on the disease and degree of damage. Tooth decay, for example, starts when high levels of acid soften the minerals in the outer enamel. This creates a hole, or cavity, that we typically treat first by filling with metal amalgam or, increasingly, composite resins color-matched to the tooth.
If decay has invaded the pulp (the innermost layer of the tooth), you’ll need a root canal treatment. This procedure removes infected material from the pulp and replaces the empty chamber and the root canals with a special filling to guard against another infection. We then cap the tooth with a life-like crown for added protection.
Gum disease, on the other hand, is caused by dental plaque (a thin film of bacteria and food particles on tooth surfaces), and requires a different approach. Here, the strategy is to remove all of the plaque and calculus (hardened plaque deposits) we can find with special hand instruments or ultrasonic equipment, and often over several sessions. If the infection extends deeper or has created deep pockets of disease between the teeth and gums, surgery or more advanced techniques may be necessary.
Though effective, some of these treatments can be costly and time-consuming; the tooth itself may be beyond repair. Your best move is to first undergo a complete dental examination. From there, we can give you your best options for dealing with a problem tooth.
If you would like more information on the best treatment approach for your teeth, 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 “Save a Tooth or Get an Implant?”
Currently, one-third of Americans are either diabetic or have prediabetic symptoms. Caused by an imbalance in blood sugar levels, diabetes can complicate and increase the risk for other inflammatory conditions like heart disease and that includes another disease typified by inflammation: periodontal (gum) disease.
Each November, dentists join other healthcare professionals in commemorating American Diabetes Month. Besides making people aware of the widespread impact of diabetes, it's also a chance to highlight ways to manage the disease and promote better health for your body overall, including your gums.
If you have diabetes (or your doctor is concerned you may develop it), here's what you should know to keep it from harming your gum health.
Keep your diabetes under control. The adverse effects of diabetes on the body, including the gums, can be minimized through medication, good dietary habits and exercise. Because of its chronic nature, though, managing diabetes should become a permanent part of your daily life. But it's essential to keep symptoms under control to protect your gums from infection.
Practice daily oral hygiene. Gum disease can occur with anyone, not just those with diabetes. A few days without proper oral hygiene to remove bacterial plaque is all it takes to trigger an infection. So be sure you're brushing and flossing each day, as well as having routine professional dental cleanings at least every six months.
See us at the first sign of gum problems. If you notice your gums are reddened, swollen or bleeding after brushing and flossing, see us as soon as possible. If it is gum disease, the sooner we begin treatment, the less likely the infection will cause extensive damage—including tooth loss. It's also possible to have gum disease but not have any symptoms initially. That's why it's important to see us on a regular basis to check your gum health.
Keep your healthcare providers informed. Some studies seem to indicate that if you have both diabetes and gum disease, treating one condition could help improve symptoms with the other. Be sure both the dentist treating your gum disease and the physician managing your diabetes know about the other condition. It may be possible to adjust and coordinate treatment to get the most benefit for both.
Living with diabetes is a challenge, especially if you're also dealing with gum disease. Keeping your diabetes under control and caring for your teeth and gums can help make that challenge easier.
If you would like more information about protecting your dental health while managing diabetes, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Diabetes and Periodontal Disease” and “Gum Disease and Systemic Health.”
To keep a healthy smile, brushing and flossing your teeth every day should be at the top of your to-do list, along with regular dental visits. Dental visits are usually scheduled every six months when your dental professional will remove any built-up plaque and tartar (hardened plaque deposits) missed during everyday hygiene.
If you've experienced periodontal (gum) disease, however, these dental visits may become even more important toward preventing a re-infection. For one thing, your dentist may want to see you more frequently.
Gum disease is caused by bacteria living in dental plaque, which first infect the superficial layers of gum tissue. Even though the body initiates an inflammatory response to fight it, the infection continues to grow as long as there is plaque present to fuel it. The problem isn't just plaque on the visible tooth surface—hidden plaque beneath the gum line can create deep pockets of infection that can be difficult to treat.
To stop the infection, dentists must manually remove plaque through procedures known as scaling and root planing. Any and all plaque and tartar deposits must be removed, even those deep around the roots, to arrest the infection. This often requires several treatment sessions and sometimes gum surgery to access areas below the gum line.
These types of treatments, especially in the disease's early stages, have a good chance of restoring health to your gums. But because of the high possibility of reinfection, your dentist will need to step up your regular dental maintenance from now on. This could mean visits as frequent as every few weeks, depending on your particular case of gum disease and your dentist's recommendation.
Your dental visits after gum disease may also become more involved than before. Your dentist will now monitor you closely for any signs of reinfection and at the first sign initiate a new round of treatment. You may also need surgical procedures to make some areas around your teeth more accessible for future cleaning and maintenance.
Periodontal maintenance after gum disease helps ensure another infection doesn't rise up to undermine your progress. To paraphrase a well-known quote, eternal vigilance is the price of continuing good dental health.
Although periodontal (gum) disease starts with the gums, the teeth may ultimately suffer. An infection can damage the gum attachment and supporting bone to the point that an affected tooth could be lost.
The main cause for gum disease is dental plaque, a bacterial biofilm that accumulates on teeth due to ineffective oral hygiene. But there can be other contributing factors that make you more susceptible to an infection. Smoking tobacco is one of the most harmful as more than half of smokers develop gum disease at some point in their life. If you’re a heavy smoker, you have double the risk of gum disease than a non-smoker.
There are several reasons why smoking increases the risk of gum disease. For one, smoking reduces the body’s production of antibodies. This diminishes the body’s ability to fight oral infections and aid healing. As a smoker, your body can’t respond adequately enough to the rapid spread of a gum infection.
Another reason for the increased risk with smoking are the chemicals in tobacco that damage the connectivity of gum tissues to teeth that keep them anchored in place. The heavier the smoking habit, the worse this particular damage is to the gums. This can accelerate the disease and make it more likely you’ll lose affected teeth.
Smoking can also interfere with getting a prompt diagnosis of gum disease because the nicotine in tobacco reduces the blood supply to the gums. Usually a person with an infection may first notice their gums are reddened or swollen, and bleed easily. Smoking, however, can give a false impression of health because it prevents the infected gum tissues from becoming swollen and are less likely to bleed. As a result, you may learn you have the disease much later rather than sooner, allowing the infection to inflict more damage.
There are ways to reduce your disease risk if you smoke. The top way: Kick the smoking habit. With time, the effects of smoking on your mouth and body will diminish, and you’ll be better able to fight infection.
You should also practice daily brushing and flossing to keep plaque at bay, followed by regular dental cleanings to remove hard to reach plaque and calculus (tartar) deposits. You should also see your dentist at the first sign of trouble with your gums.
If you would like more information on the prevention and treatment of 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 “Smoking and Gum Disease.”
Fibromyalgia is a chronic condition that produces widespread pain and stiffness in the muscles and joints. The pain, muscle spasms and tingling it causes can disrupt sleep, alter moods and impair memory function.
Dealing with just this one condition can be overwhelming. But did you know 3 out 4 fibromyalgia patients also develop chronic pain and dysfunction involving their jaw joints? Known collectively as temporomandibular joint disorders (TMD), these jaw joint problems cause pain, muscle spasms and difficulty moving the jaws that can interfere with eating and speaking. TMD can also contribute to headaches and earaches.
Many researchers believe this prevalence of TMD among fibromyalgia patients stems from both conditions originating from the same primary cause—a malfunction within the central nervous system. In both cases, the brain and spinal cord may not be able to process pain signals in a normal fashion. This malfunction could also be generating and amplifying pain signals even when nerves are receiving no stimulation.
For decades now, the most effective treatment strategy for TMD has been to manage the symptoms with physical therapy and exercises, thermal therapy or medications. Relief for fibromyalgia has depended on medication and relaxation techniques like biofeedback therapy. But with the evidence of some connection between the two conditions, it may be helpful to coordinate treatment for both with a team approach involving all your healthcare providers, rather than treat them separately.
To that end, make sure both your dentist or physician treating you for TMD and your physician treating your fibromyalgia each know about the other condition. Consulting together, your healthcare team may find treatments (like certain drugs that counteract neurotransmitter imbalances) that might help reduce symptoms in both conditions. And cognitive-behavioral therapy, meditation and other therapeutic pain management techniques can help you cope with the pain.
Continued research into these two debilitating conditions and the possible links between them may have an effect on how we treat both. A holistic approach to treating them could be the wave of the future.
If you would like more information on the links between TMD and other chronic pain conditions, 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 “Fibromyalgia and Temporomandibular Disorders.”