Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.
Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.
Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.
A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.
The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.
The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.
We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.
The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.
A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.
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?”
Although dental disease prevention has made great strides over the last century, tooth decay and periodontal (gum) disease continue to pose a major health threat. People who’ve lost all of their teeth (edentulism) or most of them suffer the most with adverse effects on their overall health, function and appearance.
Removable dentures have been the traditional and most affordable means to treat edentulism. But even with material and construction advances in recent years, dentures can still lose their fit over time as the bone in the jaw shrinks. This happens because the bone no longer has the stimulus of natural teeth and older cells can’t be replenished at a healthy rate; the continuing compression of traditional dentures on the jaw’s bony ridges compounds the problem.
As the bone shrinks the dentures become loose and uncomfortable to wear. Among other results, this poor fit can drastically affect how you eat: studies of denture wearers have found a decrease in their diet’s nutritional value because they’re eating fewer vegetables or fibrous, “chewy” foods and more foods with refined carbohydrates and fats that are easier to eat but less nutritious.
There is an alternative, though, that might slow bone loss and provide a better long-term fit: an overdenture supported by dental implants. With this appliance, a few implants are strategically installed in the upper or lower jaw. Matched attachments securely fasten the denture to the implants. In this case, the implants not the jaw ridge and gums support the denture thereby preserving the bone.
If you’re healthy enough to undergo a tooth extraction, you should be able to handle implant surgery, a minor procedure usually performed with local anesthesia and with little to no discomfort afterward. It may even be possible to retrofit your current denture to work with the implants, but that will need to be determined during the planning stages.
Although more expensive than a traditional denture, overdentures are much more affordable than fixed restorations stabilized with implants. The difference, though, is the increase in your quality of life — for better nutrition, physical health and social confidence.
If you would like more information on treatment for teeth loss, 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 “Implant Overdentures for the Lower Jaw.”
Regular dental visits are an important part of maintaining healthy teeth and gums. But it’s what goes on between those visits — daily hygiene and care — that are the real ounce of prevention.
Here are 4 things you should be doing every day to keep your mouth healthy.
Use the right toothbrush and technique. Brushing with fluoride toothpaste at least once every day is a must for removing plaque, a thin film of bacteria and food particles which is the main cause of dental disease. Your efforts are more effective if you use a soft-bristled, multi-tufted brush that’s replaced often, especially when bristles become splayed and worn. To remove the most plaque and avoid damaging your gums, brush with a gentle, circular motion for at least two minutes over all tooth surfaces.
Don’t forget to floss. Your toothbrush can get to most but not all the plaque on your teeth. Flossing — either with flossing string, pre-loaded flossers or a water irrigator — helps remove plaque from between teeth. Don’t rely on toothpicks either — they can’t do the job flossing can do to remove plaque.
Mind your habits. We all develop certain behavioral patterns — like snacking, for instance. Constant snacking on foods with added sugar (a major food source for bacteria) increases your disease risk. Consider healthier snacks with fresh fruits or dairy, and restrict sugary foods to mealtimes (and the same for sports and energy drinks, which have high acid levels). Stop habits like tobacco use, excessive alcohol consumption or chewing on hard objects, all of which can damage your teeth and gums and create a hostile environment in your mouth.
Watch for abnormalities. If you pay attention, you may be able to notice early signs of problems. Bleeding, inflamed or painful gums could indicate you’re brushing too hard — or, more likely, the early stages of periodontal (gum) disease. Tooth pain could signal decay. And sores, lumps or other spots on your lips, tongue or inside of your mouth and throat could be a sign of serious disease. You should contact us if you see anything out of the ordinary.
If you would like more information on how to care for your teeth and gums, 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 “10 Tips for Daily Oral Care at Home.”
According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.
At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.
And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.
As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.
Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.
Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.
Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.
If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?”
You've no doubt heard about certain foods and beverages that increase your risk for dental disease. These foods, often high in added sugar or acid, can lead to tooth decay or periodontal (gum) disease.
But have you heard about foods with the opposite effect — actually protecting your teeth against disease? Many of these dental-friendly foods are plant-based and fibrous: they stimulate saliva production, one of the mouth's best disease-fighting weapons.
But there are also some foods you might not expect to make the good list for dental health. Here are 3 surprising foods that could help you fight dental disease.
Cheese. We've long recognized milk as important to dental health — but cultured dairy products like cheese are also good for teeth. Cheese stimulates saliva, which neutralizes acid and replenishes the enamel's mineral content. Cheese also contains decay-stopping minerals like calcium, phosphorous and casein. And although milk cheese contains the sugar lactose, this particular type triggers less acid production than other sugars.
Black & green teas. You may have heard about the staining effect of tea, and avoided it as a result. But both forms of tea are also rich in antioxidants, substances that protect us against disease, including in the mouth. Black tea also contains fluoride, which strengthens enamel against cavities. If you drink tea, of course, you should exercise diligent hygiene to reduce any staining effect.
Chocolate. Yes, you read that right, chocolate: unrefined cocoa to be exact, which contains a number of compounds that resist decay. Ah, but there's a catch — chocolate in the form of your favorite candy bar usually contains high amounts of sugar. Sweetened chocolate, then, is a mixed bag of decay-resistive compounds and decay-promoting sugar. To get the benefit you'll have to partake of this favorite food of the Aztecs in a more raw, less sweetened form.
Of course, there's no single wonder food that prevents tooth decay. Your best approach is a diet rich in fresh fruits and vegetables, dairy and quality protein while limiting sugar-added and acidic foods.Â And don't forget daily brushing and flossing, coupled with regular dental visits for cleanings and checkups. Having a comprehensive dental care plan will help ensure your teeth remain healthy and disease-free.
If you would like more information on food choices and dental health, 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 “Nutrition & Oral Health.”
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