The red and puffy gums that sometimes accompany the onset of periodontal (gum) disease don't always catch your attention. You may not even get any symptoms at all, in fact, until the disease has become well advanced.
That's why regular dental visits are so important for gum health: For while you may not notice anything abnormal about your gums, we have a simple procedure known as periodontal probing that can help diagnose the condition of your gums.
Gum disease is a common bacterial infection that affects millions of people worldwide. It most often begins with plaque, a filmy, bacterial buildup on teeth. These bacteria feed and multiply on the remnant food particles in the film, increasing the chances for an infection.
As it grows—as well as the inflammation the body initiates to fight it—the infection weakens the gum attachment to teeth. This can cause the miniscule gap between gums and teeth at the gum line to widen, forming a void called a periodontal pocket. The deeper and wider the pocket, the more advanced the gum infection.
We may be able to verify the presence of a periodontal pocket by using a long, thin probing instrument with millimeter gradations. We gently insert the probe at various locations around a tooth as far as it will comfortably go. We then record the depth by reading the gradation measures lined up with the top of the gums, as well as observing how snug or loose the probe feels within the gum space.
One to three millimeters signifies a healthy attachment between the tooth and gums—anything more than that usually indicates gum disease. Measurements of 5mm indicates a problem, the higher the number, the more advanced is the periodontal disease.
We use these probe readings and other factors to guide our treatment approach in individual cases of gum disease. With a less-advanced infection we may only need to remove plaque and calculus adhering to the crown and just below the gum line. More advanced gum disease infecting the root area may require surgical access through the gums.
All in all, keeping up with regular dental visits can increase the chances of early diagnosis, when the disease is still in its initial stages. And daily oral hygiene to remove harmful plaque may help you avoid gum disease altogether.
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 “Understanding Periodontal Pockets.”
You could have an unattractive smile because of a chipped tooth or one slightly out of alignment. Or, it could be both of the above, plus some heavy staining to boot. Correcting each flaw individually might require a combination of different methods like orthodontics or porcelain crowns, which can take an extended period of time to complete.
But you may be able to correct numerous smile flaws with just one method—and in no more than a couple of treatment visits. It's called direct veneers.
Unlike regular veneers, direct veneers don't require a dental technician to craft a thin porcelain shell to bond over teeth. Rather, a dentist applies a tooth-colored material called composite resin to the problem teeth and "sculpts" an entirely new look that can correct multiple dental flaws at one time.
The dentist usually begins the process by creating a model ("wax-up") of proposed changes based on physical impressions of the jaw and teeth. Both dentist and patient can study the model and modify it if necessary, when finalizing the treatment plan.
At a subsequent appointment, the dentist prepares the tooth surface for bonding by removing a thin layer of tooth enamel, then shapes the teeth to better accommodate the composite resin. This tooth prep is similar to that done with traditional veneers, so it's permanent—the teeth will require some form of restoration from then on.
After applying an etchant and a bonding agent, the dentist applies the composite resin in small amounts, hardening each layer with a special light before applying the next one. With each subsequent layer, the dentist sculps the composite material to eventually resemble the wax-up model.
After completing the composite application, the dentist then uses hand tools and a dental drill to complete shaping, as well as an abrasive strip between teeth to aid future flossing. After just a few hours, the transformation is complete.
Direct veneers are durable, but not to the same extent as regular veneers or other cosmetic enhancements. They can also pick up stains over time, and may require re-treatment at some point. Still, direct veneers are a cost-effective way to improve the appearance of teeth with multiple flaws that could radically change your smile for the better.
A few months into wearing braces you may notice your gums are swollen. It's likely you've developed periodontal (gum) disease.
Gum disease is a bacterial infection that usually begins with dental plaque. This thin, accumulated biofilm on teeth is filled with bacteria that cause dental disease. The more of it that remains on your teeth, the higher your risk for a gum infection.
In addition to regular dental cleanings, the best way for a person to reduce their gum disease risk is to remove plaque on a daily basis through brushing and flossing. Unfortunately, wearing braces complicates this: The brackets and wires affixed to your teeth can get in the way of your toothbrush and regular dental floss. As a result, you can easily miss plaque hidden around these bits of hardware.
Aside from gum disease, the braces themselves can irritate your gums. This irritation inflames the gums and may even cause more tissue to grow. Compound this overgrowth with a possible gum infection and it's no wonder your gums are severely swollen.
To lessen the chances of swollen gums with braces, you'll need to beef up your daily hygiene efforts. Simply put, it will typically take more time than normal to thoroughly clean around your braces. A few specialized tools, though, might make it easier.
An interproximal brush with a narrower head than a regular toothbrush is useful for accessing tight places around brackets. And a floss threader or a water flosser (which uses pressurized water to loosen and remove plaque) may help you better maneuver around wires to remove plaque between teeth.
Keeping your teeth clean as possible will certainly help you avoid gum swelling due to disease. But swelling from tissue overgrowth may not be resolved until your braces come off. In severe cases, it may even be necessary to remove the braces to treat the gums before resuming orthodontic treatment.
In any case, be as thorough as possible with your oral hygiene efforts during orthodontics and see your regular dentist for cleanings every six months. When you have completed orthodontic treatment, cleanings every six months are usually recommended. It's the best way to keep your gums healthy while you're wearing braces.
If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”
Performing for an awards show is a quite a feather in an entertainer's cap. So, up-and-coming country music star Carly Pearce was obviously excited when she gained a slot on last November's Country Music Awards. But an accident a couple of weeks before the event almost derailed her opportunity when she fell and knocked out two of her front teeth.
Fortunately, Pearce took quick action and, thanks to a skilled dental and medical team, was able to put her mouth back together before the show. Those watching her perform her hit single, “I Hope You're Happy Now,” as she smiled broadly would never have known otherwise about her traumatic emergency if she hadn't spilled the beans.
Orofacial injuries can happen to anyone, not just entertainers. You or someone you love could face such an injury from a motor vehicle accident, hard sports contact or, like Pearce, a simple slip and fall. But if you also act quickly like Pearce, you may be able to minimize the injury's long-term impact on dental health and appearance.
Here are some guidelines if you suffer a dental injury:
Collect any tooth fragments. Dental injuries can result in parts of teeth—or even a whole tooth—coming out of the mouth. It may be possible, though, to use those fragments to repair the tooth. Try to retrieve and save what you can, and after rinsing off any debris with cold water, place the fragments in a container with milk.
Re-insert a knocked-out tooth. You can often save a knocked-out tooth by putting it back in its socket as soon as possible. After cleaning off any debris, hold the tooth by its crown (never the root) and place it back in the empty socket. Don't fret over getting it in perfectly—your dentist will assist its placement later. Place a piece of clean cloth or cotton over the tooth and have the injured person bite down gently but firmly to hold it in place.
See the dentist ASAP. You should immediately see a dentist if any tooth structure has been damaged, or if a tooth is loose or has been moved out of place. If you're not sure, call your dentist to see if you should come on in or if you can wait. If a dentist is not available, go immediately to an emergency room or clinic. With many dental injuries, the longer you wait, the more likely the teeth involved won't survive long-term.
A dental injury could happen in a flash, with consequences that last a lifetime. But if, like Carly Pearce, you take prompt action and obtain necessary dental care, you could save an injured tooth—and the smile that goes with it.
Along with tooth decay, periodontal (gum) disease is a primary enemy of oral health. If not caught and treated, a gum infection could spread and eventually cause tooth loss.
But although prevalent among the general population, one demographic in particular is highly susceptible to gum disease—smokers and tobacco users in general. It's estimated over 60 percent of all smokers will contend with a gum infection at some point during their lifetimes. Smokers are also twice as likely as non-smokers to develop advanced gum disease that could lead to serious dental damage.
The high rate of gum disease among smokers (and to some extent, all tobacco users) is connected to the effect that tobacco has on oral health in general. Studies show that nicotine constricts blood vessels in the mouth, which in turn reduces their delivery of antibodies to fight disease-causing bacteria. As a result, smokers have more harmful bacteria in their mouths than non-smokers, which increases their risk of dental disease.
Smokers are also less likely than non-smokers to display inflammation or redness, the initial signs of a burgeoning gum infection. This too has to do with the constricted blood vessels in the gums that can't deliver adequate oxygen and nutrients to these tissues. As a result, the gums can appear pink and healthy, yet still be infected. This could delay diagnosis of gum disease, allowing the infection to become more advanced.
Finally, smoking can interfere with the treatment of gum disease. Because of nicotine, a tobacco users' infections and wounds are often slower to heal. Combined with late diagnoses of gum disease, this slower healing creates an environment where smokers are three times more likely than non-smokers to lose teeth from gum disease.
If you do smoke, it's important to let your dentist know how much and for how long you've smoked, which could be relevant to any dental care or treatment. Better yet, quitting the habit could improve your oral health and lower your risk for teeth-destroying gum disease.
If you would like more information on the effects of smoking on oral 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 “Smoking and Gum Disease.”
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