It’s likely you depend on your regular dentist for the lion’s share of your dental care. But in cases of advanced disease or trauma, you may need the services of a dental specialist.
This could be the case with periodontal (gum) disease, a bacterial infection triggered by a thin biofilm on tooth surfaces called dental plaque that isn’t adequately removed through daily oral hygiene practices. While your regular dentist can effectively treat many forms of gum disease, there are times when you should see a periodontist who specializes in the gum, supporting bone and connective tissues.
So, when should you see a periodontist for gum disease treatment? Here are 3 situations that may call for this important dental specialist.
If your dentist refers you. Your dentist may be quite proficient in treating gum disease, mainly by removing the dental plaque and tartar sustaining the infection. But if the infection has advanced deep within the gum tissues especially around the roots and bone, you may need more advanced measures, including surgery, performed by a periodontist.
If you’d like a second opinion. Of course, you don’t need a referral to see a periodontist. You can make an appointment with one for another opinion about your diagnosis and recommended treatment plan. If you choose to see a periodontist, make sure they have access to all your dental and medical records, as well as your past health history.
If you have other health issues. Gum disease often doesn’t occur in a vacuum – it may exist and even influence (or be influenced by) other inflammatory medical conditions. If you have such a condition like diabetes or cardiovascular disease, you may opt to see a periodontist first for a more comprehensive evaluation.
In the meantime, keep an eye out for the first signs of disease including red, swollen or bleeding gums (if you smoke, be aware smoking hides these signs of disease). And practice daily brushing and flossing as well as obtaining regular dental cleanings to keep plaque accumulation to minimum. Preventing gum disease and getting treatment as early as possible may help you avoid more invasive treatments later.
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 “When to See a Periodontist.”
We readily understand the physical costs of a decayed tooth or infected gums — pain, discomfort and loss of function. It’s much more difficult to understand the emotional and social costs of a lost smile. Without that understanding we may be tempted to view restorative solutions as a luxury we can’t afford.
But there is a definite cost to a smile that embarrasses or makes you unhappy. It can inhibit your friendships and family relations and cause you to become withdrawn from others. Your career may suffer, especially if your vocation involves networking or similar social outreach where you no longer feel free to be outgoing. Most of all, though, your own feelings about your look can keep you from pursuing the things you love or that matter the most to you.
Viewed in that light, a “smile makeover,” a comprehensive approach to transforming your appearance, is an investment in a better life, not a frivolity. Although the word “cosmetic” can mean “a superficial outer adornment,” in the dental profession the meaning is much deeper. Dentists who specialize in smile design are focused on the overall effect of their work — not only with your mouth but with your whole face.
The process begins with a complete examination of your mouth to identify your particular dental needs. We also want to know about your expectations and desires for a better smile. We use that, along with the realities of your physical condition and other factors, to develop a treatment plan. The plan may be as singular as whitening procedures or porcelain veneers applied to the outside of your teeth — or it may be comprehensive with a variety of procedures that could include other specialties like orthodontics or oral surgery. The overall aim is to develop a plan that’s right for you, and realistically satisfies your expectations.
The end result can be life-changing. Even subtle changes can alter your own image perceptions and free you to be yourself in your personal and professional relationships. In the end the positive impact of your new smile will more than offset the costs for achieving it.
If you would like more information on smile transformation, 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 “The Impact of a Smile Makeover.”
Tooth decay and periodontal (gum) disease pose the most common dangers to dental health. But there are some rare conditions that can also place teeth at risk to be on the lookout for during regular dental checkups.
One such condition is root resorption in an adult tooth, in which the root itself or its surface breaks down and is absorbed by the body. Resorption occurs naturally in a primary (“baby”) tooth so it can loosen and give way for an incoming permanent tooth. Â Resorption still occurs in a limited form with young permanent teeth but should eventually stop.
Sometimes, though, it doesn’t, either from the inside of the tooth out (internal resorption) or more often from the outside in, usually around the neck-like (or “cervical”) portion of the tooth. This more common occurrence, External Cervical Resorption (ECR), can first appear as pink spots on the enamel and then progress into cavity-like areas. If not found and treated promptly, damage can occur quickly and lead to tooth loss.
We don’t fully understand the exact nature and causes for ECR, but we have identified risk factors for its development. Excessive orthodontic force on the teeth or any other trauma can cause damage to the periodontal ligament (which holds teeth in place with the jaw bone). Teeth grinding habits and some dental procedures like internal tooth whitening can also be risk factors.That being said, though, the vast majority of people who experience these issues don’t develop ECR.
Although the causes aren’t fully understood, we can still treat it: the key to success is early detection. You probably won’t notice early signs of ECR, but we can often detect spots from routine x-rays. We can then remove the tissue cells within the lesions causing the damage and restore the area with a tooth-colored filling material. If ECR has extended near the tooth’s interior pulp layer, then a root canal treatment may be needed.
Needless to say, the more extensive ECR occurs in the roots, the less likely the tooth can be saved and may need to be extracted. It’s important, therefore, to maintain regular dental checkups (at least twice a year) to increase your chances of catching a developing problem early.
If you would like more information on root resorption in adult 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 “Root Resorption: An Unusual Phenomenon.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
If you've suddenly noticed your smile looking more “toothy,” you may have a problem with your gums. They may have lost their normal attachment to your tooth and begun to shrink back — or recede.
Millions of people have some form of gum recession. The most common cause is periodontal (gum) disease, but it's not the only one. You may be more susceptible to gum recession because of heredity — you have thin gum tissues passed down to you from your parents. You may also be brushing too hard and too often and have damaged your gums.
Healthy gums play an important role in dental health. The crown, the tooth's visible part, is covered with a hard, protective shell called enamel. As the enamel ends near where the root begins, the gums take over, forming a tight band around the tooth to protect the roots from bacteria and acid.
Receding gums expose these areas of the tooth meant to be covered. This can lead to another tell-tale sign — tooth sensitivity. You begin to notice pain and discomfort while you consume hot or cold foods. And because it leaves your teeth and gums looking much less attractive, it can affect your confidence to smile.
Fortunately, though, we can help restore receded gums. If you have gum disease, it's imperative we treat it as early as possible. We do this by removing plaque, a thin film of bacteria and food particles that triggers the infection. We use special techniques and hand instruments to remove plaque and calculus (hardened plaque deposits) from all tooth surfaces including along the roots.
Gum disease treatment can help stop and even reverse gum recession. In some cases, though, the recession may have advanced too far. If so, we may need to consider surgically grafting donor tissue to the recessed areas. Depending on the site and extent of recession, this can be a very involved procedure requiring microscopic techniques.
The best approach, though, is to take care of your gums now. Daily brushing and flossing removes harmful plaque; regular dental visits take cleaning a step further and also give us an opportunity to detect disease early. By looking out for your gums now you might be able to avoid gum recession in the future.
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