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.”
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
Lots of people don’t know that April is National Stress Awareness Month; don’t fret if you’re one of them. For many, stress is already a common feature of everyday life. According to the American Psychological Association, 62% of Americans are stressed at their jobs, and stress has been estimated to cause the loss of some 275 million working days every year.
In addition to its other negative physical and mental consequences, stress can also spell trouble for your oral health. It may lead to the problems of teeth clenching and grinding, which dentists call bruxism. A habitual behavior that can occur in the daytime or at night, bruxism is thought to affect perhaps one in ten adults. While the evidence that stress causes bruxism is not conclusive, there’s a strong case for the linkage.
Bruxism sometimes causes symptoms like headaches, soreness or pain in the jaw muscles or joints, and problems with fully opening the mouth. It can be detected in the dental office by excessive tooth wear, and/or damage to tooth surfaces or dental work. Grinding or tapping noises heard at night may indicate that someone is grinding their teeth while sleeping. In children, nighttime bruxism is common and not necessarily a reason for concern; in adults, it may be more troubling.
So what can you do if you’re experiencing this problem? If you find yourself clenching and grinding during the daytime, simply becoming more aware of the behavior and trying to limit it can help. A bit of clenching during times of stress isn’t abnormal, but excessive grinding may be reason for concern. Many of the same techniques used to relieve stress in other situations—such as taking a step back, talking out your issues, and creating a calmer and more soothing environment—may prove helpful here as well.
Occasionally, prescription drugs may cause bruxism as an unwanted side effect; in this case, a medical professional may recommend changing your medication. The use of stimulants like coffee and mood altering substances like alcohol and illicit drugs have also been associated with teeth grinding—so if you’re having this issue, consider foregoing these substances and making healthier lifestyle choices.
There are also a number of dental treatments that can help protect your teeth from excessive grinding. The most common is an occlusal guard or “night guard.” This is a custom-fabricated appliance made of plastic that fits comfortably over your teeth. Usually worn at night, it keeps your teeth from actually coming into contact with each other and being damaged. Occasionally, additional treatments such as bite adjustment or orthodontics may be recommended to help solve the problem.
If you would like more information about teeth clenching and grinding, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”
Although dental visits are routine for most people, it’s a different experience for a few. About one in ten adults have high anxiety or fear of going to the dentist and may avoid it altogether—even when they have an acute situation.
If you’re one of those with dental visit anxiety there’s good news—we may be able to help you relax and have a more positive experience. Here are 3 things you need to know about reducing your anxiety at the dental office.
It starts with the dentist. While every patient deserves a compassionate, understanding dentist, it’s especially so if you suffer from dental visit anxiety. Having someone who will listen to your concerns in a non-judgmental way is the first step toward feeling more comfortable in the dentist’s chair. It also takes a sensitive practitioner to work with you on the best strategy for relaxation.
Relaxation often begins before your visit. There are various degrees of sedation (which isn’t the same as anesthesia—those methods block pain) depending on your level of anxiety. If you experience mild to moderate nervousness, an oral sedative an hour or so before your appointment could take the edge off and help you relax. Oral sedatives are also mild enough for use with other forms of sedation like nitrous oxide gas, and with local anesthesia.
High anxiety may require deeper sedation. If your level of anxiety is greater, however, we may recommend IV sedation to induce a much more relaxed state. The sedation drugs are delivered directly into your blood stream through a small needle inserted into a vein. Although you’re not unconscious as with general anesthesia, we can place you into a “semi-awake” state of reduced anxiety. The drugs used may also have an amnesiac effect so you won’t remember details about the procedure. This can help reinforce positive feelings about your visit and help reduce future anxiety.
If you’re anxious about dental visits, make an appointment with us to discuss your concerns. We’re sure we can work out a strategy to reduce your anxiety so you can receive the dental care you need.
If you would like more information on sedation therapy, 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 “IV Sedation in Dentistry.”
Losing teeth will certainly disrupt your otherwise beautiful smile. It could also potentially affect your food choices and whether or not you receive proper nutrition.
But something else just as consequential could be happening beneath the surface of your gums—you could be losing bone. Significant bone loss in the jaw could adversely affect remaining teeth and facial structure, as well as limit your future restoration choices.
To understand why this occurs we must first consider what bone is: living, cellular tissue. Like the body's other cells, bone has a life cycle: cells form, live and eventually dissolve (or resorb), and are then replaced by new cells. Stimulation from forces generated during chewing traveling up through the tooth roots to the jawbone keep this cycle going at a healthy pace.
But when a tooth is missing, so is this stimulation. This could slow the replacement rate and cause bone volume to gradually decrease. The jawbone width could decrease by as much as 25% the first year alone and several millimeters in height after just a few years.
Although dentures (a popular and affordable choice) can restore lost function and appearance, they can't duplicate this needed stimulation. They even accelerate bone loss by irritating and creating compressive forces on the bony ridges and the gums they rest upon.
One restoration, however, can actually help stop bone loss and may even reverse it: dental implants. This happens because an implant's metal titanium post imbedded in the jawbone attracts bone cells to grow and adhere to its surface. This could actually increase bone density at the site.
To gain this advantage, it's best to obtain implants as soon as possible after tooth loss. If you allow bone loss to occur by waiting too long, there may not be enough to properly support an implant. Even then it might be possible to build up the diminished bone through grafting. But if that's not possible, we'll have to consider a different restoration.
To determine the condition of your bone after losing teeth, visit us for a complete examination. Afterward, we'll be able to discuss with you the best way to address both your overall dental health and your smile.
If you would like more information on treating missing 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 “The Hidden Consequences of Losing Teeth.”
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