Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
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? Branching Tooth Roots can be Periodontal Nightmares.”
All treatments for periodontal (gum) disease focus on one goal — to remove any bacterial plaque and calculus (hardened plaque deposits) that are at the heart of the infection. Plaque is a thin surface film of food particles and bacteria that cause gum disease.
Plaque builds up on tooth surfaces due to inadequate oral hygiene. And as the disease progresses brushing and flossing won’t be enough — you’ll need our services and specialized equipment to fully remove the plaque and calculus. The basic technique is called scaling in which we remove plaque and calculus manually from tooth surfaces above and just a few millimeters below the gum line.
As the disease develops, though, the slight natural gap between teeth and gums may begin to increase to form voids known as periodontal pockets. Filled with infection, these pockets can extend below the gum line onto the roots of the tooth. If the pocket extends more than 4 millimeters, basic scaling may not be able to remove all of the plaque and calculus.
Periodontists (dentists who specialize in the treatment and care of gum tissues) can perform a surgical method to access these deeper areas. Known as flap surgery, this procedure aims not only to reach and disinfect periodontal pockets and root surfaces, but also repair damaged gum tissue and create a better environment for future hygiene and treatment.
As the name implies, we create an opening in the gum tissue with one side remaining attached to the gum structure — much like the flap of a paper envelope. Through this opening we’re able to reach areas to remove plaque and calculus, as well as install both bone grafts to regenerate lost bone and growth factors to stimulate tissue growth. Once finished, we stitch the flap back into place with sutures and, in many cases, place a moldable dressing to protect and hold the flap secure while the incision heals.
This relatively minor procedure can be performed with local anesthesia and requires only a few days of recuperation. The results, though, can provide long-term benefits — reduced infection, better bone and gum health, and a more conducive environment for future maintenance of health — that could save your teeth and your smile for many years to come.
If you would like more information on treatments for 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 “Periodontal Flap Surgery.”
A "toothy grin" might be endearing, but not necessarily healthy. More of the teeth showing may mean your gums have pulled back or receded from the teeth. If so, it's not just your smile that suffers—the parts of teeth protected by the gums could become more susceptible to disease.
There are a number of causes for gum recession. Some people are more likely to experience it because of genetically thinner gum tissues. Over-aggressive brushing could also contribute to recession. But the most common cause by far is periodontal (gum) disease, a bacterial infection triggered by dental plaque accumulating on teeth mainly as a result of inadequate hygiene.
There are some things we can do to help heal and restore recessed gums, most importantly treating gum disease. The number one goal of treatment is to uncover and remove all dental plaque from tooth and gum surfaces, which can take several sessions and sometimes minor surgery if the infection has reached the tooth roots. But removing plaque and tartar (calcified plaque) is necessary to stop the infection and allow the gums to heal.
For mild recession, this may be enough for the gums to regain normal coverage. But in more severe cases we may need to help rejuvenate new tissue with grafting surgery. In these highly meticulous procedures a surgeon uses microscopic techniques to position and attach donated tissue to the recession site. The graft serves as a scaffold on which new tissue growth can occur.
While these treatments can be effective for reversing gum recession, they often require time, skill and expense. It's much better to try to prevent gum recession—and gum disease—in the first place. Prevention begins with daily brushing and flossing to prevent plaque buildup, as well as regular dental visits for more thorough cleanings. Be on the lookout too for any signs of a beginning gum infection like swollen, reddened or bleeding gums and see your dentist as soon as possible to minimize any damage to your gums.
Caring for your gums is equally as important as caring for your teeth. Healthy gums equal a healthy mouth—and an attractive smile.
If you would like more information on preventing gum recession, 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 Recession.”
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.
To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.
Â While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.
The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter.Â It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.
Â Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.
Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.
If you would like more information on your treatment options for 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
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