Posts for: September, 2014
Periodontal disease is the leading cause of tooth loss in adults. A recent survey by the Centers for Disease Control and Prevention showed that nearly half of Americans older than 30 had some signs of periodontal disease. That's more than 64 million people.
How much do you know about this potentially serious disease? Take our quiz and find out.
True or False: Gum Disease is caused by bacteria in the mouth
TRUE. Of the hundreds of types of bacteria that occur naturally in the mouth, only a small percentage are harmful. But when oral hygiene (brushing and flossing) is lacking, these can build up in a dental plaque, or biofilm. This often causes inflammation of the gums, the first step in the progression of gum disease.
True or False: Gum disease is more prevalent among younger people
FALSE. Gum disease is most often a chronic disease, meaning that it progresses over time. Statistics show that as we age, our chances of developing gum disease increase, as does the disease's severity. In fact, according to the study mentioned above, about 70% of adults 65 and over have mild, moderate or severe periodontitis, or gum disease.
True or False: Bleeding of the gums shows that you're brushing too hard
FALSE. You might be brushing too hard — but any bleeding of the gum tissue is abnormal. Gum sensitivity, redness and bleeding are typically the early warning signs of gum disease. Another is bad breath, which may be caused by the same harmful bacteria. If you notice these symptoms, it's time for a checkup.
True or False: Smokers are more likely to develop gum disease
TRUE. Not only are smokers more likely to develop gum disease, but in its later stages they typically show more rapid bone loss. Smoking also prevents the warning signs of gum disease - bleeding and swelling of the gum tissues - from becoming apparent. Other risk factors for developing the disease include diabetes and pregnancy (due to hormonal changes). Genetics is also thought to play a role in who gets the disease — so if you have a family history of gum disease, you should be extra vigilant.
True or False: The effects of gum disease are limited to the mouth
FALSE. Numerous studies suggest that there is a relationship between periodontal health and overall health. Severe gum disease, a chronic inflammatory disease, is thought to increase the risk of cardiovascular diseases like heart attack and stroke. It may also lead to complications in pregnancy, and problems of blood-sugar control in diabetics.
So if you have any risk factors for gum disease, or if you notice possible symptoms, don't ignore it: let us have a look. We can quickly evaluate your condition and recommend the appropriate treatments if necessary. With proper management, and your help in prevention, we can control gum disease.
If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”
While dental implants are considered the gold standard for tooth replacement, removable dentures are still a viable choice, especially for patients with edentulism (complete tooth loss). Removable dentures have also undergone considerable advancement to improve their function, appearance and longevity.
But even with these advancements, dentures still require a fair amount of skill, experience and — of utmost importance — a sense of art. If you’re considering this option, long-term success depends on a careful process of construction, fit adjustment and regular checkups to maintain that fit.
Our first step is to determine exact tooth placement on each denture. Using facial features (or photos before tooth loss) we establish placement landmarks so that corresponding upper and lower teeth align properly. We also consider tooth size, their orientation in relation to the lip, and the needed space to leave between the upper and lower teeth when they are at rest. We make these determinations based on accepted standards of beauty, but also taking into account your particular comfort level with any features that might alter your appearance.
The denture’s gums must also look realistic when you smile, especially if your upper lip rises above the teeth to expose more gum tissue. We also want to match the color and texture of your natural gums, as well as incorporate palatal rugae, the little ridges behind the upper front teeth that aid with speech and chewing food.
When we first place the new dentures in your mouth, we may need to adjust them for balance between the upper and lower sets when they come together. An imbalanced fit could have an adverse effect on your ability to bite, chew and speak normally.
Your dentures should have a good, comfortable fit. Over time, however, you will encounter some degree of bone loss because you no longer have your natural teeth to stimulate bone growth and absorb the forces created during function when your teeth contact. This and other factors may cause your dentures to become loose and uncomfortable to wear. For that reason, it's important for you to visit us regularly to maintain that good fit and check the health of underlying tissues and bone.
Careful planning and denture construction help ensure your new dentures successfully restore form and function to your mouth. Regular monitoring will also ensure they continue to serve you well for as long as possible.
If you would like more information on removable dentures, 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 “Removable Full Dentures.”
Sleep apnea, a form of sleep-related breathing disorders that is estimated to affect some 22 million Americans, is sometimes thought of as the “quiet culprit” lurking behind many other maladies. But ask anyone who sleeps alongside a sufferer, and you'll get a different response: It isn't quiet at all! Instead, it's often marked by loud snoring and scary episodes where breathing seems to stop. If you've ever worried that you or someone you care about may have this condition, here are five facts you should know.
1) Sleep apnea is a potentially deadly disease
For one thing, it leads to chronic fatigue that can make accidents far more likely — a special concern in potentially dangerous situations, like operating machinery or driving a vehicle. It also appears to be related to heart conditions such as high blood pressure, irregular heartbeat, coronary artery disease, and even stroke. Plus, it can lead to weight gain, depression and mood disorders.
2) People with sleep apnea may wake hundreds of times every night
These “micro-arousals” may occur 50 or more times per hour, and may keep a person from getting any relaxing sleep — even though they retain no memory of the episodes. That's why people who suffer from sleep apnea often go through their days on the verge of exhaustion. And they aren't the only ones who suffer: Their bed partners may also be kept up throughout the night, becoming anxious and irritable.
3) Persistent snoring can be a symptom of sleep apnea
Snoring is caused when breath being drawn into the lungs is obstructed by soft tissue structures in the upper airway. Most everyone snores sometimes… but chronic loud snoring is a common symptom of obstructive sleep apnea (OSA) — and the louder and more frequent the snoring, the greater the likelihood of OSA. To confirm a diagnosis of sleep apnea, a sleep study using special monitors may be conducted in a clinical setting, or an at-home test may be used.
4) Your dentist may be able to help diagnose and treat sleep apnea
What does dentistry have to do with sleep apnea? For one thing, sleep apnea is a disease that involves structures in the oral cavity — an area dentists are quite familiar with. Sometimes, fatigued folks who suffer from OSA begin snoring when they recline in the dental chair, showing their symptoms firsthand. But even if their patients don't fall asleep, dentists with proper training are recognized by the American Academy of Sleep Medicine (AASM) as being able to provide first line therapy for mild to moderate sleep disorders.
5) An oral appliance is a good step to try before more invasive treatments
If it's appropriate in your situation, your dentist can custom-fabricate an oral appliance that may alleviate sleep-related breathing disorders. This device, worn while you're sleeping, helps to maintain an open airway in the throat and to reduce breathing problems. With a success rate of around 80%, in many cases it's comparable to the more complex CPAP (continuous positive air pressure) machines, but people often find it easier to wear. Plus, it's a non-invasive treatment that can be explored before deciding on a more involved treatment, such as surgery.
If you would like more information about dentistry and sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”
Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.
Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.
Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.
There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.
If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.
In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.
We now have amazing therapies to replace lost teeth with life-like replicas that look and perform like real teeth. But for oral health in general it’s still better to save a natural tooth if we can.
That’s the main purpose of a root canal treatment — to rescue a tooth whose pulp (an area of tissue and nerve bundles inside the tooth) has died from trauma or ravaged by a bacterial infection that continues to progress up into the bone via the root canals. By accessing the pulp through a small opening in the top of the tooth we remove the dead and infected pulp tissue, thoroughly disinfect the empty pulp chamber and root canals, and then fill them with a special filling. We then seal the opening (and later install a permanent crown) to prevent future fracture of the tooth and re-infection.
So, how can you know your tooth is in danger? Your first indication may be an intense tooth pain that comes on quickly. This pain is emanating from the nerves in the pulp as the tissue begins to die. Once the nerves have died, they will no longer transmit pain signals: hence the pain will subside rather quickly in about two or three days.
So it is important to understand that the absence of pain doesn’t mean the infection has subsided — quite the contrary, it’s still present and active, making its way along the root canals of the tooth. At this point you may begin to notice a secondary pain when you bite down on the tooth. This is originating from other nerves located around the periodontal ligament (the main tissue that helps hold teeth in place with the bone) as the tissues become inflamed from the infection. You may also develop an abscess, an area in the gum tissue where infectious pus may collect. Depending on its location, the abscess can be acutely painful or “silent,” meaning you may not feel any pain at all. The infection is still there, though, and the tooth is still in danger.
If you encounter any of the pain symptoms just described, you should visit us for an examination as soon as possible. If the cause indicates the need for a root canal treatment time is of the essence — the longer we delay, the greater the risk of ultimate tooth loss.
If you would like more information on root canal treatments, 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 “Signs and Symptoms of a Future Root Canal.”