It’s been a long road back to oral health for you after periodontal (gum) disease. But after several plaque removal sessions and perhaps even surgical procedures to address deep infection, your gums have regained their healthy pink appearance.
But now you must face a hard reality: because you’ve had gum disease you’ll need to be extra vigilant with your oral hygiene to avoid another round with this destructive disease. But don’t worry—you won’t have to fight your prevention battle alone. We’ll continue to provide you care that reduces your risk of re-infection. We call that care periodontal maintenance (PM).
The heart of PM care involves regular dental visits for monitoring, cleanings and treatment when necessary. While most patients may visit their dentist at least twice a year, as a previous gum disease patient we may advise more frequent visits, especially if you’ve just finished periodontal treatment. Depending on the extent of your disease, we may begin with a visit every other week or once every two to three months. If your mouth continues to be disease-free we may suggest increasing the time between visits.
During your visit we’ll carefully examine your mouth, as well as screen you for any signs of potential oral cancer. We’re looking for both signs of re-infection or new issues with your teeth and gums. We’ll also assess the effectiveness of your oral hygiene efforts and advise you on ways you can improve.
If we find any signs of disease, we’ll then formulate a treatment plan to effectively deal with it. With frequent visits we have a better chance of discovering re-infection early—and the earlier the better to minimize any further damage. We may also need to take steps to make future PM care easier. This could include gum surgery to alter the tissues around certain teeth for easier access for examination and cleaning.
Our main focus with PM care is to look ahead: what can we do now to prevent a future bout of gum disease or at least lessen its effect? With continued monitoring and care we can drastically reduce your risk for further damage from this destructive disease.
If you would like more information on post-gum disease maintenance, 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 Cleanings.”
Two important practices boost your protection from dental disease: twice-a-year dental visits; and daily brushing and flossing. Of the two, that second one could be the most important.
Personal oral hygiene cleans the teeth of dental plaque, a thin film of bacteria and food particles that accumulates on them each day. This plaque buildup is the number one cause for both tooth decay and periodontal (gum) disease, so removing it reduces your risk of an infection.
But it's not just a matter of doing these tasks—it's also doing them well. A quick once-over isn't going to have the same preventive power as a more thorough job.
Here then are 4 tips for improving your daily oral hygiene efforts.
Time yourself brushing. It usually takes about two minutes to thoroughly brush all tooth surfaces. So, set a timer for two minutes, focusing on methodically brushing the front, back and biting surfaces of each tooth.
Easy does it. Brushing teeth requires only a gentle bit of manual force as the mild abrasives and detergents in your toothpaste provide most of the action of loosening plaque. In fact, aggressive brushing can lead to enamel and gum damage. Practice gentle scrubbing action when you brush.
Don't neglect flossing. While brushing gets most of the hygienic attention, it can't effectively get to areas between teeth where over half of built-up plaque can accumulate. Be sure then to floss at least once a day to remove plaque between teeth that brushing can miss.
Test yourself. Your dentist may be the ultimate judge for the quality of your hygiene, but you can check your effectiveness between visits. For instance, run your tongue across your teeth—it should feel smooth, not rough or gritty. Using a plaque disclosing agent periodically can also reveal missed plaque.
And don't forget to keep up your regular dental visits, which are necessary for removing plaque you might have missed or tartar that may have formed. They're also a great time to get advice from your dentist or dental hygienist on how you can further improve your own efforts in daily dental care.
If you would like more information on best oral hygiene practices, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.
With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”
That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.
Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.
Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.
Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.
But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.
This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.
Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.
As they mature, your child's teeth, gums and jaws develop—if all goes well, they'll all be healthy and functioning normally when they enter adulthood. But tooth decay and other problems could derail that development and cause lingering oral health issues later in life.
Following these 4 guidelines now during your child's early years will help ensure their teeth and gums have a healthy future.
Start oral hygiene early. There's no need to wait for their first teeth to come in to begin your child's regular oral hygiene. Start with wiping their gums right after feeding with a clean wet cloth to minimize bacterial development. Then, start brushing as soon as teeth appear—to begin with, use a slight smear of toothpaste on the brush. As they mature, teach them to brush and later floss for themselves.
Check your water. Most utilities add tiny traces of fluoride to their drinking water supply. If your water supplier does, it can make a big difference (along with fluoride toothpaste) in helping your child avoid tooth decay. If your system doesn't, then speak to your dentist about whether your child could benefit from topical fluoride applied directly to their teeth.
Keep a check on sugar. Decay-causing bacteria thrive on the sugar added to processed foods, candies and many beverages. Even milder forms of sugar like lactose found in milk or formula can stimulate bacterial growth. So, in addition to daily brushing and flossing, do your best to minimize sugar in your child's diet. And don't put infants or toddlers to bed with a bottle filled with any liquid other than water.
See the dentist. Starting around their first birthday, regular dental visits can help keep your child's dental development on track. Dental visits are also an opportunity for preventive treatments against decay like sealants or topical fluoride. Your dentist may also detect the early signs of bite problems that if addressed now, could lessen their impact later in life.
Your child's dental health could get off course before you even realize it. But partnering with your dentist, you can help make sure your child's teeth and gums have a bright and healthy future.
If you would like more information on how best to care for your child's 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 “Top 10 Oral Health Tips for Children.”
Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and dental 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 “Osteoporosis Drugs & Dental Treatment.”
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