My Blog

Posts for: February, 2018

By Paul F Levy, DDS, PC
February 26, 2018
Category: Oral Health
Tags: oral health  
ChronicBitingHabitsCanLeadtoLooseTeeth

Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss.

Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose.

This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility.

If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences.

If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan.

If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth.

If you would like more information on loose 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 “Loose Teeth.”


By Paul F Levy, DDS, PC
February 18, 2018
Category: Oral Health
Tags: oral hygiene  
InflammationisaKeyElementinBothOralandSystemicDiseases

Anybody can contract periodontal (gum) disease if they don't brush and floss every day. Inadequate hygiene allows a thin film of disease-causing bacteria and food particles called plaque to build up.

But while we're all at risk for gum disease, some people are more so. This is especially true for those with diabetes, heart disease or other systemic conditions. The common denominator among all these conditions is inflammation, the body's defensive response to disease or injury.

When tissues become infected or damaged, the body causes swelling at the site to isolate the affected tissues, clear out diseased or dead cells and start tissue repair. Inflammation also produces redness, pain and, particularly with gum tissues, bleeding.

Inflammation is an important part of the body's ability to heal itself. It's possible, though, for the inflammatory response to become chronic. If that happens, it can actually begin doing more harm than good.

We're learning that chronic inflammation is a factor in many systemic diseases. For example, it can interfere with wound healing and other issues associated with diabetes. It also contributes to fatty deposit buildup in arterial blood vessels, which can lead to heart attacks or strokes. And in gum disease, chronic inflammation can cause gum detachment, followed by bone and tooth loss.

We're also learning that inflammation can create connections between these various health conditions. If you have an inflammatory disease like heart disease or diabetes, your risk for gum disease not only increases but it may also be difficult to bring under control. Likewise, if you have persistent gum disease, the associated inflammation could aggravate or even increase your risk for other systemic diseases.

Researchers hope continued discoveries about the interrelationship of inflammation with various conditions will lead to better treatment strategies, including for gum disease. In the meantime, getting prompt treatment for any inflammatory condition, especially gum disease, could help your treatment prospects with other conditions.

If you would like more information on connections between dental disease and other health conditions, 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 Link between Heart & Gum Diseases.”


By Paul F Levy, DDS, PC
February 03, 2018
Category: Oral Health
Tags: gum disease  
PeriodontalProbingIncreasesAccuracyinDiagnosingGumDisease

If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.

That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.

Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.

During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.

Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.

If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.

Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.

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 article “Understanding Periodontal Pockets.”