What is Gum Disease?

Gum disease, or periodontal disease is a chronic inflammation and infection of the gums and surrounding tissue. It is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in their life. Periodontal diseases include gingivitis and periodontitis.

 

What causes gum disease?

 

Bacterial plaque – a sticky, colorless film that constantly forms on the teeth – is recognized as the primary cause of gum disease. If plaque isn't removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar).Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper, and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction.

 

Are there other factors?

 

Yes. Genetics is also a factor, as are lifestyle choices. A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues than non-tobacco users, while stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control. Pregnant women experience elevated levels of hormones that cause the gums to react differently to the bacteria found in plaque, and in many cases can cause a condition known as "pregnancy gingivitis."

 

What are the warning signs of gum disease?

 

Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, pus between the gum and tooth, persistent bad breath, a change in the way teeth fit together when the patient bites and a change in the fit of dentures. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental exams.

 

What does periodontal treatment involve?

 

In the early stages of gum disease, most treatment involves a special cleaning called scaling and root planning, which removes plaque and tartar around the tooth and smoothing the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums – sometimes with the assistance of a laser – and removing the hardened plaque build-up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.

How do you prevent gum disease?

 

Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk. Your dentist can design a personalized program of home oral care to meet your needs.

 

What is the role of the general dentist?

 

The general dentist usually detects gum disease and treats it in the early stages. Some general dentists have acquired additional expertise to treat more advanced conditions of the disease. If the general dentist believes that the gum disease requires treatment by a specialist, the patient will be referred to a periodontist. The dentist and periodontist will work together to formulate a treatment plan for the patient.

 

How can I maintain treatment at home?

 

Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of periodontal therapy. Patients should visit the dentist every three to four months (or more, depending on the patient) for spot scaling and root planing and an overall exam. In between visits, they should brush at least twice a day, floss daily and brush their tongue. Manual soft nylon bristle brushes are the most dependable and least expensive. Electric brushes are also a good option, but don't reach any further into the pocket than manual brushes. Proxy brushes (small, narrow brushes) and other interdental cleaners are the best way to clean between the recesses in the teeth and should be used once a day. Wooden toothpicks and rubber tips should only be used if recommended by your dentist.

Mouthguard Warrior Kids

Most people, kids included, have experienced the "weekend warrior" syndrome, where you think your body is invincible to injury and that you do not need protective gear such as helmets for your head and pads for your knees, shins and elbows. In particular, teeth are often forgotten. Although the dental profession unanimously supports the use of mouthguards in a variety of athletic and recreational activities, consumers remain resistant to and ill-informed of the importance and advantages of wearing a mouthguard during their weekend activities.

 

"There are three reasons most people don't wear mouthguards: cost, the ‘headache factor‘ and image," says David Kumamoto, DDS, FAGD. "What people fail to realize is how many serious injuries such as concussions, jaw fractures and neck injuries are prevented by mouthguards."

 

It is estimated that mouthguards prevent more than 200,000 injuries each year. Although orofacial injuries are traditionally associated with contact sports such as football and hockey, findings show that soccer players are more likely than football players to sustain an orofacial injury and basketball players have a risk up to 15 times that of football players. These statistics do not include the number of people participating in leisure sports such as flag football and pick-up basketball games with friends. And, more people currently participate in organized soccer than those participating in competitive football, where mouthguards and face masks are mandatory.

 

"Pick-up games prove more of a risk than supervised sports because there are no officials to enforce game rules," says Dr. Kumamoto. "But even supervised sports have their share of serious injuries due to the lack of protective equipment. Sudden falls and accidental collisions during a game or athletic activity can cause dental injuries."

 

"Of the three types of mouthguards that are currently available, a custom-made mouthguard by your dentist offers the best protection, fit and comfort level because it is made from a cast to fit your teeth," says Dr. Kumamoto. "Mouth-formed guards are available at sporting goods stores and are less expensive than custom-made guards, however the fit is not as good and it will not last as long. A stock mouthguard, the least expensive choice, offers the least protection since little can be done to adjust the fit. However, even the least expensive mouthguard is better than none."

 

The Academy of General Dentistry recommends that players participating in basketball, softball, wrestling, soccer, lacrosse, rugby, in-line skating and martial arts, whether for an athletic competition or leisure activity, wear mouthguards while competing.

Dental Sealants: Is My Child a Candidate?

  By age 19, tooth decay affects nearly 70 percent of America's children, according to the Centers for Disease Control and Prevention (CDC). Left untreated, tooth decay, also known as cavities, may result in pain and infection.

 

One highly effective option to help prevent cavities is dental sealants – a thin plastic film painted on the chewing surface of teeth.

 

Dental sealants have been proven a safe and cost-efficient dental procedure for patients prone to cavities. Even health care task forces are recognizing the benefits of dental sealants, recommending school-based programs.

 

However, an article in the February 2006 issue of AGD Impact, the Academy of General Dentistry's (AGD) monthly newsmagazine, cites several reports that explain dental sealants are still underused, despite their advantages in averting tooth decay for an average of five to seven years.

 

"Studies show that many children are exceptional candidates for dental sealants.," says AGD spokesperson Mark Ritz, DDS, MAGD. "Parents should consider sealants as a preventive measure in their child's oral health and discuss this option with their dentist."

 

Surveys show the majority of all cavities occur in the narrow pits and grooves of a child's newly erupted teeth because food particles and bacteria are not easily cleaned out. A risk assessment by a dentist best determines if a child is a candidate for dental sealants.

 

Dental sealants act as a barrier to "seal-off" space between the tooth surface and any small food particles or bacteria that may otherwise cause a cavity in an "unsealed" tooth.

 

Paired with twice-daily brushing with a fluoridated toothpaste, a healthy diet and visiting the dentist twice a year to monitor the sealants' placement or bond on the tooth, properly applied dental sealants are 100-percent effective in preventing cavities.

 

"Remember that dental sealants do not protect against gum disease such as gingivitis, oral cancer or many common dental conditions," says Dr. Ritz. "Regular dental checkups are vital to monitor overall oral health."

 

Benefits of dental sealants:

 

• Paired with good oral health care, sealants are 100-percent effective against cavities in teeth that are sealed and properly maintained.
• Minimally invasive, safe and effective preventive procedure.
• Costs less than getting a cavity filled.

Taking Herbal Supplements? Tell Your Dentist

Alternative medicine isn't so alternative anymore. Once dismissed as a fad or fringe movement, alternative medicine has become an increasingly popular component of mainstream health care, including dentistry.

 

But patients need to use caution when using any alternative, "natural" treatments, including herbal supplements.

 

"'Stop, look and listen' applies to the health-food counter as much as the intersection," says Academy of General Dentistry spokesperson Eric Z. Shapira, DDS, MAGD. Most patients neglect to include vitamins and herbal remedies when listing their medications for their dentist or physician. But even the most common herbs, such as St. John's wort and ginkgo biloba, can cause serious health problems if taken in combination with other drugs or taken in extreme dosages.

 

"People think herbs are harmless because they are considered 'natural,' and they think, if one is good, 10 are better," said Dr. Shapira. But overdoing it with supposedly safe herbs can cause health problems as serious as internal bleeding and heart arrhythmia, Dr. Shapira warns.

 

He also points out that all drugs are natural. "Almost all medicines start out as plants, but established drugs have the benefit of being standardized and regulated by the Food and Drug Administration," he says. Herbal medications are not standardized or regulated in any way.

 

Dr. Shapira urges patients to be well informed before taking any herbal concoction or embarking on an alternative therapy such as acupuncture, chiropractic or even aromatherapy. That means more than reading the manufacturers' promotional material or Internet sites.

 

 

 

Recommendations for some natural remedies for oral health:

 

Fluoride – This naturally occurring mineral has been proven to protect teeth from decay. Many municipal water supplies contain fluoride. Other sources are fluoride toothpaste, mouthwash and topical rinses and pastes applied in the dental office.

 

Alcohol-free mouthwash – Some common mouthwashes contain alcohol to cover up the smell of plaque. But alcohol dries out the mouth, which can cause discomfort and create an environment for more plaque to thrive.

 

Tea – A folk remedy that works, wet tea bags can provide relief from canker sores, swollen gums and toothache.

 

Zinc – This mineral is widely available in lozenges that can relieve the pain of a sore throat, but use sparingly. As with any herb, vitamin or mineral, patients need to follow directions and inform their dentist of its use.

The importance of x-rays

Radiographic, or X-ray, examinations provide your dentist with an important tool that shows the condition of your teeth, its roots, jaw placement and the overall composition of your facial bones. X-rays can help your dentist determine the presence or degree of periodontal (gum) disease, abscesses and many abnormal growths, such as cysts and tumors. X-rays also can show the exact location of impacted and unerupted teeth. They can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination.

Your radiographic schedule is based on your dentist's assessment of your individual needs, including whether you're a new patient or a follow-up patient, adult or child. In most cases, new patients require a full set of mouth X-rays to evaluate oral health status, including any underlying signs of gum disease, and for future comparison. Follow-up patients may require X-rays to monitor their gum condition or their chance of tooth decay.

See a Baby Tooth? See a Dentist

 

Baby teeth are worth more than just a dollar under the pillow. Providing proper care and oral hygiene during a child's first year of life can mean a lifetime of good oral health.

 

Traditionally, parents have waited to bring their children to the dentist until primary teeth begin to appear. A 2002 consumer poll by the American Academy of Pediatric Dentistry shows that nearly 70 percent of parents wait until their children are 3 years old before taking them to the dentist. But a dental visit by age 1 – or within six months of the eruption of the first baby tooth – is crucial, says Academy of General Dentistry (AGD) spokesperson Cynthia E. Sherwood, DDS.

 

Dr. Sherwood says this early visit gives a dentist the opportunity to see potential problems such as early-childhood caries (also known as baby bottle tooth decay); educate the parent on proper oral hygiene for the child; and give the toddler a positive experience in a dental setting. This can do wonders in allaying fears and boosting the child's future attitude toward visiting the dentist, Dr. Sherwood says.

 

Education is the heart of the age-1 exam. "When we see a toddler, we primarily talk to the parents about growth, development, thumb sucking, bottle and breast feeding, oral hygiene and nutritional issues, use of fluoride and why baby teeth are important," Dr. Sherwood said.

 

During this first visit, the dentist usually will sit knee-to-knee with the parent, with the child nestled in the parent's lap, and the dentist will ask the parent to demonstrate how she or he brushes the child's teeth. Then, if parent and tot are comfortable, the dentist will turn the child around onto his or her lap, so the dentist can get a good look at the child's teeth and gums. This "pleasant, painless visit" should take no more than 15 minutes, Dr. Sherwood said.

 

"Sitting knee-to-knee with the parent, playing with the baby and talking with the parent, I can get a very good sense of the child's oral health care, and this position gives us a good opportunity to get a good look at the child's teeth," says Dr. Sherwood. "It's a great experience for everyone involved."

 

Toddler dos and don'ts:

 

DO:

 

• Take your child to the dentist within six months of the eruption of the first baby tooth, definitely by age 1.
• Follow your dentist's advice regarding nutrition, hygiene routine, fluoride and dental-visit schedule.
• Teach your child how to brush around age 3, and brush your teeth with your children to model good technique and spot problems.

DON'T:

 

• Think baby teeth don't matter "because they'll just fall out anyway."
• Allow children to have continual access to a bottle or "sippy cup" filled with anything other than water.
• Give your children the impression that visiting the dentist is unpleasant.

Does a Smaller Waist Mean Smelly Breath?

 

Many people wanting to slim down are jumping on the low-carbohydrate diet trend in an attempt to lose weight. However, as dieters shed pounds, many are saying goodbye to carbs and hello to halitosis. 

 

Low-carb diets work by limiting the amount of carbohydrates ingested, which allows the body to burn stored fat instead of carbohydrates. When the body burns fat as fuel, chemicals called ketones are produced. These ketones are released in the breath and urine and may result in halitosis. Ketones aren't the only bad breath culprit for this diet. The types of foods ingested also play a role.

 

"Most cases of bad breath originate from the breakdown of food particles that produce sulfur compounds, and from bacteria on the gums and tongue," says Academy of General Dentistry spokesperson Bruce DeGinder, DDS, MAGD. " High-protein foods can produce more sulfur compounds, especially overnight on the surface of the tongue when saliva production is diminished."

 

Tips to combat halitosis:

 

1. Drink water to wash away germs

 

Drinking plenty of water can help dilute the concentration of ketones, but that isn't the only benefit. Drinking water throughout the day can help cleanse teeth of excess bacteria and food debris. Bad breath can sometimes be caused by food particles caught in the teeth, and drinking water will help rinse away odor-causing particles.

 

2. Chew sugarless gum with xylitol

 

Chewing sugarless gum after meals can help keep bad breath away. Saliva production increases during chewing and this can help neutralize acid production and rinse food particles from the mouth. Chewing parsley can have the same effect because it also increases saliva production.

 

Sugar-free gum with xylitol can also help prevent cavities. Xylitol is a natural sweetener found in plants and fruits, and research shows it inhibits the growth of Streptococcus mutans, the oral bacteria that cause cavities.

 

3. Keep a toothbrush handy and brush after all meals

 

Brushing and flossing at least twice a day can help keep your mouth healthy and prevent odors. An AGD survey found that 75 percent of people eat at the office but less than 15 percent of them brush their teeth after eating. Cleaning the tongue with a toothbrush or tongue scraper after meals can also help alleviate odors.

 

If halitosis continues, a general dentist or doctor can help determine the source of the odor. Halitosis can sometimes have more serious causes. "Ketone breath is also used to describe a fruity smell on the breath that can be an indication that a person may have diabetes," says Dr. DeGinder. "This can originate when the body is breaking down fat particles because there is not sufficient glucose present as fuel for energy."