Posts for: September, 2018
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.”
While tooth decay seems to get most of the “media attention,” there’s another oral infection just as common and destructive: periodontal (gum) disease. In fact, nearly half of adults over 30 have some form of it.
And like tooth decay, it begins with bacteria: while most are benign or even beneficial, a few strains of these micro-organisms can cause gum disease. They thrive and multiply in a thin, sticky film of food particles on tooth surfaces called plaque. Though not always apparent early on, you may notice symptoms like swollen, reddened or bleeding gums.
The real threat, though, is that untreated gum disease will advance deeper below the gum line, infecting the connective gum tissues, tooth roots and supporting bone. If it’s not stopped, affected teeth can lose support from these structures and become loose or out of position. Ultimately, you could lose them.
We can stop this disease by removing accumulated plaque and calculus (calcified plaque, also known as tartar) from the teeth, which continues to feed the infection. To reach plaque deposits deep below the gum line, we may need to surgically access them through the gums. Even without surgery, it may still take several cleaning sessions to remove all of the plaque and calculus found.
These treatments are effective for stopping gum disease and allowing the gums to heal. But there’s a better way: preventing gum disease before it begins through daily oral hygiene. In most cases, plaque builds up due to a lack of brushing and flossing. It takes only a few days without practicing these important hygiene tasks for early gingivitis to set in.
You should also visit the dentist at least twice a year for professional cleanings and checkups. A dental cleaning removes plaque and calculus from difficult to reach places. Your dentist also uses the visit to evaluate how well you’re doing with your hygiene efforts, and offer advice on how you can improve.
Like tooth decay, gum disease can rob you of your dental health. But it can be stopped—both you and your dentist can keep this infection from ruining your smile.
The “magic” behind a dental implant’s durability is the special affinity its imbedded titanium post has with bone. Over time bone grows and attaches to the titanium surface to produce a strong and secure hold.
But there’s one important prerequisite for ultimate implant success—there must be an adequate amount of bone available initially to properly position the post during implantation. Otherwise, the implant may not have enough support to position it properly or cover the implant surface completely with bone.
Inadequate bone can be a problem for patients who lost teeth some time before and now desire to an implant restoration. This happens because when teeth are missing, so are the forces they generate during chewing. These forces stimulate new bone growth around the tooth root to replace older, dissolved bone at a healthy rate. If that replacement rate is too slow, the volume and density of bone may gradually diminish.
There is a way, though, to build up the bone for future implantation. Known as bone preservation procedure or a ridge augmentation, it’s a surgical procedure in which the dentist adds bone grafting material to the extraction socket or the bony ridge. The graft serves as a scaffold for new bone cells to grow and multiply. If successful, there will be enough new bone volume after several months of healing to support proper implant placement.
Bone grafting can add more time to the implant process. It may also mean you will not be able to undergo immediate crown placement after implantation (a “tooth in one day” procedure). Instead we would probably suture gum tissue over the implant to protect it and allow for full integration with the bone over a few more months. In the meantime, though, we could fit you with a temporary restoration like a removable partial denture (RPD) or a bonded bridge to improve the appearance of the space while the bone continues to heal.
After several months, your implant will have a better chance of a secure hold and we can then attach a life-like crown. Even if you’ve suffered bone loss, you’ll then have the benefit of not only a durable implant but also a new smile.