Posts for: February, 2018
Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.
Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.
Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.
As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.
But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.
While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.
And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.
If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Periodontal Plastic Surgery.”
Due to financial circumstances, people often have a lost tooth restored with a removable partial denture, an effective appliance that restores function and a degree of aesthetic appearance. Later, though, they may want to improve both function and appearance with a dental implant.
If this describes you, you’re making a great choice. Dental implants are the closest technology we have to a natural tooth. But there may be a roadblock to your implant, especially if a long time has passed since your tooth loss—there may not be enough bone at the site to place an implant.
The heart of an implant is a titanium metal post surgically imbedded in the jawbone. The titanium naturally attracts bone cells, which grow and adhere to it to form a solid hold that can support a porcelain crown or other restorations like bridges or dentures. But to achieve a natural appearance it’s important that the implant is placed in the right location. To achieve that requires adequate bone.
But there may not be adequate bone if the tooth has been missing for a while. The forces generated when we chew travel through the teeth to the jawbone, which stimulates bone growth. If that stimulus is absent because of a missing tooth, new bone cells may not replace older ones at a healthy rate and the total bone volume begins to diminish. A denture can’t compensate and, in fact, accelerates bone loss.
But there may be a solution: bone grafting. With this procedure we place a donor bone graft into the area of bone deficiency some time before implant surgery. The graft serves as a scaffold for new bone cells to grow upon. Hopefully, this will produce enough healthy bone to support an implant. If the bone deficiency is minor, we may place the implant and the bone graft at the same time.
If you have experienced bone loss, we must first determine the amount of bone at the missing tooth site and whether grafting is a viable option. Bone grafting postpones your implant, but the delay will be worth the wait if we’re successful. With increased bone volume you’ll be able to obtain a new tooth that’s superior to your current restoration.
The red, scaly rash suddenly appearing on your face doesn’t cause you much physical discomfort, but it’s still embarrassing. And to make matters worse treating it as you would other skin ailments seems to make it worse.
Your ailment might be a particular skin condition known as peri-oral dermatitis. Although its overall occurrence is fairly low (1% or less of the population worldwide) it seems to be more prevalent in industrialized countries like the United States, predominantly among women ages 20-45.
Peri-oral dermatitis can appear on the skin as a rash of small red bumps, pimples or blisters. You usually don’t feel anything but some patients can have occasional stinging, itching or burning sensations. It’s often misidentified as other types of skin rashes, which can be an issue when it comes to treatment.
Steroid-based ointments that work well with other skin ailments could have the opposite effect with peri-oral dermatitis. If you’re using that kind of cream out of your medicine cabinet, your rash may look better initially because the steroid constricts the tiny blood vessels in the skin. But the reduction in redness won’t last as the steroid tends to suppress the skin’s natural healing capacity with continued use.
The best treatment for peri-oral dermatitis is to first stop using any topical steroid ointments, including other-the-counter hydrocortisone, and any other medications, lotions or creams on it. Instead, wash your skin with a mild soap. Although the rash may flare up initially, it should begin to subside after a few days.
A physician can further treat it with antibiotic lotions typically containing Clindamycin or Metronidazole, or a non-prescription, anti-itch lotion for a less severe case. For many this clears up the condition long-term, but there’s always the possibility of relapse. A repeat of this treatment is usually effective.
Tell your dentist if you have recurring bouts of a rash that match these descriptions. More than likely you’ll be referred to a dermatologist for treatment. With the right attention—and avoiding the wrong treatment ointment—you’ll be able to say goodbye to this annoying and embarrassing rash.