Posts for: June, 2020
Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.
Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.
Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.
A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.
The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.
The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.
We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.
The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.
A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.
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?”
Dental implants aren't simply prosthetic teeth, but rather an innovative system that restores both smile appearance and dental function. And while an implant can indeed replace a single tooth, they can do so much more. Integrated with removable dentures or a fixed bridge, they provide a secure solution to multiple missing teeth.
Implants essentially replace a missing tooth's root, the basis for their lifelikeness and functionality. As such, they're also the most sophisticated restoration used today, requiring a high degree of technical and aesthetic skill to place them properly. In reality, implantation is more a process than a procedure.
If you're considering implants, that process begins with a comprehensive dental exam. During the exam, we'll assess the exact condition of your oral and facial structures like the length of remaining teeth, your bite and jaw dimensions. We'll use this information to plan the type and placement of your implants. The exam may also reveal problems like bone loss that might postpone your implants or suggest another form of restoration.
Using digital technology, we then locate the exact positions for your implants on the jaw to ensure the best outcome. This often results in the creation of a surgical guide, a plastic template placed over the jaw that accurately pinpoints the locations for the drilling sequence during implant surgery.
In most cases once the implants are surgically installed, gum tissue may be sutured over the implant to protect it while it integrates with the bone. In some cases, though, a visible crown may be placed immediately, so the patient can enjoy a tooth-filled smile the same day. This immediate crown, though, is temporary and will be replaced with a more durable, permanent one in a few months.
During this interim, the titanium in the implant post will attract bone cell growth, which will build up on the implant surface. This increased bone contact will help secure the implant fully in the jaw, giving the implant its signature durability.
Once the integration is complete, the permanent crown is affixed to the implant (or implants in the case of a fixed or removable dental appliance). It may have been a long road, but you'll have the closest thing to real teeth.
If you would like more information on implant restorations, 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 “New Teeth in One Day.”
A "toothy grin" might be endearing, but not necessarily healthy. More of the teeth showing may mean your gums have pulled back or receded from the teeth. If so, it's not just your smile that suffers—the parts of teeth protected by the gums could become more susceptible to disease.
There are a number of causes for gum recession. Some people are more likely to experience it because of genetically thinner gum tissues. Over-aggressive brushing could also contribute to recession. But the most common cause by far is periodontal (gum) disease, a bacterial infection triggered by dental plaque accumulating on teeth mainly as a result of inadequate hygiene.
There are some things we can do to help heal and restore recessed gums, most importantly treating gum disease. The number one goal of treatment is to uncover and remove all dental plaque from tooth and gum surfaces, which can take several sessions and sometimes minor surgery if the infection has reached the tooth roots. But removing plaque and tartar (calcified plaque) is necessary to stop the infection and allow the gums to heal.
For mild recession, this may be enough for the gums to regain normal coverage. But in more severe cases we may need to help rejuvenate new tissue with grafting surgery. In these highly meticulous procedures a surgeon uses microscopic techniques to position and attach donated tissue to the recession site. The graft serves as a scaffold on which new tissue growth can occur.
While these treatments can be effective for reversing gum recession, they often require time, skill and expense. It's much better to try to prevent gum recession—and gum disease—in the first place. Prevention begins with daily brushing and flossing to prevent plaque buildup, as well as regular dental visits for more thorough cleanings. Be on the lookout too for any signs of a beginning gum infection like swollen, reddened or bleeding gums and see your dentist as soon as possible to minimize any damage to your gums.
Caring for your gums is equally as important as caring for your teeth. Healthy gums equal a healthy mouth—and an attractive smile.
If you would like more information on preventing gum recession, 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 “Gum Recession.”