Posts for tag: periodontal disease

By Kent S. Denton, D.D.S., P.A.
May 23, 2017
Category: Dental Procedures
LasersCouldOneDaybeCommonplaceforTreatingGumDisease

There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause for gum disease, from all tooth and gum surfaces.

The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They're also time-consuming: full treatment can take several sessions, depending on how extensive the infection has spread.

In recent years, we've also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.

Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.

Dentists who have used lasers in this way do report less tissue damage, bleeding and post-treatment discomfort than traditional treatments. But because research is just beginning, there's not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.

At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.

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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

By Kent S. Denton, D.D.S., P.A.
April 10, 2016
Category: Oral Health
YourCaseofGingivitisCouldDevelopintoSomethingMoreHarmful

That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”

Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.

ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.

Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes. We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.

We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.

It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.

If you would like more information on ANUG and other periodontal gum 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 “Painful Gums in Teens & Adults.”

By Kent S. Denton, D.D.S., P.A.
June 19, 2013
Category: Oral Health
GumDiseaseAreyouatRisk

Did you know that roughly 75% of Americans suffer from some sort of gum disease? Gum disease (also known as periodontal disease) refers to the progressive loss of attachment between the fibers that connect the bone and gum tissues to the teeth, and the consequential loss of the tooth-supporting bone itself.

As you get older, your chances for developing gum disease increase significantly. Here are a few other factors that might put you at a higher risk for developing gum disease:

  • Family History. 30% of the population may be genetically susceptible to gum disease. Luckily, there are new tests that can assess if you are at risk. However, even with good oral hygiene, studies have shown that genetically susceptible individuals may be 6 times more likely to develop gum disease.
  • Tobacco. Smokers are four times more likely to develop periodontal disease. Smokers have more disease-causing biofilm bacteria and collect it more quickly. They also lose more attachment between the teeth and gums, which leads to more loss of bone that supports the teeth.
  • Bleeding Gums. Some people mistakenly think that it is normal for their gums to bleed when they brush. In fact, this is an indication that you are not brushing and flossing effectively and a common symptom of gum disease. Pregnant women are also more likely to have bleeding gums, because elevated hormone levels may cause gum tissues to be more responsive to bacterial biofilm, thus bleeding more easily. That is why we recommend that pregnant women have regular cleanings at three to four month intervals.

We often refer to gum disease as silent, because symptoms may not appear until the disease has advanced. For this reason, you should conduct a self-assessment to identify if you are at risk.

  • Have your gums receded and/or do your teeth appear longer?
  • Are any of your teeth feeling or getting loose?
  • Do your gums appear red or swollen?
  • Have you recently had a tooth or teeth extracted because they were loose?

If you answered “yes” to any of these questions, then you may be at risk for gum disease. You should make an appointment with our office so that we can conduct a thorough examination and prescribe treatment, if necessary.

If you would like more information about gum disease, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Assessing Risk for Gum Disease.”

By Kent S. Denton, D.D.S., P.A.
January 15, 2013
Category: Oral Health
BetterDentalHygieneMeansaHealthierHeart

Did you know that studies have shown a relationship between gum disease and heart disease?

The common link is inflammation. This means that if you reduce inflammation caused by gum disease (periodontal disease), you also reduce your risk for heart attacks and strokes. The methods we stress for good dental hygiene — consistent effective brushing and flossing, regular professional cleanings by a hygienist, and dental treatment when needed — are also important for the maintenance of a healthy cardiovascular system (from cardio, meaning heart, and vascular, meaning blood vessels).

Here's how it works. Dental plaque is a film of bacteria that settles on your teeth near the gum line every day. When you brush and floss, you remove as much of this bacterial film, or biofilm, as you can. Bacteria that are not removed multiply and produce acid products that begin to dissolve the enamel of your teeth. They also irritate your gum tissues.

Your immune system tries to remove the bacteria and their byproducts through inflammation, your body's way of attacking substances that shouldn't be there (such as bacteria). However, long-term inflammation can be harmful to your own tissues as well. Inflammation in your gums, a symptom of periodontal disease, can destroy gum tissue, bone and the ligaments that hold your teeth in place.

Ongoing inflammation can also increase your risk for heart disease and stroke. Bacterial byproducts of periodontal inflammation have been shown to cause the liver to manufacture a protein called CRP (C-reactive protein) that spreads the inflammation to the arteries, where it promotes formation of blood clots.

Of course, other factors are also related to an increased incidence of cardiovascular disease. These include smoking, diabetes, obesity, high blood pressure, and physical inactivity. Family history and depression can also influence gum disease and heart disease.

Diet is another factor. You have probably heard of “good” cholesterol (HDL) and “bad” cholesterol (LDL). The bad one, low-density lipoprotein or LDL, is found in animal fats. It can cause an accumulation of fat breakdown products (also called plaque, but a different substance from dental plaque) inside your arteries. The arteries become narrow, so that they can be easily blocked, resulting in heart attacks and strokes. Studies have shown that inflammation of the lining of the blood vessels accelerates this effect.

If tests show that you have high levels of LDL, your doctor may advise you to modify your diet and take specific medication to reduce arterial plaque. You will also be advised to make lifestyle changes to reduce your risk factors. Lowering your weight, getting more exercise, and stopping smoking can have a positive effect on your heart health — and so can improving your dental hygiene to combat periodontal disease.

Contact us today to schedule an appointment to discuss your questions about the relationship between gum disease and heart disease. You can also learn more by reading the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.”