Posts for: October, 2014
While periodontal disease can take on a variety of forms, most are caused by a thin layer of bacterial plaque called biofilm. This layer of plaque will form every 8-12 hours and sticks like glue to your teeth near the gum line. With time, tartar formation occurs at and below the gum line.
If left unchecked, biofilm can give rise to a very unhealthy progression. It first triggers an infection that leads to painful inflammation, progressive bone loss and the gum tissue losing attachment with a tooth. Void spaces (or pockets) form where the gum and bone tissue once adhered; infectious plaque and tartar moves into these pockets and advances deeper to the root. Overcome by disease, the tooth is in danger of being lost.
It's imperative then to remove as much of this entrenched plaque and tartar as possible. Renewed oral hygiene is not enough — removing plaque and tartar from the root surfaces requires a treatment known as root planing.
Root planing is a meticulous, labor-intensive process. We first clear away larger portions of plaque around the teeth and gums with hand instruments or an ultrasonic device and then flush out the pockets with water. After administering a local anesthetic for pain, we would then turn to a number of small hand instruments known as curettes to probe and scrape away as much remaining plaque below the gum line as we can get to.
Root planing requires experience and a good sense of touch to work in areas that can't be clearly seen. Observing the gum line, though, can give us a good indication of progress as these tissues will actually change color once the biofilm and tartar deposits have been removed.
Being so deeply entrenched, not all the deposits might be removed during one session. However, as plaque and tartar are removed, the gum tissues will begin to heal and become less inflamed. This will make it easier to remove plaque in subsequent sessions.
Root planing takes time, but the effort is well worth it. In the short term you'll notice less inflammation and pain around your teeth and gums. In the long-term, it just may save your teeth.
If you would like more information on root planing and periodontal 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 “Root Planing.”
Ever wonder just exactly what causes cavities? Once upon a time, “Toothworms” — miniscule, yet relentless pests — were thought to be responsible for this widespread malady. This belief persisted from ancient times through the 17th Century; William Shakespeare even made reference to the baneful beasts in his play Much Ado about Nothing. (“What, sigh for a toothache? [It] is but a humor or a worm.”) Today, however, we know why no one ever observed an honest-to-goodness toothworm: it’s because they’re much too tiny to see with the naked eye.
Actually, it isn’t worms, but much smaller organisms that cause tooth decay. These harmful plaque bacteria (along with many helpful microorganisms) live in the mouth, and build up on surfaces of the teeth when they aren’t cleaned properly. They feed on sugar in the diet, and release substances that erode tooth enamel, which causes small holes called cavities. Cavities, in turn, are what’s responsible for most toothaches.
While we may scoff at old legends, one fact remains: Even today, according to the National Institutes of Health, tooth decay is the number one chronic disease of both children and adults; and it’s almost entirely preventable. We can’t blame it on toothworms — but what can we do about it?
Glad you asked! The best way to avoid decay is through prevention. That means brushing your teeth twice a day with a fluoride toothpaste, and flossing them every day. It also means eating a balanced diet and avoiding acidic and sugary foods — like soda, some juices, and sweet, sticky snacks. If you do consume these types of foods, limit them to mealtimes; that gives your saliva enough time in between to neutralize the acids naturally. And, of course, make an appointment see us twice a year for a complete check-up and professional cleaning.
If you do begin to notice the symptoms of tooth decay (toothache, for example) it’s important to come in to the dental office right away, so we can treat the problem before it gets worse. Prompt action can often help save a tooth that might otherwise be lost. Besides filling the cavity, we may be also able to recommend ways to help prevent the disease from affecting other teeth. And if you need a more extensive procedure to relieve the problem — such as a root canal — we can make sure you get the appropriate treatment.
We’ve come a long way since the “toothworm” days — but we can still do a lot more to make tooth decay a thing of the past.
If you would like more information about tooth decay and cavity prevention, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine article “Tooth Decay — The World’s Oldest & Most Widespread Disease” and “Tooth Decay — How To Assess Your Risk.”
“Don’t panic” is your first priority when faced with a sudden mouth injury. Of course, that may be easier said than done when you or a family member has just experienced a chipped, fractured or even dislodged tooth.
It helps, therefore, to have some idea beforehand on what to do and, especially, when to do it. You should think in terms of immediate, urgent and less urgent injuries: a tooth completely knocked out of its socket requires immediate action — within 5 minutes of the injury; a tooth that’s moved out of its normal position but still in the socket is an urgent matter that needs professional attention within 6 hours; and a chipped tooth is less urgent, but still needs to be seen by a dentist within 12 hours.
As you may have gathered, the most important thing you can do when a dental injury occurs is to contact our office as soon as possible. If for some reason you can’t, you should visit the nearest emergency center.
There are also some actions you should take for a knocked-out permanent tooth because there’s a chance it can be replanted in the socket if you act within 5 minutes of the injury. First, rinse the tooth with cold, clean water (bottled or tap) if it’s dirty. Be sure to handle it gently, avoiding touching the root. Grasping the crown-end with your thumb and index finger, place the tooth into the empty socket and push it firmly into place. Apply light but firm pressure with your hand or a wad of wet tissue to make sure it doesn’t come out. Don’t worry about correct alignment — we can adjust that later during examination.
If the tooth is chipped or broken, try to locate the broken pieces — it may be possible to re-bond them to the tooth. You should store them in a container with milk or the injured person’s saliva (the same can be done for a knocked out tooth if reinserting it isn’t practical). The broken pieces should then be transported with the injured person to emergency treatment.
Taking these actions may not ultimately save a traumatized tooth, but they will certainly raise its chances for survival.
If you would like more information on preventing and treating dental injuries, 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 “The Field-Side Guide to Dental Injuries.”