Posts for: March, 2017
If you suspect you have periodontal (gum) disease, it's important to get a correct diagnosis and begin treatment as soon as possible. The sooner you begin treatment the better the long-term outcome.
Gum disease is a bacterial infection that's most often triggered by plaque, a thin film of food particles on tooth surfaces. Plaque buildup most often occurs when a person doesn't practice effective oral hygiene: daily brushing and flossing and professional cleanings at least twice a year.
The most common type of gum disease, gingivitis, can begin within days of not brushing and flossing. It won't always show itself, but you can have symptoms like swollen, red or bleeding gums, as well as bad taste and breath. You could also develop painful abscesses, which are localized pockets of infection within the gums.
If we don't stop the disease it will eventually weaken the gum attachment to the teeth, bone loss will occur and form deep pockets of infection between the teeth and bone. There's only one way to stop it: remove the offending plaque from all tooth surfaces, particularly below the gum line.
We usually remove plaque and calculus (hardened plaque deposits) manually with special hand instruments called scalers. If the plaque and calculus have extended deeper, we may need to perform another procedure called root planing in which we shave or “plane” the plaque and calculus (tartar) from the root surfaces.
In many cases of early gum disease, your family dentist can perform plaque removal. If, however, your gum disease is more extensive, they may refer you to a periodontist, a specialist in the treatment and care of gums. Periodontists are trained and experienced in treating a full range of gum infections with advanced techniques, including gum surgery.
You can also see a periodontist on your own for treatment or for a second opinion — you don't necessarily need a referral order. If you have a systemic disease like diabetes it's highly advisable you see a periodontist first if you suspect gum disease.
If you think you might have gum disease, don't wait: the longer you do the more advanced and destructive the disease can become. Getting an early start on treatment is the best way to keep the treatment simple and keep gum disease from causing major harm to your teeth and gums.
If you would like more information on the diagnosis and treatment of 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 “When to See a Periodontist.”
The best way to prevent dental visit anxiety in your children is start those visits around their first birthday, and continue with them through childhood. Age One visits are the best way to ensure they're comfortable with the dentist now and that they'll continue the habit into adulthood.
But in spite of your best efforts and those of your dental provider, there's no guarantee your child won't experience dental visit anxiety at some point. If that happens, we recommend conscious sedation.
Conscious sedation is the use of certain medications to help a patient relax. It's not the same as anesthesia, which eliminates pain by numbing tissues (local anesthesia) or inducing unconsciousness (general anesthesia). During conscious sedation a patient remains awake or at the most in a dream-like state, can still respond to touch or verbal commands, and although monitored doesn't require assistance in heart or lung function.
We can induce this relaxed state in a number of ways: orally, with medication given by mouth a short time before the visit; intravenously, the medication delivered through a drip directly into the bloodstream; or by inhalation, usually nitrous oxide gas mixed with oxygen and delivered by mask.
Oral sedation is the most common. On the day of the procedure, we'll give your child one or more sedative drugs, usually in syrup form. For best results we advise they eat a low-fat dinner the night before and not eat or drink any food or liquid afterward. We typically use Midazolam and Hydroxyzine, both of which are proven safe and fast acting.
During the procedure, we'll also assign a team member to monitor their vital signs while they're under the influence of the drugs. We may also employ special positioning or immobilization equipment to keep movement to a minimum.
After the procedure, we'll continue to monitor vitals until they return to pre-sedation levels. The child should remain home the rest of the day to rest and return to school the next day.
Conscious sedation is regulated by states: providers must be trained and licensed to administer sedation drugs with continuing education requirements. Even so, the use of sedation for children is becoming more widespread and helps to safely ensure they're getting the dental care they need.
If you would like more information on comfortable dentistry for children, 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 “Sedation Dentistry for Kids.”
Tooth decay is one of the world's most prevalent diseases — and one of the most preventable. We've known the primary prevention recipe for decades: brushing and flossing daily, and dental cleanings and checkups at least twice a year.
But consistent oral hygiene isn't enough — you should also pay attention to your overall health, diet and lifestyle habits. Each of these areas in their own way can contribute to abnormally high mouth acid, which can soften enamel and open the door to tooth decay.
Lower saliva production is one such problem that can arise due to issues with your health. Among its many properties, saliva neutralizes acid and helps maintain the mouth's optimum neutral pH level. But some health conditions or medications can reduce saliva flow: less saliva means less neutralization and chronic acidity.
You can also inhibit saliva flow with one particular lifestyle habit — smoking. Tobacco smoke can damage salivary glands. Nicotine, tobacco's active ingredient, constricts blood vessels, leading to fewer antibodies delivered by the blood stream to mouth tissues to fight disease.
A diet heavy on acidic foods and beverages can also increase mouth acidity. It's not only what you're eating or drinking — it's also how often. If you're constantly snacking or sipping on something acidic, saliva doesn't have a chance to complete the neutralizing process.
In addition to your daily oral hygiene practice, you should also make changes in these other areas to further lower your risk of tooth decay. If you're taking medications that cause dry mouth, see if your doctor can prescribe a different one or try using products that stimulate saliva. Quit smoking, of course, as much for your mouth as for the rest of your health.
On the dietary front, reduce your intake of acidic foods and beverages, especially sodas, energy or sports drinks. If you've counted on the latter for hydration, switch to water instead. And limit acidic foods to mealtime rather than throughout the day.
It's all about maintaining a healthy pH level in your mouth. Doing so along with good oral hygiene will help you better avoid destructive tooth decay.
If you would like more information on preventing tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”