Periodontist - Cedar Rapids
1909 51st St NE
Cedar Rapids, IA 52402
319-294-4800

SeeYourDentistASAPIfYouHaveaLoosePermanentTooth

Unless you're 6 years old and on speed dial with the Tooth Fairy, a loose tooth isn't a good feeling. It's also a sign something is wrong in your mouth. If you don't take prompt action, you may lose that tooth for good.

To begin with, teeth are held in place by an elastic tissue known as the periodontal ligament. The ligament lies between the tooth and bone and attaches to both through tiny fibers. The thing to note about the ligament is that it does allow for tooth movement, which serves as a “shock absorber” against the forces generated while biting and chewing.

But that movement is normally so slight, you won't perceive it. If you do, chances are there's a problem with the ligament attachment, which may have been damaged due to trauma or disease.

A hard blow to the face could certainly damage both the teeth and their attachments. But it can also happen if one tooth extends out farther than the rest and absorbs more stress during chewing. You could encounter similar damage if you attempt DIY orthodontics or wear tongue jewelry.

The more common source of ligament damage, though, is periodontal (gum) disease, usually caused by dental plaque, a thin film of bacteria and food particles left on tooth surfaces. If not treated, the infection can advance deeper into the gum tissues (and eventually the supporting bone), causing the ligaments to weaken and detach. In fact, a loose tooth is often a sign of well-advanced gum disease.

If you notice a loose tooth, you should make an appointment with us as soon as possible. Our first step is to ascertain the underlying cause and initiate any needed treatment. We may also want to splint a loose tooth to adjacent teeth to prevent excessive movement while the ligaments heal and reform their attachment to the tooth.

There will be times when a loose tooth is beyond repair. In that case, it may be best to remove the tooth and install a life-like replacement like a dental implant. But that's not inevitable. If at all possible and practical, we'll try to save your loose tooth.

If you would like more information on loose permanent teeth, 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 Permanent Teeth Become Loose.”

GumDiseaseCanBeStoppedbutYouCouldBeinForaLongFight

It often begins without you realizing it—spreading ever deeper into the gums and damaging tissue attachments, teeth and supporting bone in its way. In the end, it could cause you to lose your teeth.

This is periodontal (gum) disease, a bacterial infection caused by dental plaque, a thin biofilm that accumulates on tooth surfaces. It in turn triggers chronic inflammation, which can cause the gum attachments to teeth to weaken. Detaching gum ligaments may then produce diseased voids—periodontal pockets—that can widen the gap between the teeth and the gums down to the roots.

There is one primary treatment objective for gum disease: uncover and remove any and all plaque and tartar (hardened plaque). If the infection has advanced no further than surface gum tissues, it may simply be a matter of removing plaque at or just below the gum line with hand instruments called scalers or ultrasonic equipment.

The disease, however, is often discovered in more advanced stages: The initial signs of swollen, reddened or bleeding gums might have been ignored or simply didn't appear. Even so, the objective of plaque and tartar removal remains the same, albeit the procedures may be more invasive.

For example, we may need to surgically access areas deep below the gum line. This involves a procedure called flap surgery, which creates an opening in the gum tissues resembling the flap of an envelope. Once the root or bone is exposed, we can then remove any plaque and/or tartar deposits and perform other actions to boost healing.

Antibiotics or other antibacterial substances might also be needed for stopping an infection in advanced stages. Some like the antibiotic tetracycline can be applied topically to the affected areas to directly stop inflammation and infection; others like mouthrinses with chlorhexidine might be used to fight bacteria for an extended period.

Although effective, treatment for advanced gum disease may need to continue indefinitely. The better approach is to focus on preventing a gum infection through daily brushing and flossing and regular dental cleanings. And at the first sign of problems with your teeth and gums, see us as soon as possible—the earlier in the disease progression that we can begin treatment, the better the outcome.

If you would like more information on preventing and 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 “Treating Difficult Areas of Periodontal Disease.”

BoneLossattheRootscanPutYourToothinDangerofLoss

There’s more to teeth than meets the eye. Hidden beneath the visible crown are the tooth’s roots set within the jawbone, secured and protected by the gums from bacteria and infection. But if the gums shrink back (recede), the roots become exposed and susceptible to disease, especially at the points where multiple roots branch from each other, areas called furcations.

It all begins with periodontal (gum) disease caused by built-up bacterial plaque from insufficient brushing and flossing. The infection triggers inflammation that over time weakens gum tissues. They begin to detach from the teeth, which can eventually lead to gum recession and root exposure.

This also causes bone loss, especially at the furcations. We can detect any loss (known as a furcation invasion) and how far along it may be with x-ray imaging or by manually probing with an instrument called a periodontal probe.

There are three general classes measuring furcation invasions. In the earliest, Class I, we can feel the invasion as a slight groove; in Class II, it increases to two or more millimeters across. In Class III the bone loss extends from one side of the root all the way to the other (a “through and through”).

At this stage a patient is in danger of losing the tooth, so we’ll have to act promptly. This means first removing accumulated dental plaque and calculus (tartar) to stop the infection and allow the gums to heal. With severe damage, we may need to assist healing with bone and gum tissue grafting, in which we place donor grafts to serve as scaffolding for the appropriate tissue to grow upon.

You can help prevent this situation by practicing effective daily hygiene and visiting your dentist for thorough cleanings at least twice a year (or more if recommended). And at the first signs of a gum infection—swollen, reddened or bleeding gums—make an appointment as soon as possible to have it checked. The sooner we can detect and treat gum disease, the less likely a furcation invasion or worse will be in your future.

If you would like more information on gum disease diagnosis and treatment, please contact us or schedule an appointment for a consultation.

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

DoThisForaHealthierMouthandOverallWell-Being

Health is on everyone's mind, especially after dealing with COVID-19 this past year. Beyond the immediate concerns of coping with this novel coronavirus, many are taking a closer look at improving their overall well-being. If that describes you, then don't forget this very important component of good health—your teeth and gums.

It's easy to see the body as just a collection of individual organs and anatomical structures. But in reality, all these individual parts are intertwined—if one part is unhealthy, it could directly or indirectly impact the health of all the others.

That's especially true in the mouth. There's some evidence that both tooth decay and periodontal (gum) disease can increase inflammation throughout the body, and worsen conditions like diabetes. And problems like chronic jaw joint pain or teeth loss could make it more difficult for the body to meet its nutritional needs.

In other words, you need to take just as much care of your teeth and gums as you do the rest of your body. In recognition of Oral Health Month this June, here's how.

Clear away plaque. Dental plaque, a thin bacterial film that accumulates daily on tooth surfaces, is the most common cause of tooth-destroying dental diseases. Removing plaque buildup every day with brushing and flossing is the single best thing you can do personally to maintain optimal oral health.

See your dentist. Even so, the most thorough hygiene regimen can miss a few plaque deposits. These can then harden into tartar (or calculus) that's nearly impossible to remove with brushing or flossing. A regular dental cleaning clears up any lingering plaque and tartar to further lower your disease risk.

Eat a "tooth-friendly" diet. A diet high in carbohydrates (particularly refined sugar) and processed foods can spell trouble for both the body and the mouth. But whole foods rich in micronutrients like calcium, potassium, or vitamin D, strengthens your teeth and gums against tooth decay or gum disease.

Maintain your dental work. Dental work like fillings, crowns, implants or bridges aid dental health and function, not to mention appearance. But they can wear over time, so keep up regular dental visits to assess their condition and make any needed repairs. Be sure you also clean them and the rest of your mouth daily.

A healthy body depends on a healthy mouth. Following these steps for better oral health will go a long way in achieving optimum physical well-being.

If you would like more information about best oral health practices, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.

Archive: