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

Posts for category: Oral Health

UsetheSamePreventionStrategytoDefeatToothDecayandGumDisease

Archeologists can tell us quite a bit about our primitive ancestors. For example, because of their coarse, abrasive diet and a primitive understanding of oral hygiene, their teeth had a rough go of it. They simply wore out faster — a contributing factor, no doubt, to their short life spans of thirty or forty years.

But thanks to improvements in lifestyle, healthcare and diet, people live much longer today. And so do their teeth, thanks to advances in dental care and disease prevention. While teeth still wear to some degree as we age, if we care for them properly with daily oral hygiene and regular dental visits, we can keep that wear to a minimum. Teeth truly can last a lifetime.

Unfortunately, it's still all too common for people to lose their teeth prematurely. The main reason: the two most prevalent dental diseases, tooth decay and periodontal (gum) disease. Tooth decay arises from high concentrations of mouth acid that erode enamel, teeth's irreplaceable protective shell. Gum disease is an infection that damages the bone supporting tissues as it infiltrates deep below the visible gum line.

While they occur by different mechanisms, the two diseases have some commonalities. They both, of course, can lead to tooth loss. And, they're both triggered by oral bacteria found in dental plaque, a thin film of food particles built up on tooth and gum surfaces. Multiplying bacteria feed on plaque and produce acid as a by-product. And certain bacterial strains infect gum tissues.

Both of these diseases can be treated successfully, especially if detected early. But the better approach is to prevent them in the first place. This introduces another commonality — they share the same prevention strategy of daily, comprehensive brushing and flossing for plaque removal, regular dental cleanings and checkups, and a sharp eye for any signs of disease like bleeding gums or tooth pain.

With diligent dental care and close attention to your oral health, you increase your chances of avoiding the full threat of these diseases. And with healthy teeth, you have a better chance of living a long and healthy life.

If you would like more information on minimizing tooth wear, 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 “How and Why Teeth Wear.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

4ThingsthatcanCauseGumRecessionandWhattodoAboutThem

Besides attractively showcasing your teeth, your gums protect your teeth and underlying bone from bacteria and abrasive food particles. Sometimes, though, the gums can pull back or recede from the teeth, leaving them exposed and vulnerable to damage and disease.

Here are 4 things that could contribute to gum recession—and what you can do about them.

Periodontal (gum) disease. This family of aggressive gum infections is by far the most common cause for recession. Triggered mainly by bacterial plaque, gum disease can cause the gums to detach and then recede from the teeth. To prevent gum disease, you should practice daily brushing and flossing and see your dentist at least twice a year to thoroughly remove plaque. And see your dentist as soon as possible for diagnosis and treatment at the first sign of red, swollen or bleeding gums.

Tooth position. While a tooth normally erupts surrounded by bone, sometimes it erupts out of correct alignment and is therefore outside the bony housing and protective gum tissue. Orthodontic treatment to move teeth to better positions can correct this problem, as well as stimulate the gum tissues around the involved teeth to thicken and become more resistant to recession.

Thin gum tissues. Thin gum tissues, a quality you inherit from your parents, are more susceptible to wear and tear and so more likely to recede. If you have thin gum tissues you'll need to stay on high alert for any signs of disease or problems. And you should also be mindful of our next common cause, which is….

Overaggressive hygiene. While it seems counterintuitive, brushing doesn't require a lot of "elbow grease" to remove plaque. A gentle scrubbing motion over all your tooth surfaces is usually sufficient. On the other hand, applying too much force (or brushing too often) can damage your gums over time and cause them to recede. And as we alluded to before, this is especially problematic for people with thinner gum tissues. So brush gently but thoroughly to protect your gums.

If you would like more information on treating 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.”

BoneLosstheHiddenConsequenceofYourMissingTeeth

Losing teeth will certainly disrupt your otherwise beautiful smile. It could also potentially affect your food choices and whether or not you receive proper nutrition.

But something else just as consequential could be happening beneath the surface of your gums—you could be losing bone. Significant bone loss in the jaw could adversely affect remaining teeth and facial structure, as well as limit your future restoration choices.

To understand why this occurs we must first consider what bone is: living, cellular tissue. Like the body's other cells, bone has a life cycle: cells form, live and eventually dissolve (or resorb), and are then replaced by new cells. Stimulation from forces generated during chewing traveling up through the tooth roots to the jawbone keep this cycle going at a healthy pace.

But when a tooth is missing, so is this stimulation. This could slow the replacement rate and cause bone volume to gradually decrease. The jawbone width could decrease by as much as 25% the first year alone and several millimeters in height after just a few years.

Although dentures (a popular and affordable choice) can restore lost function and appearance, they can't duplicate this needed stimulation. They even accelerate bone loss by irritating and creating compressive forces on the bony ridges and the gums they rest upon.

One restoration, however, can actually help stop bone loss and may even reverse it: dental implants. This happens because an implant's metal titanium post imbedded in the jawbone attracts bone cells to grow and adhere to its surface. This could actually increase bone density at the site.

To gain this advantage, it's best to obtain implants as soon as possible after tooth loss. If you allow bone loss to occur by waiting too long, there may not be enough to properly support an implant. Even then it might be possible to build up the diminished bone through grafting. But if that's not possible, we'll have to consider a different restoration.

To determine the condition of your bone after losing teeth, visit us for a complete examination. Afterward, we'll be able to discuss with you the best way to address both your overall dental health and your smile.

If you would like more information on treating missing 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 “The Hidden Consequences of Losing Teeth.”

AvoidBoneLossaroundToothRootsthroughRegularDentalCare

Periodontal (gum) disease is a serious matter. Not only can it wreak havoc with your gums, it could also cause bone loss in the jaw that supports your teeth.

Gum disease is a bacterial infection that originates from a thin film of food particles on tooth surfaces called plaque. If you're not diligent about removing plaque through daily brushing and flossing, it can become a feeding ground for certain strains of bacteria that trigger gum infections. Left untreated, the disease can advance deeply into the teeth's supporting structures.

We're particularly concerned about furcations, the specific locations where multiple roots of a tooth fork or separate. When these locations become infected we call it a furcation involvement or invasion. The bone along the furcation will begin to deteriorate and dissolve, following a progression of stages (or classes) we can measure by probing the gum tissue or through x-ray evaluation:

  • Class I: the furcation feels like a groove, but without any noticeable bone loss;
  • Class II: a depression of about two or more millimeters develops indicating definite bone loss;
  • Class III:  bone loss now extends from one side of the root to the other, also known as “through and through.”

Treating furcation involvements can prove challenging because the infection is usually well below the gum line (sub-gingival). As with all gum disease treatment, our primary approach is to remove all plaque and calculus (hardened plaque deposits) where we find it, including around the roots. We typically use specially shaped instruments to clean the root surfaces. We can also employ an ultrasonic device that loosens plaque and calculus with high-frequency vibrations and flushed away with water.

Sometimes, we may need to surgically access involved furcations to clean them and stimulate bone growth with grafting. We can also use surgery to make the areas easier to clean — both for you and for us during your regular office cleanings — to prevent reoccurrences of infection.

Of course, preventing gum disease in the first place is your best defense against oral problems like furcation bone loss. Be sure you brush and floss every day, and visit us for thorough cleanings at least twice a year (unless we recommend more). This will help make sure not only your gums, but the bone that supports your teeth stays healthy.

If you would like more information on treating periodontal (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?



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