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

Posts for category: Oral Health

StopGumDiseaseBeforeitHarmsYourHealth

If you're over 30 your chances for developing periodontal (gum) disease are better than half. And it's not a minor matter—untreated gum disease can lead not only to tooth loss, but to an increased risk of cardiovascular disease and other inflammatory conditions.

Fortunately, we have effective ways to treat gum disease, even in advanced stages. But the best approach by far in avoiding a devastating outcome for your teeth is to prevent gum disease from developing in the first place.

It helps first to know how gum disease begins. The most common cause is dental plaque, a thin biofilm of food particles on tooth surfaces that harbors the bacteria that triggers the disease. If you keep your teeth clean of built-up plaque and tartar (calcified plaque) with daily brushing and flossing and regular dental cleanings, you'll minimize the growth of disease-causing bacteria.

If you don't practice effective oral hygiene, however, within a few days you could develop an initial infection called gingivitis. This form affects the outermost layers of the gums and triggers a defensive response from the body known as inflammation. Ordinarily, inflammation helps protect surrounding tissues from infection spread, but it can damage your gums if it becomes chronic. Your weakened gums may begin to detach from the teeth, forming voids filled with inflammation known as periodontal pockets. Eventually, the infection can spread to the supporting bone and lead to tooth loss.

In addition to a dedicated oral hygiene and dental care program, you should also be on the lookout for early signs of gingivitis. Infected gums can become red, swollen and tender to the touch. You may notice they bleed easily while brushing and flossing, or a foul taste or breath that won't go away even after brushing. And if some of your teeth feel loose or don't seem to bite together as they used to, this is a sign of advanced gum disease that deserves your dentist's immediate attention.

Practicing preventive hygiene is the best way to stop gum disease before it starts. But if gum disease does happen, catching it early can be a game-changer, both for your teeth and your smile.

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 “How Gum Disease Gets Started.”

BeontheAlertforGumDiseaseWhileWearingBraces

On your way to a more attractive smile, you’ll have to deal with some inconveniences while wearing braces like avoiding certain foods or habits or dealing with possible embarrassment about your new “metal smile.” But there’s one consequence of wearing braces that could dramatically affect your dental health: the difficulty they pose for keeping your teeth clean of dental plaque.

Dental plaque is a thin film of bacteria and food particles that if allowed to build up on tooth surfaces could trigger tooth decay or periodontal (gum) disease. Brushing and flossing thoroughly every day helps prevent this buildup.

Unfortunately, metal brackets and wires can get in the way and cause you to miss areas while performing these hygiene tasks. This could cause plaque buildup in those isolated areas that could trigger an infection. And if you (or someone you love) are also a teenager, the natural adolescent surge in hormones can increase your infection risk.

If while wearing braces you notice your gums are reddened, swollen or bleeding when you brush, these are all signs of infection and the body’s inflammatory response to it. The longer the infection continues, the weaker the tissues become, causing them to gradually detach from the teeth. Along with bone deterioration (another effect of the disease), this can ultimately lead to tooth loss.

To prevent this from happening, you’ll need to be as thorough as possible with daily brushing and flossing. To help make it easier, you can use special tools like an interproximal brush that can maneuver around the braces better than a regular brush. For flossing you can use a floss threader to more readily guide floss between teeth or a water flosser that uses a pressurized stream of water rather than floss thread to remove plaque.

This extra cleaning effort while wearing braces can greatly reduce your disease risk. But you’ll still need to keep an eye out for any symptoms like swollen or bleeding gums, and see your dentist as soon as possible. If the symptoms become severe you may need your braces removed until the disease can be brought under control. The health and future vitality of your teeth and gums is what’s of primary importance.

If you would like more information on dental care while wearing braces, 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 Swelling During Orthodontics.”

LoosePermanentTeethisaProblem-takeActionNow

If you've noticed one of your teeth feeling loose, you're right to believe it's not a good thing. Loose permanent teeth are a sign of an underlying problem.

Periodontal (gum) disease is usually the culprit. Caused by bacterial plaque, a thin film of food particles, gum disease causes the tissues that support teeth to weaken and detach. While a tooth can become loose from too much biting force (primary occlusal trauma), it's more likely bone loss from gum disease has caused so much damage that even the forces from normal biting can trigger looseness.

A loose tooth must be treated or you may lose it altogether. If it's from gum disease, your treatment will have two phases.

In the first phase we need to stop the gum infection by removing plaque and calculus (hardened plaque deposits). Hand instruments known as scalers or ultrasonic equipment are usually sufficient for removing plaque and calculus around or just below the gum line. If the plaque extends deeper near or around the roots, we may need to consider surgical techniques to access these deeper deposits.

Once the infection is under control and the tissues have healed, we can then undertake the second phase: reducing biting forces by breaking clenching and grinding habits, doing a bite adjustment for advanced problems and securing loose teeth with splinting.

Although there are different types of splinting — both temporary and permanent — they all link loose teeth to adjacent secure teeth much like pickets in a fence. One way is to bond dental material to the outer enamel of all the teeth involved; a more permanent technique is to cut a small channel extending across all the teeth and bond a rigid metal splint within it.

To reduce biting forces on loose teeth, we might recommend wearing a bite guard to keep the teeth from generating excessive biting forces with each other. We may also recommend orthodontics to create a better bite or reshape the teeth's biting surfaces by grinding away small selected portions of tooth material so they generate less force.

Using the right combination of methods we can repair loose teeth and make them more secure. But time is of the essence: the sooner we begin treatment for a loose tooth, the better the outcome.

If you would like more information on treating loose 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 “Treatment for Loose Teeth.”

StayAheadofGumDiseaseRe-InfectionwithPeriodontalMaintenance

If you've undergone treatment for periodontal (gum) disease, you know how involved it can be. After several sessions of plaque and calculus (hardened plaque deposits) removal, your swollen, red gums finally begin to regain their healthy pink color.

But with gum disease, the battle may be over but not necessarily the war. If we don't remain vigilant, there's a high chance you'll experience a re-infection.

That's why periodontal maintenance (PM) is so important for gum disease patients after treatment. Plaque, the thin film of bacteria and food particles responsible for the infection, can grow again on your tooth surfaces as it did before. You'll have to practice diligent, daily brushing and flossing to curb that development.

But it's also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For most people that's usually twice a year, but for gum disease patients it could be up to four times a year, especially just after treatment. And there's more to these visits than cleaning.

Since our goal is to reduce the chances of re-infection as much as possible, we'll thoroughly examine your teeth, gums and any implants for signs of disease (we'll also include an oral cancer screening). We want to assess the health of your teeth and gums and to see how well you're doing hygiene-wise with plaque control.

If we find signs of gum disease, we'll discuss this with you and schedule a new round of treatment. The sooner we initiate treatment, the better your outcome. In some cases, we may perform procedures that make it easier to access and clean areas where plaque tends to build up.

Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it re-occurs. Keeping up diligent PM will help ensure your gums continue to stay healthy.

If you would like more information on after care following periodontal (gum) disease, please contact us or schedule an appointment for a consultation.

PutanEndtoUncomfortableandEmbarrassingCrackedMouthCorners

We’ve all had physical ailments that were more irritating than serious. The problem of skin cracking at the corners of the mouth fits into that category.

Both dentists and dermatologists encounter this condition often and have a name for it: perleche, derived from the French word lecher, meaning “to lick.” The term arises from patients’ tendency to excessively lick the broken skin to soothe the itching or burning.

Perleche most often arises from certain mouth conditions, although systemic problems like anemia or diabetes may also cause it. Children or younger adults, especially those with orthodontic braces or a tendency to drool as they sleep, often develop perleche; older adults with wrinkling around the mouth are also susceptible. Mouth dryness caused by reduced saliva flow may also irritate the skin and cause discomfort.

As the skin becomes irritated, the person may begin to lick the corners of the mouth to soothe them. This sets up conditions for an infection, most often caused by yeast known as candida albicans. The infection may become more acute and begin to affect the entire inside of the mouth or throat.

If you’ve developed perleche, our primary treatment goal is to reduce any infection with the aid of oral or topical antifungal drugs. One drug, Nystatin, is often taken as a lozenge that dissolves in the mouth and works its way from there through the rest of the body. You can also apply antifungal ointments several times a day to the corners of the mouth, often in combination with steroid ointments that reduce redness and swelling. You can also apply antifungal zinc oxide paste to the cracked skin, which also serves as a barrier between the skin and outer contaminants.

To reduce the chance of future outbreaks, we may recommend you rinse with Chlorhexidine, as well as replace missing teeth or refit loose dentures — these too are contributing factors to erupting yeast infections. You might also need to undergo dermatologic treatment for wrinkles if they’ve proven to be a factor in developing perleche.

Although not a major problem, perleche can be exceedingly uncomfortable and embarrassing. Thanks to a number of treatment options, you don’t have to put up with that discomfort for long.

If you would like more information on perleche (angular cheilitis), 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 “Cracked Corners of the Mouth.”



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