By Steven D. Dunning DDS
June 16, 2018
Category: Dental Procedures
GumDiseaseisStillaThreattoYourDentalImplants

You’ve invested quite a bit in your new dental implants. And it truly is an investment: because of implants’ potential longevity, their long-term costs could actually be lower than other restorations whose upfront costs might be less.

But to better ensure their longevity, you’ll need to keep your implants and the natural tissues supporting them clean of bacterial plaque, a sticky biofilm that can cause periodontal (gum) disease. Although the implant itself is unaffected by disease, the natural tissues around it can be.  An infection could ultimately weaken the bone supporting the implant and lead to its failure.

Such an infection involving implants could advance rapidly because they don’t have the natural defenses of the original teeth. Our natural teeth are connected to the jaw through the periodontal ligament, a collagen network that attaches to both the teeth and the bone through tiny tissue fibers. This connection also provides access to antibodies produced by the body to fight infection.

By contrast, we place implants directly into the jawbone. While this creates a very secure attachment, the implant won’t have the same connection as teeth with the body’s immune system. That means any infection that develops in surrounding tissues can spread much more rapidly—and so must be dealt with promptly.

Treating this particular form of gum disease (known as peri-implantitis) is similar to infections with natural teeth and gums, with one important difference involving the tools we use to remove plaque from them. While natural teeth can handle metal scalers and curettes, these can create microscopic scratches in the porcelain and metal surfaces of an implant and create havens for further bacterial growth. Instead, we use instruments made of plastic or resin that won’t scratch, as well as ultrasonic equipment to vibrate plaque loose.

To avoid an infection, it’s important that you brush your implants and surrounding tissues just like you would your natural teeth (be sure you use a soft-bristled brush). And keep up regular dental visits for thorough cleanings and checkups to stay ahead of any developing gum infection. Maintaining your dentures will help ensure they continue to brighten your smile for a long time.

If you would like more information on dental implants, 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 “Dental Implant Maintenance: Implant Teeth Must be Cleaned Differently.”

By Steven D. Dunning DDS
June 11, 2018
Category: Oral Health
Tags: gum disease   nutrition  
WatchWhatCarbsYouEattoReduceYourRiskofFurtherGumDisease

If you’ve had issues with periodontal (gum) disease, no doubt a few things have changed for you. You may be seeing us for dental cleanings and checkups more frequently and you have to be extra diligent about your daily brushing and flossing.

There’s one other thing you may need to do: change your diet. Some of the foods you may be eating could work against you in your fight against gum disease. At the same time, increasing your intake of certain foods could boost your overall oral health.

The biggest culprits in the first category are carbohydrates, which make up almost half the average diet in the Western world, mainly as added sugar. Although carbohydrates help fuel the body, too much can increase inflammation—which also happens to be a primary cause of tissue damage related to gum disease.

Of course, we can’t paint too broad a brush because not all carbohydrates have the same effect on the body. Carbohydrates like sugar or processed items like bakery goods, white rice or mashed potatoes quickly convert to glucose (the actual sugar used by the body for energy) in the bloodstream and increase insulin levels, which can then lead to chronic inflammation. Complex or unprocessed carbohydrates like vegetables, nuts or whole grains take longer to digest and so convert to glucose slowly—a process which can actually hinder inflammation.  

Eating less of the higher glycemic (the rate of glucose conversion entering the bloodstream) carbohydrates and more low glycemic foods will help reduce inflammation. And that’s good news for your gums. You should also add foods rich in vitamins C and D (cheese and other dairy products, for instance) and antioxidants to further protect your oral health.

Studies have shown that changing to a low-carbohydrate, anti-inflammatory diet can significantly reduce chronic inflammation in the body and improve gum health. Coupled with your other efforts at prevention, a better diet can go a long way in keeping gum disease at bay.

If you would like more information on the role of diet in dental health, 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 “Carbohydrates Linked to Gum Disease.”

BoneGraftingMightbeNecessaryBeforeYouObtainanImplant

Every year dentists place over 5 million dental implants for lost teeth, often removing the problem tooth and installing the implant at the same time. But getting a “tooth in a day” depends on a number of health factors, especially whether or not there’s adequate bone available for the implant. Otherwise, the implant’s placement accuracy and success could be compromised.

Bone loss can be a similar problem when a tooth has been missing for a long period of time. If this describes your situation, you may have already lost substantial bone in your jaw. To understand why, we need to know a little about bone’s growth cycle.

When bone cells reach the end of their useful life, they’re absorbed into the body by a process called resorption.  New cells then form to take the older cells’ place in a continuous cycle that keeps the bone healthy and strong. Forces generated when we chew travel through the teeth to the bone and help stimulate this growth. But when a tooth is missing, the bone doesn’t receive this stimulus. As a result, the bone may not replace itself at a healthy rate and diminish over time.

In extreme cases, we may need to consider some other dental restoration other than an implant. But if the bone loss isn’t too severe, we may be able to help increase it through bone grafting. We insert safe bone grafting material prepared in a lab directly into the jaw through a minor surgical procedure. The graft then acts like a scaffold for bone cells to form and grow upon. In a few months enough new bone may have formed to support an implant.

Bone grafting can also be used if you’re having a tooth removed to preserve the bone even if you’re not yet ready to obtain an implant. By placing a bone graft immediately after extraction, it’s possible to retain the bone for up to ten years—enough time to decide on your options for permanent restoration.

Whatever your situation, it’s important that you visit us as soon as possible for a complete examination. Afterward we can assess your options and hopefully come up with a treatment strategy that will eventually include smile-transforming dental implants.

If you would like more information on obtaining dental implants, please contact us or schedule an appointment for a consultation.

By Steven D. Dunning DDS
June 01, 2018
Category: Oral Health
Tags: braces   gum disease  
TheRiskforGumDiseaseIncreasesWhileWearingBraces

Your child has had braces for a few months and making good progress with correcting a poor bite (malocclusion), but you’ve also noticed something else: his gums are becoming red and swollen.

These are symptoms of gingivitis, a periodontal (gum) disease. It’s an infection that arises when plaque, a thin film of bacteria and food particles, isn’t adequately removed from teeth with daily brushing and flossing. The braces increase the risk for gingivitis.

This is because the hardware — metal or plastic brackets cemented to the teeth and joined together by metal bands — makes it more difficult to reach many areas of the teeth with a brush or floss string. The plaque left behind can trigger an infection that causes inflammation (swelling) and bleeding.

To exacerbate the situation, gums don’t always take well to braces and can react by overgrowing. Wearing braces may also coincide with a teenager’s surge in hormones that can accelerate the infection. Untreated, gingivitis can develop into advanced stages of disease that may eventually cause tooth loss. The effect is also heightened as we’re orthodontically putting stress on teeth to move them.

You can stay ahead of gingivitis through extra diligence with daily hygiene, especially taking a little more time to adequately get to all tooth surfaces with your brush and floss. It may also help to switch to a motorized brush or one designed to work around braces. You can make flossing easier by using special threaders to get around the wires or a water flosser that removes plaque with a pulsating water stream.

And don’t forget regular dental visits while wearing braces: we can monitor and treat overgrowth, perform thorough dental cleanings and treat occurrences of gingivitis. In some cases you may need to visit a periodontist, a specialist in gums and supporting teeth structures, for more advanced treatment. And if the disease becomes extensive, the braces may need to be removed temporarily to treat the gums and allow them to heal.

Orthodontic treatment is important for not only creating a new smile but also improving your teeth’s function. Keeping a close eye out for gum disease will make sure it doesn’t sidetrack your efforts in gaining straighter teeth.

If you would like more information on dental care during orthodontics, 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.”

By Steven D. Dunning DDS
May 27, 2018
Category: Dental Procedures
Tags: dental implants   smoking  
3ReasonsWhySmokingDoesntMixwithDentalImplants

If you smoke, you know better than anyone how a hard a habit it is to kick. If you want to quit, it helps to have a motivating reason—like lowering your risk for cancer, cardiovascular disease or similar conditions.

Here’s another reason for quitting tobacco: it could be making your teeth and gums less healthy. And, if you’re facing a restoration like dental implants, smoking can make that process harder or even increase the risk of failure.

So, to give your willpower some needed pep talk material, here are 3 reasons why smoking doesn’t mix with dental implants.

Inhaled smoke damages mouth tissues. Though you may not realize it, the smoke from your cigarette or cigar is hot enough to burn the top layer of skin cells in your mouth, which then thickens them. This could affect your salivary glands causing them to produce less saliva, which in turn could set off a chain of events that increases your risk of tooth decay or periodontal (gum) disease. The end result might be bone loss, which could make installing dental implants difficult if not impossible.

Nicotine restricts healthy blood flow. Nicotine, the chemical tobacco users crave, can restrict blood flow in the tiny vessels that course through the mouth membranes and gums. With less blood flow, these tissues may not receive enough antibodies to fight infection and fully facilitate healing, which could interfere with the integration of bone and implants that create their durable hold. Slower healing, as well as the increased chances of infection, could interrupt this integration process.

Smoking contributes to other diseases that impact oral health. Smoking’s direct effect on the mouth isn’t the only impact it could have on your oral health. As is well known, tobacco use can increase the risk of systemic conditions like cardiovascular and lung disease, and cancer. These conditions may also trigger inflammation—and a number of studies are showing this triggered inflammatory response could also affect your body’s ability to fight bacterial infections in the mouth. Less healthy teeth, gums and underlying bone work against your chances of long-term success with implants.

If you would like more information on dental implants, 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 “Dental Implants & Smoking: What are the Risks?





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