Posts for: February, 2014
If your gums bleed when you brush your teeth, it’s unlikely the cause is brushing too hard. The more common reason (especially if you’re experiencing little to no pain) is periodontal (gum) disease caused by the accumulation of bacterial deposits known as dental plaque and calculus where your teeth and gums meet.
This bacterial dental plaque results in an infection in the soft tissues of the gum; the body responds to this infection with antibodies, which in turn cause the gums to become swollen, or inflamed. As this biological “war” rages on, both the infection and inflammation become chronic. The tissues are weakened from this disease process and bleed easily.
Bleeding gums, then, is an important warning sign of possible gum disease. As the infection progresses the normal attachment between the teeth and gums begins to break down and form pockets in the void. The infection will continue within these pockets, eventually spreading deeper into the gums and bone. The gum tissue may begin to recede, resulting in bone loss and, if untreated, to tooth loss.
In the early stages of the disease, bleeding gums could be the only symptom you notice. It’s possible the bleeding may eventually stop, but this doesn’t mean the disease has, and is more likely advancing. If you’ve encountered bleeding gums, you should visit us as soon as possible for a complete examination.
There’s a two-pronged approach for treating gum disease. The first prong — and top priority — is to remove as much of the offending bacterial plaque and harder deposits (calculus) as possible, along with the possibility of follow-up antibacterial and antibiotic treatment. This may require more than one session, but it’s necessary in stopping the disease. The second prong is instituting proper oral hygiene: daily brushing and flossing (using proper techniques we can teach you) and semi-annual professional cleanings in our office to remove any plaque or calculus not removed with brushing.
Bleeding gums is your body’s way of telling you something isn’t right with your gums. The sooner you seek diagnosis and treatment, the better your chances of halting the damage caused by the disease.
If you would like more information on bleeding gums as a warning sign 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 “Bleeding Gums.”
Normally, teeth erupt and grow in a symmetrical alignment: on the top palate, for example, the two central incisors take center stage; on either side are the lateral incisors, and then beside these the canines (cuspids).
But what happens when teeth don’t grow in? The result can be a smile that just doesn’t quite look right; more importantly, normal function is impaired because the person can’t grasp and chew food correctly.
These missing teeth are the result of a congenital (“from birth”) defect. It’s estimated that almost a quarter of all people are missing one or more wisdom teeth, and more than 5% are missing one or more second premolars or upper lateral incisors.
In a normal arch (the upper or lower set of teeth), each tooth type performs a particular role during eating. A missing tooth causes the remaining teeth to compensate, but beyond their capacity. The remaining teeth also tend to move to fill in any gaps left by the missing teeth, as when the eye teeth move toward the central incisors in the absence of the lateral incisors. This puts them out of position, so they can’t cover (“occlude”) their counterparts on the other arch and grasp food properly.
To improve the smile and restore proper chewing function it’s necessary to first move these “out of position” teeth to their correct position through orthodontics. We would then fill the gaps that result with life-like restorations (preferably dental implants with crowns) that resemble the type of tooth that should be there.
The restoration needs to be timed carefully, especially for young patients whose jaw structure has not fully developed. If implants are installed before the jaw’s full maturity (usually late teens or early twenties), the implant crowns may not appear to be the right length as the jawbone continues to grow. Since bone growth depends on the normal pressures exerted by the teeth, there may also be insufficient bone mass in the gap area to support a dental implant. Growing bone with bone-grafting material may be necessary before installing implants.
The total process could take many months or even years, depending on age and other conditions. In the end, though, the results can be astounding — better function and a vibrant, new smile.
If you would like more information on developmental problems with 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 Don’t Grow.”
Dental professionals sometimes use specialized words, and you may not be clear about exactly what we mean. Test yourself on some of the specialized vocabulary concerning tooth whitening. How many of the following can you define correctly?
A method of making yellow, discolored teeth whiter. It is relatively inexpensive and safe, with few side effects.
2. External or extrinsic staining and whitening?
Extrinsic staining mainly results from diet and smoking. For example, foods such as red wine, coffee and tea can produce extrinsic stain. Teeth with these stains are bleached by placing whitening substance in direct contact with the living tooth surface.
3. Internal or intrinsic staining and whitening?
Intrinsic tooth discoloration is caused by changes in the structure of enamel, dentin, or pulp tissue deep within the root of the tooth. When the discoloration originates with the pulp tissue, root canal treatment may be needed to whiten the tooth from the inside.
4. Chromogenic material?
Color generating material that may get incorporated into the tooth's substance. It can be a result of wear and aging, or can be caused by inflammation within the tooth's pulp.
5. Carbamide Peroxide?
A bleaching agent discovered in the 1960s and frequently used for tooth whitening. When used, carbamide peroxide breaks into its component parts, hydrogen peroxide and urea, which bleach the colored organic molecules that have been incorporated between the crystals of the tooth's enamel.
6. Power Bleaching?
This technique is used for severely stained tooth. It uses a highly concentrated peroxide (35 to 45 percent) solution placed directly on the teeth, often activated by a heat or light source. This must be done in our office.
An antibiotic used to fight bacterial infections. It can result in tooth staining when taken by children whose teeth are still developing.
8. Rubber Dam?
Use of strong bleaching solutions requires protection for the gums and other sensitive tissues in your mouth. This is done using a rubber dam, a barrier to prevent the material from reaching your gums and the skin inside your mouth. Silicone and protective gels may also be used.
9. Whitening Strips?
Strips resembling band-aids that you can use in your home to whiten your teeth. They generally contain a solution of 10 percent or less carbamide peroxide gel. When using them, be sure to read the directions and follow them strictly to avoid injury or irritation.
10. Fade Rate?
The effects of bleaching may fade over time, from six months to two years. This is called the fade rate. It can be slowed down by avoiding habits such as smoking, along with food or drink that causes tooth staining.
Losing all of your teeth can be both physically and emotionally traumatic. Patients in this condition may need a period of transition from this loss to their permanent restoration. That’s the purpose of “immediate” dentures.
An immediate denture is a tooth appliance available for placement immediately after the final extraction so the patient’s ability to eat and speak isn’t unduly hampered (it also helps preserve their facial appearance). An immediate denture is a temporary measure until a more permanent replacement is achieved; hence, they’re not intended for long-term use.
Over time an immediate denture’s fit will deteriorate. This is because as the gums heal after extraction, and without the natural teeth present, the underlying bone and gum tissues will shrink significantly. The denture fit becomes looser, which leads to movement of the denture within the mouth. This can cause a good deal of discomfort emotionally and physically, and make it more difficult to eat and speak. It’s possible, however, to reline the immediate denture to fit the gum shrinkage and gain more service from it.
At some point, though, it’s necessary to transition from the immediate denture to the permanent restoration. If the permanent solution is a removable denture, we will need to wait until the gums have completely healed. At that time we will make a new and accurate impression of your mouth that reflects any changes since extraction. Even with this high level of accuracy, though, the final fit will depend on the amount of remaining bone and gum tissue needed to support the denture.
There are other options besides a removable denture. We can install a pair of implants in conjunction with a removable denture that can stabilize and retain it in the mouth; implants can also support a fixed bridge. You should weigh all the advantages and disadvantages to these options (including cost), to determine which one is the best solution for you.
In the meantime, the immediate denture will enable you to function in a normal manner, as well as aid with your appearance. Remember, though, it’s only meant for a short period of time — at some point you will need to transition from “immediate” to a more permanent and satisfying replacement.
If you would like more information on dentures, 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 “Immediate Dentures.”