Posts for: March, 2014
Although they may appear inert, teeth are anything but — they grow and change like other bodily tissues until complete maturation. Teeth roots are especially adaptable; teeth with multiple roots develop much like forks in a road as each root takes a different path toward the jawbone.
This fork where they separate is called a furcation. It’s normal for lower molars and premolars to have two furcations, while upper molars traditionally have three. Furcations pose difficulties for teeth cleaning and maintenance. If bone loss has occurred around them, a condition called a furcation invasion has occurred. This loss is most likely due to periodontal (gum) disease, an inflammation arising from bacterial plaque on the teeth that hasn’t been removed through proper oral hygiene.
We identify furcation invasions through x-ray imaging and tactile probing. They’re classified in three stages of development: Class I describes early onset in which marginal bone loss has occurred, exposing a groove that leads to the beginning of the furcation; Class II is moderate bone loss where a space of two or more millimeters has developed horizontally into the furcation; and, Class III, advanced bone loss whereby the bone loss has extended from one side of the tooth to the other, or “through and through furcation.”
Our first step in treatment is to remove any detectable plaque and calculus on the tooth surface, including the roots (known as scaling and root planing). These areas can be difficult to access, especially near furcations, and requires special instruments known as scalers or curettes. We may also employ ultrasonic scalers that use high-frequency vibrations coupled with water to break up and flush out the plaque and calculus.
We then apply antimicrobial or antibiotic medicines to further disinfect the area and inhibit bacterial growth while the affected tissues heal. As the infection and inflammation subsides, we then turn our attention during subsequent visits to address the bone loss around the furcation. This may involve surgical procedures to aid in re-growing gum tissue and bone and to create better access for cleaning and maintaining the area.
Finally, it’s important to establish good oral hygiene habits and regular checkups and cleanings to prevent further complications or a reoccurrence of the disease. Maintaining these habits will help you avoid tooth loss and other problems with your oral health.
If you would like more information on furcations, 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?”
So you came in to the dental office for an exam, and now you’ve been told you need a root canal. But you’re wondering: Do I really have to do this? I’ve heard all sorts of things about the procedure. What if I wait a while — would that be so bad?
The answer is: It just might! Whenever we dentists recommend a root canal procedure, we have good reasons for doing so. Here are the top five reasons why you shouldn’t delay getting this important treatment.
- The tooth is infected and dying; a root canal stops the infection. While the outer layers of the tooth are hard, the inner pulp is made of soft, living tissue. This tissue sometimes becomes infected (through deep decay, cracks in the tooth surface, etc.), and begins to die. Once that happens, treatment is needed right away — to stop the pain, control the infection, and keep it from spreading.
- Root Canal Treatment Alleviates Pain. That’s right: Root canal treatment doesn’t cause pain — it relieves it. The procedure is relatively painless, despite the old stories you might have heard. In fact, it’s not unlike having a cavity treated, though it may take a little longer. So if you’re experiencing tooth pain (a major symptom in most cases of root canal trouble), remember that the sooner you get it treated, the sooner you’ll be pain-free.
- It won’t get better on its own… If you ignore some things, they will go away. Root canal problems aren’t one of those things. In some cases, if you wait long enough, the pain will go away. But that’s not a good sign, because the problem won’t go away on its own; it simply means that the nerves inside the tooth are all dead. The infection continues to smolder like glowing coals in a fire.
- …But it could get worse. Left untreated, bacteria from the infected tooth pulp can travel through the roots of the tooth and into the tissue of the gums and jaw. That can cause a painful, pus-filled abscess to form, which will require urgent treatment. In extreme cases, It can also result in increasing systemic (whole-body) inflammation, potentially putting you at risk for more serious conditions, like heart disease and stroke.
- Root Canal Treatment Can Save the Tooth. If you neglect treatment of a root canal problem long enough, you’re at serious risk for losing the infected tooth. And tooth loss, once it starts, can bring on a host of other problems — like an increased risk of tooth decay on remaining teeth, as well as gum disease, bite problems… and, as oral health problems escalate, even more tooth loss. Why put yourself at risk?
If you would like more information about root canal treatment, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “A Step-By-Step Guide To Root Canal Treatment” and “Tooth Pain? Don’t Wait!”
While hygiene and regular dental care go a long way to reduce your risk of oral disease and disorders, you’re still subject to your heredity. Everything from tooth alignment to the shape of your jaws is determined by your genes.
So is the biological structure of your gum tissue. Aside from minute variations, gum tissue structure falls into two broad categories — “thin” or “thick,” which refer to the actual thickness of the tissue and the underlying bone. The tooth’s appearance is the best indicator of which type you may have: those with more triangular-shaped tooth (often called scalloped) have thin gum tissue; a person with a squarer appearance (flat) has thick gum tissue. People of Asian descent tend to have thin/scalloped tissue while those with European or African heritage tend to have thick/flat tissues.
Thick gum tissue isn’t superior to thin, or vice-versa. In fact, each type is susceptible to certain types of diseases or adverse conditions.
Thin tissues are more susceptible to the occurrence of receding gums. Caused mainly by periodontal disease and toothbrush abrasion, the gum tissue recedes and exposes more of the unprotected tooth surface that should be below the gum line. This increases the risk of decay and tooth loss. Patients with thick tissue, on the other hand, have a higher risk of developing a condition known as “pocketing.” As the thicker gum tissue becomes inflamed from dental plaque, it loses its attachment to the teeth and forms a small pocket. The end result is possible bone and tooth loss.
There’s not much you can do about which type of gum tissue you have, for which you can thank (or blame!) your ancestors. But there’s something you can do to reduce your risk of periodontal disease. First and foremost, you should practice good daily hygiene, brushing with a soft-bristled tooth brush and gentle flossing. It’s also important to maintain regular cleanings and checkups in our office; not only will this ensure complete plaque and tartar removal, but gives us a better chance to detect either receding gums or pocketing early. Earlier detection can mean better treatment outcomes — and a saved smile.
If you would like more information on genetic types of periodontal tissues, 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 “Genetics & Gum Tissue Types.”
According to a recent study from the National Cancer Institute, a branch of the National Institutes of Health, the incidence of cancer is dropping and the survival rate is increasing. In general, the outlook for patients undergoing treatment for the disease is getting better and better. Unfortunately, it's possible that some essential lifesaving treatments, like chemotherapy and radiation, can adversely affect your oral health. If you (or a loved one) need cancer treatment, however, there are some things you should know that can help minimize the possible complications and side effects.
- Chemotherapy and radiation are effective cancer treatments, but they may cause oral health problems. These therapies work by attacking cancer cells, but they can also damage healthy cells, including those in the salivary glands and the lining of the mouth. Common symptoms may include a dry mouth or uncomfortable mouth sores. Cancer patients may also be at higher risk for dental disease, especially tooth decay.
- Prevention is the best way to minimize these problems. It's important to have a complete dental evaluation before cancer treatment begins. Side effects often result when the mouth isn't healthy prior to the start of therapy — so if there's time for necessary dental treatment beforehand, it can be beneficial in the long run.
- Taking good care of the mouth is crucial at this time. During cancer treatment, proper brushing is more important than ever. A fluoride gel or antibacterial rinse may be prescribed to help prevent tooth decay. Prescription medications are sometimes recommended to alleviate dry mouth, but drinking plenty of water, chewing xylitol-containing gum, or using a soothing rinse of salt, water and baking soda can help too.
- A team approach is essential for the best care. This includes coordination between dentists and oncologists (cancer specialists), and sharing information about prescription and non-prescription drugs, medical histories and treatment plans.
- It's vital to understand and follow medical recommendations. This means not only getting the necessary treatments and taking prescribed medications, but also learning to recognize the warning signs of potential problems. With the support of our office, your oncologist, and caring family and friends, we can make cancer treatment as comfortable as possible and help obtain the best outcome.
If you would like more information about cancer treatment and oral health, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Oral Health During Cancer Treatment.”