Gum/Periodontal Disease

Gum/Periodontal Disease

Gum disease (periodontal disease) can occur at any age. Many people think of periodontal disease as an adult problem. However, studies indicate that nearly all children and adolescents have gingivitis, the first stage of periodontal disease. Advanced forms of periodontal disease are rarer in children than adults but can occur. Periodontal disease is an inflammatory infection of your gums and bone caused by the bacteria that adhere to your teeth.  dentist san antonio
The bacteria often congregate in invisible colonies called biofilm. The bacteria produce toxins or poisons that irritate your gums. The toxins also stimulate a chronic inflammatory response in which your body in essence turns on itself. Your body produces protein hormones called cytokines. They allow the tissues and bone that support the teeth to be broken down and destroyed. These cytokines act as a form of communication between other inflammatory cells not only in the gums and bone but also in other body organs far from the mouth and can have serious consequences. Additionally, physicians are beginning to measure the blood level of C-reactive protein (CRP) which is produced by the liver. The level of CRP rises when there is inflammation throughout the body and may be associated with the following:

* Cancer
* Connective tissue disease
* Heart attack
* Infections (such as gum disease)
* Inflammatory bowel disease (IBD)
* Lupus
* Pneumococcal pneumonia
* Rheumatoid arthritis
* Rheumatic fever
* Tuberculosis

In the early stage of the disease, called gingivitis, gums may swell, turn red and bleed easily. Eventually, these toxins cause the tissues to separate from the tooth and form deepened spaces called pockets. If left untreated, the disease can progress to the bone. Because gum inflammation and bone destruction are largely painless, people may wrongly assume that the painless bleeding after teeth cleaning is insignificant.

Basic signs will alert you to periodontal disease:

Bleeding Gums – Puffy, Tender, Bright Red Gums – Receding Gums

In later stages of the disease called periodontitis, the bone and the soft tissues that support the teeth can be destroyed. This can cause the teeth to become loose, fall out, or have to be removed by your dentist. Periodontitis is the most frequent cause of tooth removal for people over 40 years of age.

An article in the Journal of Periodontology states that cigarette smoking may be responsible for more than half the gum disease in US adults. Current smokers are four times more likely to have gum disease than those who have never smoked.. The more cigarettes you smoke each day, the greater the odds you’ll get gum disease. Quitting smoking seems to gradually reduce the harmful effects of tobacco on your gums.

Periodontal (gum) disease may be passed from parents to children and between couples, according to an article in the Journal of the American Dental Association. Researchers suggest that the bacteria that cause periodontal disease pass through saliva. This means that the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member. If one family member has periodontal disease, all family members should see a dental professional for a periodontal evaluation. More here

In addition, it’s well documented that women who are pregnant and have periodontal disease are far more likely to give birth earlier (prematurely) and give birth to low birth weight babies than women with healthy gums. The mouth is the portal to the body, it should be no surprise that an infected mouth can affect your unborn baby. Premature babies are born with serious health complications that last throughout life, from cerebral palsy to mental disabilities to blindness. Prematurity is also the leading cause of neonatal death in this country. The American Dental Association is working with the March of Dimes Prematurity Campaign to raise awareness of the link between gum disease and premature births.

Diabetics with gum disease have a harder time controlling their blood sugar as measured by their A1c.

Obese patients are 8 times more likely to have periodontal disease.

Recently, a link between gum disease and gastric ulcers has been established. Gastric ulcers are caused by a particular type of bacteria. That same bacteria is also found in periodontal pockets. It is theorized that this type of bacteria can be swallowed from the mouth to the stomach where it contributes to gastric ulcer formation.

Harvard researchers reported that men with a history of gum disease were at a 64% higher risk for pancreatic cancer compared with those with healthy mouths. This study’s lead author said, “People think of gum disease as being in their mouth. But when it gets severe, it’s not just in the mouth. It’s probably in the entire body.”

A study published in the Journal of Periodontology concluded that controlling gum disease may reduce the incidence and progression of chronic kidney disease.

Are you starting to see the connection, an unhealthy mouth may lead to an unhealthy body.

Be aware that Biophosphate drugs (Fosamax, Boniva, Actonel, and Reclast) that fight osteoporosis and prevent broken bones can make fighting gum disease more difficult because these drugs make bone denser. This makes it difficult for gum disease-fighting antibiotics to reach the gum infection and slows down the rate of bony repair. Please tell your dentist about all drugs that you are taking.

Your periodontal risk factors as determined by your history, x-rays, and probing will dictate how aggressively and quickly your dentist works to eliminate your inflammation. Because periodontal disease can cycle up and down in intensity over time, your dentist will also set up a monitoring program based on your risk factors and your body’s response to your initial therapy.

If you are at low risk, simple physical removal of the bacteria called debridement may eliminate the inflammation. Dentists used to scrape the bacteria off by hand, but now many use ultrasonic devices that disable the bacteria by a combination of mechanical chipping at their colonies, cavitation shock waves similar to mini tornados with the turbulence that strips the bacteria of their hair like feet/flagella and the forceful flushing of the loosened and bombarded colonies by the water stream at the ultrasonic device tip. The elimination of bleeding at previous bleeding sites is the measure of successful periodontal therapy. If you are a medium to the high-risk patient, your dentist will work to neutralize the bacteria by debridement and may place high-dose localized antibiotics next to your teeth in the more severe areas. In addition to neutralizing the bacteria, if you are at medium to high risk, your dentist may prescribe a low dose systemic antibiotic such as doxycycline to reduce the harmful production of inflammatory mediators by your body. The highest-risk patients and those lower-risk patients who show little inflammatory improvement as measured at original bleeding sites will need to be referred to a periodontal specialist. The periodontal specialist may need to do outpatient surgery to temporarily move the gum tissue out of the way so bacteria in the hardest-to-reach places can be removed and the healing process can begin. Some gum and bone damage cannot be restored by the best of therapy. This finding makes it essential to see your dentist for an inflammation evaluation on a regular basis before damage is irreversible.

Dental Bridges – Cosmetic Dentistry

Dental bridges are bridges that are cemented to your teeth on either side of a gap. It is a temporary bridge made by a dental technician before a permanent bridge is constructed. Pontiacs, false teeth, are fused between two crowns, essentially filling the area of the missing tooth. This is called a fixed bridges - general dentistry

The procedure is used to replace missing teeth in your mouth and cannot be taken out. If you wish to be able to remove them you would be better off with removable dentures. As there are areas in your mouth that are under less stress than other teeth (front teeth), a cantilever bridge is used. If the bridges are to last for many years the overall health of your mouth must be good. Use super floss or interdentally brushes to maintain strong dental bridges for years. In instances where there are wide gaps on one side of a tooth, Cantilever bridges are used. Bridges can lower your chances of gum disease, help correct over-bite, improve and improve speech. You must be serious about your oral hygiene in order for the bridges to maintain longer than a few years.

A fixed bridge is when two crowns hold a false tooth in place, attached to your actual teeth. The procedure used to create this bridge is to replace missing teeth, as well. Again, fixed bridges can’t be taken out of your mouth. In order to have a bridge, teeth must be free from infection and decay. Bridges are made from metal sub-frames with white-colored porcelain, the same color of your teeth. These bridges are applied with cement to healthy teeth. Conventional bridges require having a part of the healthy tooth shaved adjacent to the missing tooth. A three-unit bridge is placed on the shaped teeth to support the fake tooth. The bridge is used to restore the natural chewing function and appearance. It will restore your smile and proper chewing ability, maintain face shape, distribute bite properly, and prevent teeth from moving.

Your gums should be in good health before considering this procedure. Dental bridges may be placed if the gums are not optimal for health gum disease treatment. A Maryland and Dental bridge is the type of bridge made up of plastic teeth and gums supported by a metal framework. The bonded nature of the Maryland dental bridge is lower than other types of bridges but the most simple to apply. dentists office visit

It is important that you are able to smile and give people a strong first impression. Those who smile less and are embarrassed about their smile tend to be less likely to make solid first impressions. Dental bridge procedures help create the specific smile design for each individual person, designed by you and your own dentist. It can fill missing teeth, bridge gaps, fuse crowns, keep your teeth healthier and whiter, and improve your speaking ability. With two procedures available depending on your teeth’s condition, you are closer than ever to the perfect smile. Having dental bridges can also lower your chance of gum disease if maintained properly. These procedures are only for those who are serious about maintaining oral hygiene.

Starting the Invisalign Journey

This week I had an appointment to pick up my first trays for my Invisalign journey. I was quite nervous about them – especially given I dropped so much money on this process that I would have to go through with it even if they were slightly painful or worse. find more information here @

When I arrived at my appointment with the Orthodontist, where I am being treated, I was surprised to find a “Registered Dental Assistant” there to greet me. My initial thought was “ok, where is the orthodontist I met who gave me the sales pitch?” Well, the answer, I later found out, was that he wasn’t there. Despite his big sales push that general dentists should never be allowed to do Invisalign work, he isn’t even around for the first appointment. orthodontists - general dentistry

That said, the dental assistant was nice and talked me through the basics of my Invisalign program. She is actually going through getting Invisalign herself so it put me at ease knowing she not only was telling me about what would happen but she was experiencing it as well. Still I was a bit unhappy that the orthodontist wasn’t even around for the first appointment just for show.

In any case, the appointment didn’t take long at all. I was informed that the important part – the “prescription” – was all done by Dr. David R. Boschken who is my orthodontist. I understand, they’re trying to keep costs down (hence why I was able to get a reasonably good deal at a reputable establishment) so I’ll go with the flow. What matters most is that this works and doesn’t cause harm. I am still faithful that I made the right choice.

So the appointment was fairly uneventful. My first set of trays – which I was told were kind of practice trays as they wouldn’t be moving much – were to be put in with my hands (never set in place by biting down on them) and I was warned of all the ways I could lose or break my trays (don’t ever, ever leave your trays in a napkin, she warned.) Then I was shown an animation of my teeth moving into place over the next 12+ months. One thing I noticed on the animation was these blue squares on a bunch of my teeth. Uh oh, what’s that?

Apparently that is the attachments – which – if they were mentioned to me at all in the sales pitch, were mentioned as quickly as possible without any emphasis. It seems this is a common theme among Invisalign dentists and orthos — they show you the invisible, thin plastic trays but fail to show you the giant tooth-colored bumps of cement that are going to be glued to your teeth for the next year or more.

I didn’t count all of my attachments but it looks like a lot. The need for them makes sense – these plastic trays can put pressure on teeth but only in certain ways, whereas traditional braces actually attach to the teeth so can pull or push better – however, I wish I had a better idea of what I was getting myself into. In my mind this was a great solution because if I needed to take the trays out for a picture – say when I’m a bridesmaid in a wedding this November – no one would have any idea that I had Invisalign in many years to come. But, nope, I’m getting two big attachments on the teeth next to my center two, along with many others.

The attachments will be installed at my next appointment in three weeks. I’ve read all sorts of fun horror stories about the Invisalign attachments/buttons (scratching up your gums and just looking strange if they don’t match your teeth perfectly) so I’m a bit nervous. I’m not going to ask for them not to use the attachments though because that would be silly and a waste of money. At the moment I’m giving my full faith and confidence to my orthodontist and letting him call the shots. It would be nice if he showed up to call the shots or ease my concerns re: the shots, but you know, minor details.

I’ve now had the trays in for about two days. I think the description I read elsewhere of a firm grip on your jaws that’s somewhat claustrophobic is accurate, as is the tale of how one Invisalign user rubbed his tongue on the edges of the trays out of habit until it got rough and sore.

If you don’t know anything about Invisalign – here’s a quick overview of how it works: Basically you get a bunch of trays made up for you (in my case there are 24 of them) and then you change them out ever 2-3 weeks until you’re done. Then if things don’t move as your dentist or ortho wants, you get refinements, which basically means more trays to focus on problem areas. Then you’re done and you wear a retainer for the rest of your life while you sleep to keep all this hard work you paid for.invisalign retainers

While you’re using Invisalign you have to wear the trays about 22 hours a day, give or take. You basically take them out to eat and that’s it. This is unfortunate since I have a horrid lisp while wearing the trays but I’m hoping I get used to my new and – uh – improved speech. At least it makes my boyfriend crack up.

Invisalign definitely isn’t invisible. People are going to notice you have them.But so what? They’re still better than braces. My boyfriend explained that it looks like I’m walking around with crest white strips on my teeth. So, yea, there’s that.

At the moment one of my lower teeth feels sore from pressure (the good kind of pressure) and my tongue feels sore from being ripped up on the tray edge. Ouch. I’ve been really good about wearing the trays so far and following a religious cleaning routine where I brush and floss after every single meal or snack. My dentist is going to love this.

Also, a side benefit of these things is prob going to be weight loss. It’s just too much of a hassle to eat and it probably will be more of one once the attachments are glued on. So I’ll be able to hit both my teeth straightening and BMI wedding goals. Hurrah. Stay tuned for more updates along my Invisalign journey. I’ll post pictures soon as well.
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