My Blog

Posts for: August, 2021

By Lee Oppenheimer, DDS, PA
August 26, 2021
Category: Oral Health
Tags: gum disease   oral health  
TreatingGumDiseaseisGoodforYourWholeBodyNotJustYourMouth

Periodontal (gum) disease can do unpleasant things to your mouth, including losing teeth. Its effects, though, may not be isolated to the oral cavity: Gum disease could make other diseases in the body worse.

Gum disease is a bacterial infection most often caused by dental plaque, a thin bacterial film that builds up on teeth in the absence of effective oral hygiene. At the outset it may infect your gums causing them to swell, redden or bleed. Eventually, though, the infection can advance deeper toward the tooth roots and bone.

There are various methods to treat gum disease depending on the extensiveness of the infection. But these methods all share the same objective—to remove all uncovered plaque and tartar (hardened plaque). Plaque fuels the infection, so removing it starves out the disease and helps the body to heal.

The damage gum disease can do to the teeth and the surrounding gums is reason enough to seek treatment. But treating it can also benefit your overall health. That's because the weakened gum tissues often serve as an open portal for bacteria and other toxins to enter the bloodstream. From there they can travel to other parts of the body and cause disease.

Gum disease also shares another feature with some systemic conditions: inflammation. This is the body's response to disease or trauma that isolates damaged tissues from healthy ones. But with gum disease, this inflammation can become chronic and ironically do more harm than good.

A gum infection may also increase the body's overall inflammatory response, in turn aggravating other diseases like diabetes, heart disease or arthritis. Treating gum disease lowers inflammation, which in turn could ease inflammation in other conditions. Likewise, reducing your body's overall inflammatory response by properly managing these other conditions might make you less susceptible to gum disease.

It's important then to prevent and treat gum disease as if your overall health depended on it—because it does. You can prevent it by brushing and flossing daily and undergoing regular dental cleanings to remove plaque. And see your dentist promptly at the first signs of gum problems. Likewise, follow a physician-supervised program to manage any inflammatory conditions.

If you would like more information on preventing or 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 “Good Oral Health Leads to Better Health Overall.”


By Lee Oppenheimer, DDS, PA
August 16, 2021
Category: Dental Procedures
Tags: crown lengthening  
CrownLengtheningOpensupNewTeethRestorationPossibilities

A crown — a life-like “cap” made of dental porcelain that permanently covers an existing tooth — is an effective way to restore a still-viable decayed or broken tooth’s appearance. Properly fitting the crown over the tooth requires some healthy tooth structure above the gum line.

But what if the tooth has broken down to the gum line? In this case, we would need to perform a common procedure known as crown lengthening to expose more of the tooth.

Crown lengthening is a minor surgical procedure performed with local anesthesia to numb the tooth, surrounding gum tissues and supporting bone. We first make tiny incisions inside the gum-line on both the cheek and tongue side of the tooth to expose the bone, and then carefully remove a small amount of bone from either side of the tooth; this will expose or “lengthen” the tooth. Once finished, we suture the gum tissue back into place with self-dissolving sutures against the bone and tooth.

Most procedures take only sixty to ninety minutes, and the mild discomfort afterward is usually managed with pain relievers like ibuprofen. While the gum tissues may appear to be healed after a week, we typically wait six to eight weeks to perform the final crown restoration to give the tissues time to fully mature.

Crown lengthening may not work in all situations, especially with a severely fractured tooth. In these cases, we may need to evaluate the long-term viability of the tooth and consider other restorative options. Depending on your bite, it may also be necessary to treat with orthodontics first: not only will the tooth move into a better position, but the treatment may move both the gum and bone down with the tooth. Subsequent crown lengthening will then only affect the intended tooth and not adjacent ones, resulting in a more even smile.

The first step is for us to decide after a thorough examination if you would benefit from crown lengthening. If so, this minor surgical procedure could pave the way for better mouth function and a more attractive smile.

If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation.


By Lee Oppenheimer, DDS, PA
August 06, 2021
Category: Dental Procedures
Tags: gum recession  
GumRecessionDoesntHavetobePermanent

The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.

Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.

Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.

But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.

The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.

There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.

In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting.  The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.

Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.

If you would like more information on treating gum recession, 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 “Periodontal Plastic Surgery.”