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Posts for tag: gum disease

By Lee Oppenheimer, DDS, PA
February 27, 2021
Category: Oral Health
Tags: gum disease  
TreatingGumAbscessesandtheUnderlyingGumDisease

If you have periodontal (gum) disease, you’ve no doubt experienced red and swollen gums. If, however, you notice an especially inflamed area next to a tooth, you may have developed a gum abscess.

An abscess is a pus-filled sac that develops as a result of chronic (long-standing) gum disease, an infection caused by bacterial plaque that’s built up on tooth surfaces from inadequate oral hygiene or from a foreign body (food debris) getting stuck below the gums. The abscess, which typically develops between the tooth and gums, may be accompanied by pain but not always (the affected tooth may also be tender to bite on). Abscesses may grow larger, precipitated by stress or by a general infection like a common cold, and then abate for a time.

As with other abscesses in the body, a gum abscess is treated by relieving the pressure (after numbing the area with local anesthesia) and allowing it to drain. This is often followed by cleaning any infected root surfaces of bacterial plaque and then irrigating the area with a saline and/or antibacterial solution. We may also prescribe antibiotics afterward and some form of pain control (usually a non-steroidal anti-inflammatory drug like ibuprofen) to help with discomfort.

Although the results of this procedure can be dramatic, it’s just the first step in treating the overall gum disease. After a few days of healing, we continue with a complete examination and recommend further treatment, usually starting with removing bacterial plaque and calculus (hardened plaque deposits), the underlying cause for the infection and inflammation, from all tooth and gum surfaces. This may take several sessions before we begin seeing the gum tissues return to a healthier state.

The key to preventing an abscess recurrence (or any symptom of gum disease) is to remove plaque everyday through proper brushing and flossing, and visiting us twice a year (or more if you’ve developed chronic gum disease) for cleanings and checkups. Doing so will raise your chances of avoiding an uncomfortable and often painful gum abscess in the future.

If you would like more information on gum abscesses, 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 (Gum) Abscesses.”

By Lee Oppenheimer, DDS, PA
January 28, 2021
Category: Dental Procedures
Tags: gum disease  
AreLasersforGumDiseaseTreatmentinOurFuture

One of the most important revolutions in healthcare in recent decades is the increasing use of lasers. Now, laser technology is making a showing in dental care for the treatment of periodontal (gum) disease.

Lasers (an acronym for "Light Amplification by Stimulated Emission of Radiation") narrowly focus and amplify light within a small area. First developed in the early 1960s, laser technology rapidly advanced in the ensuing decades with more compact and precise devices that were eventually safe and effective for many types of medical procedures. Its remarkable features are now available for the primary focus of gum disease treatment—removing bacterial plaque.

Plaque is a thin, built-up film of bacteria and food particles on tooth and gum surfaces that serves as a haven for the bacteria that cause gum disease. The continuing presence of plaque and calculus (tartar) enables the infection to thrive and advance within the gum tissues, ultimately damaging them along with supporting bone. As the tissues weaken and bone volume diminishes, the teeth are at greater risk for loss.

It's necessary, therefore, first and foremost to remove all detectable plaque and calculus to stop the infection. This is traditionally done with special hand tools called scalers used to manually remove plaque, or with ultrasonic equipment that vibrates plaque loose to be flushed away with water. These procedures can take numerous sessions and may result in some minor post-procedural discomfort and bleeding during the cleaning.

But lasers specifically designed for plaque removal can minimize tissue damage and resulting discomfort. Because the particular laser light used reacts only with plaque and diseased tissue, it can remove them without disturbing nearby healthy tissue usually more efficiently than traditional scaling. Dentists who've used the technology frequently report less bleeding and higher patient satisfaction.

But before lasers for gum disease treatment are widely adopted, the procedure must undergo further scrutiny. Reports from dentists notwithstanding, not enough research studies have been performed to date that meet the necessary scientific criteria. But if the evidence so far from the field holds up, it's quite possible lasers will one day become a regular part of dental practice for treating gum disease.

If you would like more information on 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

By Lee Oppenheimer, DDS, PA
January 18, 2021
Category: Oral Health
Tags: gum disease   smoking  
SmokingIncreasesYourRiskforGumDisease

There are important reasons not to smoke, like minimizing your risk for deadly diseases like heart disease or lung cancer. But here's another good reason: Smoking increases your risk of gum disease and possible tooth loss. And although not necessarily life-threatening, losing your teeth can have a negative effect on your overall health.

According to the U.S. Centers for Disease Control, individuals who smoke cigarettes, cigars, pipes or e-cigarettes are twice as likely as non-smokers to develop gum disease, and four times as likely the infection will become advanced. Your risk may also increase if you're regularly exposed to second-hand smoke.

There are a number of reasons for this increased risk. For one, smokers are less likely than non-smokers to recognize they have gum disease, at least initially, because they may not display classic symptoms of an infection like red, swollen or bleeding gums. This happens because the nicotine in tobacco smoke interferes with normal blood circulation. As a result, their gums may appear healthy when they're not.

That same circulation interference can also inhibit the production and supply of antibodies to fight infection. Not only can this intensify the infection, it can also slow healing and complicate treatment. In fact, smokers are more likely to have repeated episodes of infection, a condition called refractory periodontitis.

But there is good news—smoking's effect on your gum health doesn't have to be permanent. As soon as you stop, your body will begin to repair the damage; the longer you abstain from the habit, the more your gum health will improve. For example, one national study found that former smokers who had not smoked for at least eleven years were able to achieve an equal risk of gum disease with someone who had never smoked.

Quitting smoking isn't easy, but it can be done. If abrupt cessation (“cold turkey”) is too much for you, there are medically-supported cessation programs using drugs or other techniques that can help you kick the habit. And while it may be a long road, leaving smoking behind is an important step toward improving and maintaining good dental health.

If you would like more information on protecting your gum 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 “Smoking and Gum Disease.”

By Lee Oppenheimer, DDS, PA
December 15, 2020
Category: Dental Procedures
YouMayNeedYourGumsCheckedMoreFrequentlyAfterGumDisease

After a dental examination revealed you had periodontal (gum) disease, you began undergoing treatment. Now after several cleaning sessions, the infection has subsided and your gums have returned to a healthy shade of pink.

But your gum care isn’t over — depending on the infection’s severity you may need to visit us more often than the normal six months between regular checkups.

Gum disease arises from dental plaque, a thin film of bacteria and food remnants built up on tooth surfaces due to poor oral hygiene. The bacteria cause an infection in the gums, which initiates a response from the body’s immune system that triggers inflammation.

Without proper treatment, periodontitis can come back in which the infection spreads deeper below the gum line. Pockets of infection can reoccur as gum tissues weaken and lose their attachment to teeth. This continuing damage can ultimately lead to both tooth and bone loss.

To stop the disease it’s necessary to remove all the infection-causing plaque and calculus (hardened plaque deposits) from tooth surfaces, including around the roots. This is performed manually and could require surgery once again to access areas below the gum line.

To guard against this it’s necessary for you to undergo regular periodontal maintenance (PM). Besides cleaning, PM gives us an opportunity to check for signs of returning gum disease and, if found, plan for another round of treatment.

Although not written in stone, the interval between PM appointments that seems the most effective for preventing recurrence is every three months. In cases of advanced, aggressive gum disease, appointments may need to occur at even shorter intervals, for example every two months.

PM for susceptible patients with decreased resistance to disease require extra time and effort for the hygienist, along with a renewed daily hygiene habit of effective brushing and flossing by you to keep the disease at bay. But preventing another occurrence of gum disease and its consequences is well worth this extra attention for the health of your teeth and gums.

If you would like more information on dental care after gum disease treatment, please contact us or schedule an appointment for a consultation.

By Lee Oppenheimer, DDS, PA
October 26, 2020
Category: Dental Procedures
Tags: gum disease  
DontDelayTreatmentofGumDisease

Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.

One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.

It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.

We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).

Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.

Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.

If you would like more information on treatments for gum disease, please contact us or schedule an appointment for a consultation.