Posts for: June, 2020
Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.
Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.
Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.
A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.
The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.
The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.
We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.
The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.
A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.
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 “What are Furcations?”
Millions of people wear some form of removable oral appliance. The range is pretty extensive, from orthodontic clear aligners and retainers to full or partial dentures. But while they may vary in purpose, they all require the same thing: regular cleaning and maintenance.
And there's a right way to care for them, and a wrong way. The right way ensures you'll get the most out of your appliance—the wrong way might drastically curtail their longevity. Here, then, are 4 things you should and shouldn't do to keep your appliance in tip top condition.
Clean it properly. Only use cleaning agents appropriate for an oral appliance's materials. That means avoiding the use of toothpaste—the abrasives in it won't harm tooth enamel, but they can scratch some appliance materials. Instead, use dish detergent, hand soap or a recommended cleaner with a little warm water. Also, use a different brush than your regular toothbrush.
Avoid hot water and bleach. Hot or boiling water and bleach kill bacteria, but they will also damage your appliance. Hot water can warp an appliance's soft plastic and alter its fit. Bleach can blanch plastic meant to mimic gum tissue, making them less attractive; even worse, it can break down appliance materials and make them less durable.
Protect your appliance. When you take out your appliance, be sure to store it high out of reach of curious pets or young children. And while cleaning dentures in particular, place a small towel in the sink—if they slip accidentally from your hand, there's less chance of damage if they fall on a soft towel rather than a hard sink basin.
Don't wear dentures 24/7. Dentures can accumulate bacterial plaque just like your teeth. This can increase your risk of an oral infection, as well as create unpleasant mouth odors. To minimize this, take your dentures out at night while you sleep. And be sure you're cleaning them daily by hand, soaking them in an appropriate solution or with an ultrasonic cleaner.
Your oral appliance helps keep your dental health and function going. Help your appliance continue to do that for the long haul by taking proper care of it.
If you would like more information on how best to maintain your oral appliance, 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 “10 Tips for Cleaning Your Oral Appliance.”
Primary (baby) teeth don't last long. But despite their short life span, they do a number of important things, like enabling a child to eat solid food. But perhaps their most important long-term function is “paving” the way for their permanent replacements.
If one is lost prematurely, though, the permanent tooth might not come in properly aligned. That's why if a primary tooth is in danger of loss due to decay or injury, we'll do our best to save it.
But that could get a little tricky if the infected or damaged part of the tooth is the innermost pulp. If it were an adult tooth, the best course might be a root canal treatment: access the pulp, clear out the diseased tissue, and then fill the space with a special filling. But with a primary tooth (or a young permanent tooth for that matter) that may not be advisable.
That's because the pulp plays a more important role in a child's tooth than an adult's. Its nerves and other tissues stimulate dentin growth; a full root canal could disrupt that growth and weaken the tooth in the long run.
With a child's tooth, we proceed carefully depending on how infected or damaged the pulp might be. If it's only slightly exposed or not at all, we try then to remove as much decayed tooth material outside the pulp as necessary, then apply antibacterial agents or dentin growth stimulators.
If we do have pulp exposure, we'll try to remove only as much of the affected pulp as necessary through a procedure called a pulpotomy. This technique will only be used if the remaining pulp looks healthy or restorable to health.
If not, we may need to perform a pulpectomy to remove the entire pulp. Most like a typical root canal, it's a last resort: without the pulp, dentin growth could be stunted and the tooth won't develop as healthy as it should.
Of course, the best approach is to prevent teeth from developing such problems in the first place. So, be sure to practice effective daily hygiene with your child and keep up regular dental visits beginning at age one.
If you would like more information on treating decayed primary 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 “Root Canal Treatment for Children's Teeth.”