Posts for: October, 2018
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.
Children's permanent teeth normally erupt over several years after first forming below the gum line. All their permanent teeth should come in by the time they reach early adolescence.
Unfortunately, this process doesn't always happen as it should. If the erupting teeth become crowded due to a poor bite (malocclusion), teeth still to come in may not have enough room to fully erupt. They become impacted, a condition in which the visible crown remains partially or completely submerged below the gum line.
Impacted teeth create consequences for other teeth and dental health overall. They more readily cause abscesses (a localized infection within the gum tissue) and can damage the roots of nearby teeth. Impacted front canine (eye) teeth can interfere with bite function and their visual absence mars an otherwise attractive smile.
If your child's canine teeth have failed to erupt properly, there is a way to help them fully come in if you act before their mouth structure fully matures. The first step is an orthodontic evaluation of their entire bite. This will determine if there's enough space to move other teeth to make room for the impacted canines.
If so, we would then find the exact position of the impacted teeth using x-rays and possibly cone beam CT scanning for a detailed three-dimensional image. The teeth could be in a variety of positions, such as angled toward the roof of the mouth or cheek or buried high in the jawbone. If the teeth are too far out of position the best course of action may be to remove them and replace them later with a dental implant.
If the impacted teeth, though, are in a feasible position for retrieval, we first expose each tooth through the gums with a minor surgical procedure and bond a small bracket to it. We then attach a small gold chain to the bracket that loops over an orthodontic appliance attached to other teeth. The appliance will exert pressure over several months to pull the tooth into proper position.
If successful, your child will gain the use of these important teeth and a more attractive appearance. But don't delay — this desired outcome will become much harder if not impossible to attain as their teeth and jaws continue to develop.
If you would like more information on treating impacted 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 “Exposing Impacted Canines.”
Although it’s a natural part of dental development, teething is no picnic for your baby. This process in which each of their twenty primary teeth gradually erupt through the gums usually begins around their sixth to ninth month and may not end until around age three.
These periodic tooth eruptions can cause your baby to bite, gnaw, drool or rub their ears. Teething can also disrupt sleeping patterns, decrease appetite and cause gum swelling and pain that can turn your otherwise happy baby into an unhappy one.
Managing these teething episodes is one of the most common topics parents bring up with their dentists. Since teething is supposed to happen, there’s no need for medical intervention unless the child is also experiencing diarrhea, rashes, fever or prolonged irritability associated with teething episodes. In most cases, the best you can do is to make your child more comfortable. Here are a few things to help you do just that.
Provide cold items for gnawing. Rubber teething rings, wet wash cloths or pacifiers that have been chilled can give your child something to gnaw on and ease the pressure of sore gums while the chilled temperatures help numb pain. Be sure, though, that the items aren’t frozen because extremely cold temperatures can burn the skin.
Gum massage. You can massage your child’s gums with one of your fingers during a teething episode to counteract the throbbing pressure coming from the erupting tooth. Just be sure your finger is clean and don’t use any numbing agents unless advised by your dentist or pediatrician.
OTC medication. You can ease mild to moderate teething pain with over-the-counter pain relievers like acetaminophen or ibuprofen in dosages appropriate for your child’s age. But don’t apply rubbing alcohol to the gums or massage in any pain reliever—both practices can burn the skin. And, as mentioned before, only apply numbing agents like Benzocaine with the advice and supervision of a healthcare professional.
Besides these practices, be sure to keep up regular dental checkups to monitor the teething process and ensure all is going normally. And remember: though it may seem harrowing at times, the teething process won’t last forever.
If you would like more information on easing the effects of teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”