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Posts for tag: gum disease

By George R. Shepley, DDS
September 29, 2021
Category: Oral Health
Tags: gum disease  
PeriodontalProbingCanTellUsaLotAbouttheSeverityofaGumInfection

The red and puffy gums that sometimes accompany the onset of periodontal (gum) disease don't always catch your attention. You may not even get any symptoms at all, in fact, until the disease has become well advanced.

That's why regular dental visits are so important for gum health: For while you may not notice anything abnormal about your gums, we have a simple procedure known as periodontal probing that can help diagnose the condition of your gums.

Gum disease is a common bacterial infection that affects millions of people worldwide. It most often begins with plaque, a filmy, bacterial buildup on teeth. These bacteria feed and multiply on the remnant food particles in the film, increasing the chances for an infection.

As it grows—as well as the inflammation the body initiates to fight it—the infection weakens the gum attachment to teeth. This can cause the miniscule gap between gums and teeth at the gum line to widen, forming a void called a periodontal pocket. The deeper and wider the pocket, the more advanced the gum infection.

We may be able to verify the presence of a periodontal pocket by using a long, thin probing instrument with millimeter gradations. We gently insert the probe at various locations around a tooth as far as it will comfortably go. We then record the depth by reading the gradation measures lined up with the top of the gums, as well as observing how snug or loose the probe feels within the gum space.

One to three millimeters signifies a healthy attachment between the tooth and gums—anything more than that usually indicates gum disease. Measurements of 5mm indicates a problem, the higher the number, the more advanced is the periodontal disease.

We use these probe readings and other factors to guide our treatment approach in individual cases of gum disease. With a less-advanced infection we may only need to remove plaque and calculus adhering to the crown and just below the gum line. More advanced gum disease infecting the root area may require surgical access through the gums.

All in all, keeping up with regular dental visits can increase the chances of early diagnosis, when the disease is still in its initial stages. And daily oral hygiene to remove harmful plaque may help you avoid gum disease altogether.

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 “Understanding Periodontal Pockets.”

By George R. Shepley, DDS
September 19, 2021
Category: Oral Health
HowaToothCausedHannahBronfmansMysteryAilments

Hannah Bronfman, well-known DJ and founder of the health and beauty website HBFIT.com, took a tumble while biking a few years ago. After the initial pain and bruising subsided, all seemed well—until she started experiencing headaches, fatigue and unexplained weight gain. Her doctors finally located the source—a serious infection emanating from a tooth injured during the accident.

It's easy to think of the human body as a loose confederation of organs and tissues that by and large keep their problems to themselves. But we'd do better to consider the body as an organic whole—and that a seemingly isolated condition may actually disrupt other aspects of our health.

That can be the case with oral infections triggered by tooth decay or gum disease, or from trauma as in Bronfman's case. These infections, which can inflict severe damage on teeth and gums, may also contribute to health issues beyond the mouth. They can even worsen serious, life-threatening conditions like heart disease.

The bacteria that cause both tooth decay and gum disease could be the mechanism for these extended problems. It's possible for bacteria active during an oral infection to migrate to other parts of the body through the bloodstream. If that happens, they can spread infection elsewhere, as it appears happened with Bronfman.

But perhaps the more common way for a dental disease to impact general health is through chronic inflammation. Initially, this defensive response by the body is a good thing—it serves to isolate diseased or injured tissues from healthier tissues. But if it becomes chronic, inflammation can cause its own share of damage.

The inflammation associated with gum disease can lead to weakened gum tissues that lose their attachment to teeth. But clinical research over the last few years also points to another possibility—that periodontal inflammation could worsen the inflammation associated with diseases like heart disease, diabetes or arthritis.

Because of this potential harm not only to your teeth and gums but also to the rest of your body, you shouldn't take an oral injury or infection lightly. If you've had an accident involving your mouth, see your dentist as soon as possible for a complete examination. You should also make an appointment if you notice signs of infection like swollen or bleeding gums.

Prompt dental treatment can help you minimize potential damage to your teeth and gums. It could also protect the rest of your health.

If you would like more information about the effects of dental problems on the rest of the body, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Link Between Heart and Gum Diseases.”

By George R. Shepley, DDS
August 30, 2021
Category: Oral Health
Tags: gum disease  
SmokersAreMoreSusceptibletoHarmfulGumDiseaseHeresWhy

Along with tooth decay, periodontal (gum) disease is a primary enemy of oral health. If not caught and treated, a gum infection could spread and eventually cause tooth loss.

But although prevalent among the general population, one demographic in particular is highly susceptible to gum disease—smokers and tobacco users in general. It's estimated over 60 percent of all smokers will contend with a gum infection at some point during their lifetimes. Smokers are also twice as likely as non-smokers to develop advanced gum disease that could lead to serious dental damage.

The high rate of gum disease among smokers (and to some extent, all tobacco users) is connected to the effect that tobacco has on oral health in general. Studies show that nicotine constricts blood vessels in the mouth, which in turn reduces their delivery of antibodies to fight disease-causing bacteria. As a result, smokers have more harmful bacteria in their mouths than non-smokers, which increases their risk of dental disease.

Smokers are also less likely than non-smokers to display inflammation or redness, the initial signs of a burgeoning gum infection. This too has to do with the constricted blood vessels in the gums that can't deliver adequate oxygen and nutrients to these tissues. As a result, the gums can appear pink and healthy, yet still be infected. This could delay diagnosis of gum disease, allowing the infection to become more advanced.

Finally, smoking can interfere with the treatment of gum disease. Because of nicotine, a tobacco users' infections and wounds are often slower to heal. Combined with late diagnoses of gum disease, this slower healing creates an environment where smokers are three times more likely than non-smokers to lose teeth from gum disease.

If you do smoke, it's important to let your dentist know how much and for how long you've smoked, which could be relevant to any dental care or treatment. Better yet, quitting the habit could improve your oral health and lower your risk for teeth-destroying gum disease.

If you would like more information on the effects of smoking on oral 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.”

PlaqueRemovalistheTopPriorityforPreventingorTreatingGumDisease

Tooth loss is often the unfortunate conclusion to a case of untreated periodontal (gum) disease—incentive enough to try either to prevent it or aggressively treat an infection should it occur. In either case, the objective is the same: to remove all plaque from dental surfaces.

Dental plaque (and its hardened form, tartar) is a thin buildup of bacteria and food particles on tooth surfaces. It's a ready food source for sustaining the bacteria that cause gum disease. Removing it can prevent an infection or “starve” one that has already begun.

Your first line of prevention is brushing and flossing your teeth daily to remove any accumulated plaque. Next in line are dental cleanings at least twice a year: This removes plaque and tartar that may have survived your daily hygiene.

Plaque removal is also necessary to stop an infection should it occur. Think of it as a more intense dental cleaning: We use many of the same tools and techniques, including scalers (or curettes) or ultrasonic devices to loosen plaque that is then flushed away. But we must often go deeper, to find and remove plaque deposits below the gums and around tooth roots.

This can be challenging, especially if the infection has already caused damage to these areas. For example, the junctures where tooth roots separate from the main body of the tooth, called furcations, are especially vulnerable to disease.

The results of infection around furcations (known as furcation involvements or furcation invasions) can weaken the tooth's stability. These involvements can begin as a slight groove and ultimately progress to an actual hole that passes from one end to the other (“through and through”).

To stop or attempt to reverse this damage, we must access the roots, sometimes surgically. Once we reach the area, we must remove any plaque deposits and try to stimulate regrowth of gum tissue and attachments around the tooth, as well as new bone to fill in the damage caused by the furcation involvement.

Extensive and aggressive treatment when a furcation involvement occurs—and the earlier, the better—can help save an affected tooth. But the best strategy is preventing gum disease altogether with dedicated oral hygiene and regular dental visits.

If you would like more information on preventing and 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?

By George R. Shepley, DDS
August 02, 2020
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.”