Procedures

Whether your dental needs are a complete exam and cleaning, a full-mouth restoration, or anything in between, we promise to provide you with exceptional care as we enhance the natural beauty of your smile.

Below are just some of the many procedures and services we regularly provide to our patients – with a gentle touch, and stunning results.  Your smile is our first priority, and we’ll give you something to smile about.

If you have any questions, concerns, or would like to schedule an appointment, please contact us today.  We look forward to providing you with the personal care you deserve.

Procedures

Restorations

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc.  The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

There are many types of filling materials available, each with their own advantages and disadvantages.  You and your dentist can discuss the best options for restoring your teeth.  Composite fillings, along with silver amalgam fillings, are the most widely used today.  Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced.  They are very durable, and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:

  • Chipped teeth.
  • Closing space between two teeth.
  • Cracked or broken teeth.
  • Decayed teeth.
  • Worn teeth.

How are composite fillings placed?

Composite fillings are usually placed in one appointment.  While the tooth is numb, your dentist will remove decay as necessary.  The space will then be thoroughly cleaned and carefully prepared before the new filling is placed.  If the decay was near the nerve of the tooth, a special medication will be applied for added protection.  The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

You will be given care instructions at the conclusion of your treatment.  Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

A denture is a removable dental appliance replacement for missing teeth and surrounding tissue.  They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures – complete and partial dentures.  Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain.  A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

A Complete denture may be either “conventional” or “immediate.”  A conventional type is made after the teeth have been removed and the gum tissue has healed, usually taking 4 to 6 weeks.  During this time the patient will go without teeth.  Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process.  Once the tissues shrink and heal, adjustments will have to be made.

Dentures are very durable appliances and will last many years, but may have to be remade, repaired, or readjusted due to normal wear.

Reasons for dentures:

  • Complete Denture – Loss of all teeth in an arch.
  • Partial Denture – Loss of several teeth in an arch.
  • Enhancing smile and facial tissues.
  • Improving chewing, speech, and digestion.

What does getting dentures involve?

The process of getting dentures requires several appointments, usually over several weeks.  Highly accurate impressions (molds) and measurements are taken and used to create your custom denture.  Several “try-in” appointments may be necessary to ensure proper shape, color, and fit.  At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will subside as your muscles and tissues get used to the new dentures.

You will be given care instructions for your new dentures.  Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures.

A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.

There are several types of bridges.  You and your dentist will discuss the best options for your particular case.  The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal.  This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.

Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.

Reasons for a fixed bridge:

  • Fill space of missing teeth.
  • Maintain facial shape.
  • Prevent remaining teeth from drifting out of position.
  • Restore chewing and speaking ability.
  • Restore your smile.
  • Upgrade from a removable partial denture to a permanent dental appliance.

What does getting a fixed bridge involve?

Getting a bridge usually requires two or more visits.  While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown.  Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated.  In addition, a temporary bridge will be made and worn for several weeks until your next appointment.

At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit.  Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge.  The new bridge will be permanently cemented at a later time.

You will receive care instructions at the conclusion of the procedure.  Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection.  In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed.  Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:

  • An abscess (or pimple) on the gums.
  • Sensitivity to hot and cold.
  • Severe toothache pain.
  • Sometimes no symptoms are present.
  • Swelling and/or tenderness.

Reasons for root canal therapy:

  • Decay has reached the tooth pulp (the living tissue inside the tooth).
  • Infection or abscess have developed inside the tooth or at the root tip.
  • Injury or trauma to the tooth.

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.  An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria.  If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials.  A filling will be placed to cover the opening on top of the tooth.  In addition, all teeth that have root canal treatment should have a crown (cap) placed.  This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.

You will be given care instructions after each appointment.  Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

Periodontal Disease

Periodontal (gum) disease, which is also known as periodontal disease and periodontitis, is a progressive disease which if left untreated may result in tooth loss.  Gum disease begins with the inflammation and irritation of the gingival tissues which surround and support the teeth.  The cause of this inflammation is the toxins found in plaque which cause an ongoing bacterial infection.

The bacterial infection colonizes in the gingival tissue and deep pockets form between the teeth and the gums.  If treated promptly by a periodontist, the effects of mild inflammation (known as gingivitis) are completely reversible.  However, if the bacterial infection is allowed to progress, periodontal disease begins to destroy the gums and the underlying jawbone; promoting tooth loss.  In some cases, the bacteria from this infection can travel to other areas of the body via the bloodstream.

Common Causes of Gum Disease

There are genetic and environmental factors involved in the onset of gum disease, and in many cases the risk of developing periodontitis can be significantly lowered by taking preventative measures.

Here are some of the most common causes of gum disease:

  • Poor dental hygiene – Preventing dental disease starts at home with good oral hygiene and a balanced diet.  Prevention also includes regular dental visits which include exams, cleanings, and x-rays.  A combination of excellent home care and professional dental care will ensure and preserve the natural dentition and supporting bony structures.  When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacteria toxins and can cause gingivitis or periodontitis, which can lead to tooth loss.
  • Tobacco use – Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease.  In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss.
  • Genetic predisposition – Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease.  These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition.  Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
  • Pregnancy and menopause – During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
  • Chronic stress and poor diet – Stress lowers the ability of the immune system to fight off disease, which means bacterial infections may possibly beat the body’s defense system.  Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
  • Diabetes and underlying medical issues – Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis.  Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.
  • Grinding teeth – The clenching or grinding of the teeth can significantly damage the supporting tissue surrounding the teeth.  Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth.  When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
  • Medication – Many drugs including oral contraceptive pills, heart medicines, anti-depressants and steroids affect the overall condition of teeth and gums; making them more susceptible to gum disease.  Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.

Treatment of Gum Disease

Periodontists specialize in the treatment of gum disease and the placement of dental implants.  A periodontist can perform effective cleaning procedures in deep pockets such as scaling and root planing, and also prescribe antibiotic and antifungal medications to treat infection and halt the progression of the disease.

In the case of tooth loss, the periodontist is able to perform tissue grafts to promote natural tissue regeneration, and insert dental implants if a tooth or several teeth are missing.  Where gum recession causes a “toothy” looking smile, the periodontist can recontour the gingival tissue to create an even and aesthetically pleasing appearance.

Preventing periodontal disease is critical in preserving the natural dentition.  Addressing the causes of gum disease and discussing them with your dentist will help prevent the onset, progression, and recurrence of periodontal disease.

If you have any questions or concerns about the causes or treatments pertaining to gum disease, please ask your dentist.

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination.  This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums.  The depth of a healthy sulcus measures three millimeters or less and does not bleed.  The periodontal probe helps indicate if pockets are deeper than three millimeters.  As periodontal disease progresses, the pockets usually get deeper.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis

Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis

Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.  Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed.  Unless treated, the affected teeth will become very loose and may be lost.  Generalised moderate to severe bone loss may be present.

Periodontal treatment methods depend upon the type and severity of the disease.  Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues.  When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended.  You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended.  It is usually done one quadrant of the mouth at a time while the area is numb.  In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).  This procedure helps gum tissue to heal and pockets to shrink.  Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean.  Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

Research studies have shown that there is a strong association between periodontal disease and other chronic conditions such as diabetes, heart disease, pregnancy complications and respiratory disease.

Periodontal disease is characterized by chronic inflammation of the gum tissue, periodontal infection below the gum line and a presence of disease-causing bacteria in the oral region.  Halting the progression of periodontal disease and maintaining excellent standards of oral hygiene will not only reduce the risk of gum disease and bone loss, but also reduce the chances of developing other serious illnesses.

Common cofactors associated with periodontal disease:

Diabetes

A research study has shown that individuals with pre-existing diabetic conditions are more likely to either have, or be more susceptible to periodontal disease.  Periodontal disease can increase blood sugar levels which makes controlling the amount of glucose in the blood difficult.  This factor alone can increase the risk of serious diabetic complications.  Conversely, diabetes thickens blood vessels and therefore makes it harder for the mouth to rid itself of excess sugar.  Excess sugar in the mouth creates a breeding ground for the types of oral bacteria that cause gum disease.

Heart Disease

There are several theories which explain the link between heart disease and periodontitis.  One such theory is that the oral bacteria strains which exacerbate periodontal disease attach themselves to the coronary arteries when they enter the bloodstream.  This in turn contributes to both blood clot formation and the narrowing of the coronary arteries, possibly leading to a heart attack.

A second possibility is that the inflammation caused by periodontal disease causes a significant plaque build up.  This can swell the arteries and worsen pre-existing heart conditions.  An article published by the American Academy of Periodontology suggests that patients whose bodies react to periodontal bacteria have an increased risk of developing heart disease.

Pregnancy Complications

Women in general are at increased risk of developing periodontal disease because of hormone fluctuations that occur during puberty, pregnancy and menopause.  Research suggests that pregnant women suffering from periodontal disease are more at risk of preeclampsia and delivering underweight, premature babies.

Periodontitis increases levels of prostaglandin, which is one of the labor-inducing chemicals.  Elevated levels prostaglandin may trigger premature labor, and increase the chances of delivering an underweight baby.  Periodontal disease also elevates C-reactive proteins (which have previously been linked to heart disease).  Heightened levels of these proteins can amplify the inflammatory response of the body and increase the chances of preeclampsia and low birth weight babies.

Respiratory Disease

Oral bacterium linked with gum disease has been shown to possibly cause or worsen conditions such as emphysema, pneumonia and Chronic Obstructive Pulmonary Disease (COPD).  Oral bacteria can be drawn into the lower respiratory tract during the course of normal inhalation and colonize; causing bacterial infections.  Studies have shown that the repeated infections which characterize COPD may be linked with periodontitis.

In addition to the bacterial risk, inflammation in gum tissue can lead to severe inflammation in the lining of the lungs, which aggravates pneumonia.  Individuals who suffer from chronic or persistent respiratory issues generally have low immunity.  This means that bacteria can readily colonize beneath the gum line unchallenged by body’s immune system.

If you have questions or concerns about periodontal disease and the mouth-body connection, please ask your dentist. We care about your overall health and your smile!

Periodontal disease, heart disease and stroke may seem to be unlikely bedfellows, but researchers have found that gum disease sufferers are nearly twice as likely to also suffer from coronary heart disease.  In addition, research studies have discovered that oral infection is indeed a risk factor for stroke.  People diagnosed with acute cerebrovascular ischemia were more likely to also be experiencing some degree of periodontal disease.

Periodontal disease is a progressive condition in which the gingival tissue surrounding the teeth is infected by the colonization of bacteria.  Bacteria found in plaque colonize first above, then below the g gumline causing the tissue to pull away from the teeth.  If periodontal disease is left untreated, deep pockets form between the gums and the teeth and the tissue of the underlying jawbone is also destroyed.  The destruction of bone tissue causes the teeth to shift, wobble or completely detach from the bone.

Coronary heart disease occurs when the walls of the coronary arteries become progressively thicker due to the buildup of fatty proteins.  The heart then suffers from a lack of oxygen and must labor significantly harder to pump blood to the rest of the body.  Coronary heart disease sufferers sometimes experience blood clots which obstruct normal blood flow and reduce the amount of vital nutrients and oxygen the heart needs to function properly.  This phenomenon often leads to heart attacks.

Reasons for the Connection

There is little doubt that the presence of periodontal disease can exacerbate existing heart conditions.  The periodontist and cardiologist generally work as a team in order to treat individuals experiencing both conditions.

There are several theories which may explain the link between heart disease, stroke and periodontal disease, which include the following:

  • Oral bacteria affect the heart – There are many different strains of periodontal bacteria.  Researchers assert that some of these strains of bacteria enter the bloodstream and attach to the fatty plaques in the heart blood vessels (coronary arteries).  This attachment then contributes to clot formation causing grave danger to the individual.
  • Inflammation – Periodontal disease causes severe inflammation in the gum tissue which elevates the white blood cell count and also the high sensitivity C-reactive protein levels.  Research studies have shown that elevated levels of C-reactive proteins have been linked to heart disease.
  • Infectious susceptibility – Individuals who experience particularly high levels of oral bacteria may have weaker immune systems and an inadequate host inflammatory response.  These factors may induce specific vascular effects which have previously been shown to contribute in the onset of certain forms of heart disease.

Diagnosis and Treatment

Since periodontal disease appears to be a risk factor for both heart attack and stroke, it is extremely important to seek immediate treatment.  Initially, the periodontist will conduct thorough examinations to assess the exact condition of the teeth, gums and jawbone.  X-rays can be helpful in determining whether bone loss is prevalent in the upper and lower jaw.

The dentist is able to conduct deep cleaning treatments such as scaling and root planing to remove hardened calculus (tartar) deposits from the gum pockets.  An antibiotic may be prescribed to ensure that the bacterium is completely destroyed and the periodontal infection does not spread.  In most cases, periodontal disease can be prevented with regular cleanings and proper home care.

If you have questions or concerns about periodontal disease and its relation to heart disease and stroke, please ask your dentist.

Researchers have shown that periodontal disease in expectant mothers actually exposes their unborn child to many different risks; particularly if they also happen to be diabetes sufferers.

Periodontal disease generally begins with a bacterial infection in the gum (gingival) tissue, which progressively destroys the tissue and the underlying bone.  If left untreated, the bacterial infection causes an inflammatory reaction in the body, which can significantly deepen the gum pockets (space between the teeth and gums) and forces the gum and jawbone to recede.  Eventually, the progressive nature of periodontal disease causes the teeth to become loose and unstable, and eventually fall out.

Pregnancy causes many hormonal changes which increase the risk of the expectant mother to develop gingivitis (inflammation of the gum tissue) and periodontal disease.  These oral problems have been linked in many research studies to preeclampsia, low birth weight of the baby and premature birth.  Expectant women should seek immediate treatment for periodontal disease in order to reduce the risk of pre-natal and post-natal complications.

Reasons for the Connection

There are many different reasons why periodontal disease may affect the health of the mother and her unborn child:

  • Prostaglandin – Periodontal disease appears to elevate levels of prostaglandin in mothers who are suffering from the more advanced forms of the condition.  Prostaglandin is a labor-inducing compound found in one of the oral bacteria strains associated with periodontitis.  Elevated levels of prostaglandin can cause the mother to give birth prematurely and deliver a baby with a low birth weight.
  • C – reactive protein (CRP) – This protein, which has been previously linked to heart disease, has now been associated with adverse pregnancy outcomes including preeclampsia and premature birth.  Periodontal infections elevate C-reactive protein levels and amplify the body’s natural inflammatory response.  Periodontal bacteria may enter the bloodstream causing the liver to produce CRP which leads to inflamed arteries as well as possible blood clots.  These inflammatory effects can then lead to blocked arteries causing strokes or heart attacks.
  • Bacteria spread – The bacteria which colonize in the gum pockets can readily travel through the bloodstream and affect other parts of the body.  In pregnant women, research has found that oral bacteria and associated pathogens have colonized in the internal mammary glands and coronary arteries.

Diagnosis and Treatment

There are many safe, non surgical treatment options available for pregnant women.  It is of paramount importance to halt the progress of periodontal disease in order to increase the chances of a safe and healthy delivery.

Initially, the dentist will assess the exact condition of the gums and jawbone in order to make a precise diagnosis.  Scaling and root planing are two common non-surgical procedures used to rid the tooth-root surfaces of calculus (tartar) and remove the bacterial toxins from the gum pockets.

The advantages to the pregnant woman are plentiful.  The risks of pregnancy complications caused by periodontal disease are reduced by as much as 50%, and these treatments will alleviate many unpleasant and harmful effects associated with gingivitis and periodontal infection.

Dentists can provide dental education and recommendations to the pregnant women on effective home care which can reduce risks that may affect her and/or her child’s health.  Risks of periodontal disease can be vastly reduced by proper home care, smoking cessation, dietary changes and the ingestion of supplementary vitamins.

If you have any questions or concerns about periodontal disease and its affect on pregnancy, please ask your dentist.

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year.  At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy.  Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.
  • Examination of existing restorations: Check current fillings, crowns, etc.
  • Examination of tooth decay: Check all tooth surfaces for decay.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
  • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

Cleanings & Prevention

Periodontal (gum) disease, which is also known as periodontal disease and periodontitis, is a progressive disease which if left untreated may result in tooth loss.  Gum disease begins with the inflammation and irritation of the gingival tissues which surround and support the teeth.  The cause of this inflammation is the toxins found in plaque which cause an ongoing bacterial infection.

The bacterial infection colonizes in the gingival tissue and deep pockets form between the teeth and the gums.  If treated promptly by a periodontist, the effects of mild inflammation (known as gingivitis) are completely reversible.  However, if the bacterial infection is allowed to progress, periodontal disease begins to destroy the gums and the underlying jawbone; promoting tooth loss.  In some cases, the bacteria from this infection can travel to other areas of the body via the bloodstream.

Common Causes of Gum Disease

There are genetic and environmental factors involved in the onset of gum disease, and in many cases the risk of developing periodontitis can be significantly lowered by taking preventative measures.

Here are some of the most common causes of gum disease:

  • Poor dental hygiene – Preventing dental disease starts at home with good oral hygiene and a balanced diet.  Prevention also includes regular dental visits which include exams, cleanings, and x-rays.  A combination of excellent home care and professional dental care will ensure and preserve the natural dentition and supporting bony structures.  When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacteria toxins and can cause gingivitis or periodontitis, which can lead to tooth loss.
  • Tobacco use – Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease.  In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss.
  • Genetic predisposition – Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease.  These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition.  Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
  • Pregnancy and menopause – During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
  • Chronic stress and poor diet – Stress lowers the ability of the immune system to fight off disease, which means bacterial infections may possibly beat the body’s defense system.  Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
  • Diabetes and underlying medical issues – Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis.  Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.
  • Grinding teeth – The clenching or grinding of the teeth can significantly damage the supporting tissue surrounding the teeth.  Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth.  When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
  • Medication – Many drugs including oral contraceptive pills, heart medicines, anti-depressants and steroids affect the overall condition of teeth and gums; making them more susceptible to gum disease.  Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.

Treatment of Gum Disease

Periodontists specialize in the treatment of gum disease and the placement of dental implants.  A periodontist can perform effective cleaning procedures in deep pockets such as scaling and root planing, and also prescribe antibiotic and antifungal medications to treat infection and halt the progression of the disease.

In the case of tooth loss, the periodontist is able to perform tissue grafts to promote natural tissue regeneration, and insert dental implants if a tooth or several teeth are missing.  Where gum recession causes a “toothy” looking smile, the periodontist can recontour the gingival tissue to create an even and aesthetically pleasing appearance.

Preventing periodontal disease is critical in preserving the natural dentition.  Addressing the causes of gum disease and discussing them with your dentist will help prevent the onset, progression, and recurrence of periodontal disease.

If you have any questions or concerns about the causes or treatments pertaining to gum disease, please ask your dentist.

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination.  This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums.  The depth of a healthy sulcus measures three millimeters or less and does not bleed.  The periodontal probe helps indicate if pockets are deeper than three millimeters.  As periodontal disease progresses, the pockets usually get deeper.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis

Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis

Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.  Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed.  Unless treated, the affected teeth will become very loose and may be lost.  Generalised moderate to severe bone loss may be present.

Periodontal treatment methods depend upon the type and severity of the disease.  Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues.  When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended.  You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended.  It is usually done one quadrant of the mouth at a time while the area is numb.  In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).  This procedure helps gum tissue to heal and pockets to shrink.  Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean.  Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

Research studies have shown that there is a strong association between periodontal disease and other chronic conditions such as diabetes, heart disease, pregnancy complications and respiratory disease.

Periodontal disease is characterized by chronic inflammation of the gum tissue, periodontal infection below the gum line and a presence of disease-causing bacteria in the oral region.  Halting the progression of periodontal disease and maintaining excellent standards of oral hygiene will not only reduce the risk of gum disease and bone loss, but also reduce the chances of developing other serious illnesses.

Common cofactors associated with periodontal disease:

Diabetes

A research study has shown that individuals with pre-existing diabetic conditions are more likely to either have, or be more susceptible to periodontal disease.  Periodontal disease can increase blood sugar levels which makes controlling the amount of glucose in the blood difficult.  This factor alone can increase the risk of serious diabetic complications.  Conversely, diabetes thickens blood vessels and therefore makes it harder for the mouth to rid itself of excess sugar.  Excess sugar in the mouth creates a breeding ground for the types of oral bacteria that cause gum disease.

Heart Disease

There are several theories which explain the link between heart disease and periodontitis.  One such theory is that the oral bacteria strains which exacerbate periodontal disease attach themselves to the coronary arteries when they enter the bloodstream.  This in turn contributes to both blood clot formation and the narrowing of the coronary arteries, possibly leading to a heart attack.

A second possibility is that the inflammation caused by periodontal disease causes a significant plaque build up.  This can swell the arteries and worsen pre-existing heart conditions.  An article published by the American Academy of Periodontology suggests that patients whose bodies react to periodontal bacteria have an increased risk of developing heart disease.

Pregnancy Complications

Women in general are at increased risk of developing periodontal disease because of hormone fluctuations that occur during puberty, pregnancy and menopause.  Research suggests that pregnant women suffering from periodontal disease are more at risk of preeclampsia and delivering underweight, premature babies.

Periodontitis increases levels of prostaglandin, which is one of the labor-inducing chemicals.  Elevated levels prostaglandin may trigger premature labor, and increase the chances of delivering an underweight baby.  Periodontal disease also elevates C-reactive proteins (which have previously been linked to heart disease).  Heightened levels of these proteins can amplify the inflammatory response of the body and increase the chances of preeclampsia and low birth weight babies.

Respiratory Disease

Oral bacterium linked with gum disease has been shown to possibly cause or worsen conditions such as emphysema, pneumonia and Chronic Obstructive Pulmonary Disease (COPD).  Oral bacteria can be drawn into the lower respiratory tract during the course of normal inhalation and colonize; causing bacterial infections.  Studies have shown that the repeated infections which characterize COPD may be linked with periodontitis.

In addition to the bacterial risk, inflammation in gum tissue can lead to severe inflammation in the lining of the lungs, which aggravates pneumonia.  Individuals who suffer from chronic or persistent respiratory issues generally have low immunity.  This means that bacteria can readily colonize beneath the gum line unchallenged by body’s immune system.

If you have questions or concerns about periodontal disease and the mouth-body connection, please ask your dentist. We care about your overall health and your smile!

Periodontal disease, heart disease and stroke may seem to be unlikely bedfellows, but researchers have found that gum disease sufferers are nearly twice as likely to also suffer from coronary heart disease.  In addition, research studies have discovered that oral infection is indeed a risk factor for stroke.  People diagnosed with acute cerebrovascular ischemia were more likely to also be experiencing some degree of periodontal disease.

Periodontal disease is a progressive condition in which the gingival tissue surrounding the teeth is infected by the colonization of bacteria.  Bacteria found in plaque colonize first above, then below the g gumline causing the tissue to pull away from the teeth.  If periodontal disease is left untreated, deep pockets form between the gums and the teeth and the tissue of the underlying jawbone is also destroyed.  The destruction of bone tissue causes the teeth to shift, wobble or completely detach from the bone.

Coronary heart disease occurs when the walls of the coronary arteries become progressively thicker due to the buildup of fatty proteins.  The heart then suffers from a lack of oxygen and must labor significantly harder to pump blood to the rest of the body.  Coronary heart disease sufferers sometimes experience blood clots which obstruct normal blood flow and reduce the amount of vital nutrients and oxygen the heart needs to function properly.  This phenomenon often leads to heart attacks.

Reasons for the Connection

There is little doubt that the presence of periodontal disease can exacerbate existing heart conditions.  The periodontist and cardiologist generally work as a team in order to treat individuals experiencing both conditions.

There are several theories which may explain the link between heart disease, stroke and periodontal disease, which include the following:

  • Oral bacteria affect the heart – There are many different strains of periodontal bacteria.  Researchers assert that some of these strains of bacteria enter the bloodstream and attach to the fatty plaques in the heart blood vessels (coronary arteries).  This attachment then contributes to clot formation causing grave danger to the individual.
  • Inflammation – Periodontal disease causes severe inflammation in the gum tissue which elevates the white blood cell count and also the high sensitivity C-reactive protein levels.  Research studies have shown that elevated levels of C-reactive proteins have been linked to heart disease.
  • Infectious susceptibility – Individuals who experience particularly high levels of oral bacteria may have weaker immune systems and an inadequate host inflammatory response.  These factors may induce specific vascular effects which have previously been shown to contribute in the onset of certain forms of heart disease.

Diagnosis and Treatment

Since periodontal disease appears to be a risk factor for both heart attack and stroke, it is extremely important to seek immediate treatment.  Initially, the periodontist will conduct thorough examinations to assess the exact condition of the teeth, gums and jawbone.  X-rays can be helpful in determining whether bone loss is prevalent in the upper and lower jaw.

The dentist is able to conduct deep cleaning treatments such as scaling and root planing to remove hardened calculus (tartar) deposits from the gum pockets.  An antibiotic may be prescribed to ensure that the bacterium is completely destroyed and the periodontal infection does not spread.  In most cases, periodontal disease can be prevented with regular cleanings and proper home care.

If you have questions or concerns about periodontal disease and its relation to heart disease and stroke, please ask your dentist.

Researchers have shown that periodontal disease in expectant mothers actually exposes their unborn child to many different risks; particularly if they also happen to be diabetes sufferers.

Periodontal disease generally begins with a bacterial infection in the gum (gingival) tissue, which progressively destroys the tissue and the underlying bone.  If left untreated, the bacterial infection causes an inflammatory reaction in the body, which can significantly deepen the gum pockets (space between the teeth and gums) and forces the gum and jawbone to recede.  Eventually, the progressive nature of periodontal disease causes the teeth to become loose and unstable, and eventually fall out.

Pregnancy causes many hormonal changes which increase the risk of the expectant mother to develop gingivitis (inflammation of the gum tissue) and periodontal disease.  These oral problems have been linked in many research studies to preeclampsia, low birth weight of the baby and premature birth.  Expectant women should seek immediate treatment for periodontal disease in order to reduce the risk of pre-natal and post-natal complications.

Reasons for the Connection

There are many different reasons why periodontal disease may affect the health of the mother and her unborn child:

  • Prostaglandin – Periodontal disease appears to elevate levels of prostaglandin in mothers who are suffering from the more advanced forms of the condition.  Prostaglandin is a labor-inducing compound found in one of the oral bacteria strains associated with periodontitis.  Elevated levels of prostaglandin can cause the mother to give birth prematurely and deliver a baby with a low birth weight.
  • C – reactive protein (CRP) – This protein, which has been previously linked to heart disease, has now been associated with adverse pregnancy outcomes including preeclampsia and premature birth.  Periodontal infections elevate C-reactive protein levels and amplify the body’s natural inflammatory response.  Periodontal bacteria may enter the bloodstream causing the liver to produce CRP which leads to inflamed arteries as well as possible blood clots.  These inflammatory effects can then lead to blocked arteries causing strokes or heart attacks.
  • Bacteria spread – The bacteria which colonize in the gum pockets can readily travel through the bloodstream and affect other parts of the body.  In pregnant women, research has found that oral bacteria and associated pathogens have colonized in the internal mammary glands and coronary arteries.

Diagnosis and Treatment

There are many safe, non surgical treatment options available for pregnant women.  It is of paramount importance to halt the progress of periodontal disease in order to increase the chances of a safe and healthy delivery.

Initially, the dentist will assess the exact condition of the gums and jawbone in order to make a precise diagnosis.  Scaling and root planing are two common non-surgical procedures used to rid the tooth-root surfaces of calculus (tartar) and remove the bacterial toxins from the gum pockets.

The advantages to the pregnant woman are plentiful.  The risks of pregnancy complications caused by periodontal disease are reduced by as much as 50%, and these treatments will alleviate many unpleasant and harmful effects associated with gingivitis and periodontal infection.

Dentists can provide dental education and recommendations to the pregnant women on effective home care which can reduce risks that may affect her and/or her child’s health.  Risks of periodontal disease can be vastly reduced by proper home care, smoking cessation, dietary changes and the ingestion of supplementary vitamins.

If you have any questions or concerns about periodontal disease and its affect on pregnancy, please ask your dentist.

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year.  At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy.  Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.
  • Examination of existing restorations: Check current fillings, crowns, etc.
  • Examination of tooth decay: Check all tooth surfaces for decay.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
  • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

There are over a dozen dentists in walking distance from my house. I would not drive over 45 minutes to 77 Harley Dental Practice if I was not 100% satisfied with the great service I receive here. There are too may dentists out there not to be picky, I pick 77 Harley Dental Practice for my dental work.

Michael L

Thanks so much for everything…. I may be the only person on the planet that doesn’t dread the dentist!! Best wishes”

C. W.

I find Dr. Godarzi and his entire staff to be kind, courteous and thoroughly professional. I always look forward to seeing their smiling faces.

A.H.
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