Periodontal Disease

Periodontal disease is an infectious process classified according to how much damage has been done to the structures surrounding the teeth, namely the gingiva (gums) and bone. It is an infection in your mouth. It can happen anytime, around your teeth, affecting some or many of your teeth to varying degrees. There are genetic predisposing factors to periodontal disease, and our immune systems play a role in gum health, but it is usually related to how well you are able to keep your teeth clean through proper oral self-care. The better you clean your teeth to remove all the plaque bacteria, the less likely you will be to develop periodontal disease.

Progress of the Disease

The bacteria that cause this disease first cause the gum tissue to become inflamed and pull away from the teeth. As the problem becomes more serious, the bone that supports the teeth also becomes infected and begins to break down and dissolve. The teeth then become loose. Once the bone disappears, it is extremely hard, if not impossible, for new bone to be rebuilt. The damage is permanent and your teeth, the surrounding bone, and your general health will be compromised.

Periodontal disease is classified into several types. The mildest form of this infection will show up in red and swollen gum tissue that bleeds easily. There is seldom any pain involved at this stage. You may also notice that your breath becomes offensive and you feel the need to use mouthwash. Our sense of smell does become immune to the same odor, so we can lose our ability to detect our own offensive, diseased breath. As the disease progresses, the gum tissue becomes more red and swollen, more bleeding can be seen, and the teeth begin to become loose. This tooth mobility is a sign that there is a severe problem. There may still be no pain at this advanced stage. As more and more bone is lost and more teeth become involved in the infection, it becomes harder to treat. At this point, many times, the management of your problem will involve periodontal surgical procedures. If this is the case, you may be referred to a periodontist (gum specialist) for further treatment. Most of the time, periodontal disease starts and continues because of neglect. Brushing and flossing of teeth are not being done effectively on a daily basis. You may have been neglectful in getting your teeth checked and cleaned within the time frame intervals you need. Once we have diagnosed the disease, we will inform you of the problem and suggest treatment. If treatment is not completed, however, the disease will continue to progress. Unfortunately, the disease is quite invisible to most people until severe and possible irreversible damage has occurred.

Solution

If it has been diagnosed in the early stages and has not progressed to bone loss, a proper cleaning (prophylaxis) will solve the problem. Scaling and root planing over multiple appointments may be needed for more advanced cases. In the most advanced cases, periodontal surgery and tooth loss are inevitable. You will receive an estimate of fees for the recommended treatment.

Periodontal disease is a condition that must be treated quickly. We believe that if the infection is aggressively treated in its early stages, conservative periodontal treatment may be possible and effective. Although we do not automatically rule out periodontal surgical intervention, we hope you can either avoid it or reduce the amount you will need.

Successful treatment of your periodontal problem will depend on several factors. But the most important of these is your ability to perform excellent oral self-care—brushing, flossing, and the use of periodontal aids—on a routine, daily basis. Without this, periodontal treatment will fail, and the disease will return. 

Sealants and Fluoride: Benefit to Adult Patients

Dental decay can develop at any time, regardless of a person’s age. A change in diet, change in lifestyle, change in oral self-care habits, the use of prescription medications, or a change in systemic health due to the normal aging process can all affect the caries (decay) susceptibility. Few people remain completely free of decay. Proper oral self-care on your part and properly spaced dental hygiene prevention appointments will go a long way to reduce the opportunity to have new decay begin.

As you age, it is possible that some of your gum tissue will recede, exposing the root surfaces of your teeth. This gum recession can occur from improper brushing (brushing too hard with a hard toothbrush) or as a result of past periodontal problems. The more a tooth and root are exposed, the greater is the surface area you will have to keep clean. Sometimes the teeth with exposed roots are very hard to keep clean. These roots may be sensitive to temperature changes and are often times uncomfortable to brush. Decreased salivary flow helps to create a breeding ground for bacteria to accumulate on the enamel and especially on the root surface. And root decay usually progresses quite quickly!

Goal of Prevention

Your goal should be to keep the dentist from drilling your teeth. Any reasonable preventative measure that is available should be seriously considered. When the dentist drills, you lose. When the dentist does not drill, you win,

Dental Sealants

Although sealants are primarily designed for children, adults who have a history of active decay should consider having sealants placed on the posterior (back) teeth where indicated. We will tell you where it is possible to place the sealants. Even if you have not had a cavity for a long time, consider the application of a sealant as an inexpensive insurance policy for your teeth. Perhaps you would never get decay on the unsealed surfaces. But, just as you insure your home against destruction by fire, a sealant insures the tooth surface from decay. Preventative measures may allow you to avoid having your teeth drilled. You win!  

Topical Fluoride

For a similar reason, we advise the use of topical fluoride treatments for adults. The effectiveness of systemic and topical fluoride in preventing decay is well documented. When a cavity first starts, an application of fluoride might (depending on when it is used) reduce or eliminate the need for drilling.

An alternative to the fluoride treatment we can provide in our office is a daily rinse. If you can rinse with an over-the-counter mouthrinse containing fluoride every night as directed on the rinse label, you do not need the office topical fluoride treatment. If you cannot rinse daily as instructed, you will need the benefit from a stronger office-applied topical fluoride treatment. Your oral health will benefit most from small increments of fluoride that are applied daily rather than one large concentration every 6 months. However, only you know whether you will be faithful to your rinsing routine. When in doubt, let us do it here.

If you have been a patient of Omni Dental Group, you know that we stress prevention of dental disease above all else. Sealants and topical fluoride treatments are two of the more preventative dental measures that we believe will significantly enhance your oral health. 

We Won!

2017 Spectrum Award by City Beat News 

Today, Omni Dental Group was awarded the 2017 Spectrum Award by City Beat News! This award is given for excellence in customer service over multiple, consecutive years. In addition, we have earned a 5 star rating through City Beat News. We want to thank our patients for their unwavering loyalty throughout our 23 wonderful years in business!

Check out our award here: https://awards.citybeatnews.com/starpage/view/92558

Implants, Crowns, and Bridges vs. Natural Teeth

Nothing can replace the natural teeth you were born with for chewing and function. However, very few people go through life without having teeth filled, crowns (caps) placed, or bridges and implants used to replace missing teeth. Crowns, bridges, and implants are the best answer and closest to your natural teeth, but they are not the same as healthy, natural teeth.

Crowns

Crowns are used to reconstruct a single tooth broken down by dental decay. Crowns are made of ceramic, resin, porcelain, porcelain plus metal, or resin plus metal materials. They are bonded or cemented onto the prepared tooth and cannot easily be removed from the tooth once placed. If the tooth was in good alignment before the crown was prepared, the crown will be in good alignment. If the tooth was misaligned before the crown, sometimes the crown may be made to obtain a more ideal shape and position. It is cleaned and flossed just like a natural tooth and is most like real teeth.

Bridges

Bridges are crowns that are attached together, suspending the crown portion of a false tooth in or over the space left by the missing tooth. A bridge can be used to replace one or several teeth. Sometimes a bridge is used to splint loose teeth together in order to make the teeth more stable. Bridges are usually made of metal covered with either porcelain or resin. Some of the newer bridges are made of all resin or all ceramic materials. They are cemented or bonded onto the existing prepared teeth and are not easily removed once placed. The bridge teeth can be brushed the same as natural teeth, but since they are attached together, must be flossed differently by using a floss threader or other device.

The teeth are generally the same shape as natural teeth. However, if the existing teeth (abutments) that are used to anchor the bridge have moved from their original position because a tooth or teeth have been missing for years, the added tooth (pontic) may be longer or shorter than the tooth that it is replacing. With a bridge, the false tooth will most often butt up against the soft tissue ridge where the removed tooth was.

The shape of the tongue side of the false tooth varies. It is usually smaller on the tongue side and completely fills the space. Food will have more of a tendency to collect in this area, so you must be prepared to clean it. If the missing tooth has been gone a long time, the ridge may have shrunk considerably, and the pontic tooth will be longer that the teeth on either side. If this is the case, there are several periodontal procedures that can be done prior to the construction of the bridge. These procedures will build up the tissue to its former height. The more your mouth has changed from its normal state, the harder it is to make new teeth look and feel natural.

Implant Crowns

Implant crowns are used to replace single or multiple missing teeth. They are either cemented or screwed-retained onto an implant fixture. The crowns are made of porcelain or resin and metal. But they have some significant differences from the natural teeth they replace. Teeth are supported by a root or roots that are irregular in shape. Implants are round. The cross-sectional of the implant will never match that of the tooth it is replacing. A multirooted tooth may be replaced by a single implant, so the manner in which an implant crown comes out of the soft tissue ridge will appear different from a natural tooth. There will be more space between the implant root and the adjacent teeth. Implant crowns are often cemented with temporary cement. This allows the dentist to easily take off the crown and evaluate how the implant is doing. Crowns on teeth are usually cemented with a final cement. Implant-supported crowns are wonderful, but not the same as natural teeth with crowns. Be prepared for some differences. Expect more maintenance on your part and in the dental office with crowns, bridges, and implants.

Smokers take note: There is a heightened risk of dental implant failures among smokers—as much as 20% greater failure rate!

Endodontic Therapy: An Overview

The pulp of your tooth, which contains the nerve and tiny blood vessels, can become infected. The pulp has a limited ability to heal itself. This infection can be caused by a deep cavity that reaches the center of the tooth causing the pulp to die, a traumatic injury to the tooth, or an extensive preparation (drilling) of the tooth. The extensive preparation may have been done to prepare the tooth for a crown (cap) or other large preparation for a restoration. The pulp may or may not abscess immediately in these cases. It may take years for a problem to develop. The infected pulp tissue may or may not be painful. It may or may not be visible on a dental radiograph. A tooth with this type of an abscess is not usually extracted because the infection can be treated with endodontic therapy on the tooth. This routine procedure can save the tooth and enable you to avoid the harmful effects of tooth loss. It is successful in more than 90% of the teeth in which treatment is completed.

Endodontic treatment can take one to three appointments to complete. Teeth can have one to four canals that need to be treated. An opening is created to access the nerve, and the abscessed nerve is removed from the root or roots. The canals where the nerves had been located are then cleaned and shaped and a medication may be placed in the canal to promote better healing.

When it has been determined that the canals are free of infection, they are filled with a special rubber-like material and sealed with a cementing medium. The abscessed area associated with the tooth will then begin to heal. It may take several months before healing is completed and for the tooth to become asymptomatic, that is, for any soreness to disappear.

Once the endodontic therapy has been completed, the tooth is usually restored with a cast crown or onlay. This is done to protect the tooth and prevent it from fracturing. Failure to follow through with mandatory restorative procedures after endodontic therapy on a previously uncrowned tooth can result in vertical fracture. If there is very little tooth structure remaining, we may also advise the use of a post and core to further help the tooth retain its final restoration. We will discuss with you the exact type of restoration that you will need.

Please note that this infection may cause discomfort between root canal appointments. This is normal and usually not a cause for any concern. Contact the office if there is pain and/or swelling. Remember to avoid biting down on the tooth until the root canal is completed and the final restoration has been placed. You may have had no discomfort from the tooth prior to the root canal treatment or have been unaware that you even had an abscess. However, you may experience pain or swelling after the root canal treatment has begun.

If we have prescribed antibiotics for the abscess, be sure to fill the prescription and take it until it is finished. It is important that you do this in order to quickly control the infection. If you do not take the prescribed medication, the resolution of the abscess may be delayed and problems with the postoperative pain are more likely.

Headaches: The Dental Connection

You probably remember the old song “…the knee bone’s connected to the leg bone; the leg bone’s connected to the hip bone…etc.” Your (lower) jaw bone actually is connected to your “head bone”—and it is connected by muscles, ligaments, and tendons. This area is known as the temporomandibular joint or the TMJ. When the lower jaw lines up perfectly with the upper jaw and everything functions normally, everything is fine. If the lower jaw does not line up properly or, perhaps more importantly, if there is abnormal stress present when the lower jaw contacts the upper jaw, problems can occur. The abnormal stress is usually clenching or grinding of the teeth and it can occur any time, day or night, awake or asleep. When this happens, a person can develop regular, chronic, or migraine headaches; muscle pain or tenderness in the jaw joint muscles; or the temporomandibular joint dysfunction (TMD). Forty-four million Americans suffer from chronic clenching and grinding, resulting in tooth damage and 23 million suffer from migraine headache pain.

While mouthguards have been used with some success to treat TMD patients, an FDA-approved device seems to offer a higher success rate in eliminating TMJ problems. This device has an additional advantage in that it was designed to reduce the clenching habits that often lead to chronic and migraine headaches. This device prevents the upper and lower teeth from coming into contact. By preventing high-intensity clenching (and the muscular irritation that leads to migraine pain, TMD, and chronic headaches), studies have shown that 82% of migraine and headache sufferers has a 77% reduction in the migraine incidents. In short, the frequency and intensity of headache episodes and muscle tenderness can be reduced with the use of a mouthguard.

A tension suppression system is another effective form of mouthguard that can treat TMD. This small removable device, made in the office, can be worn day and/or night and has been shown to reduce clenching intensity by 66%. It takes advantage of a naturally protective reflex that suppresses the powerful chewing muscles active in clenching. For those concerned about insurance coverage, the cost of this device is submitted first to medical insurance for evaluation of benefit coverage. Most insurance carriers do consider this device a payable benefit.

How important is the reduction of clenching stress? Try this simple demonstration. Put a pencil between the last top and bottom molars on one side and bite hard. Remember how hard you were biting. Then take the pencil and place it between the top and bottom front teeth and bite down hard again. You will not be able to bite down as hard when just biting on the front teeth. You should be able to detect a great difference between biting (clenching) on back teeth only and front teeth only. Try another test: lightly place your fingertips on either side of your head in the temporal area (above and in front of the ears). Clench your teeth and feel the muscles on either side of the head bulge out. Then take a pencil, place it between the top and bottom front teeth, and bite down again. You will easily feel that the temporal muscles do not (cannot) bulge out as much, meaning that not as much clenching compression is possible.

Source: Elsevier Mosby, Dental Practice Tool Kit: Patient Handouts, Forms, and Letters

6 Of The Most Common Dental Problems, Fixed!

Smile! There’s good news from the world of dentistry: Older American are keeping their teeth longer than ever before and the average number of teeth people retain into old age is increasing, says Judith Ann Jones, DDS, a spokesman on elder care for the American Dental Association and director of The Center for Clinical Research at the Boston University Goldman School of Dental Medicine.
But Jones is not all smiles. As people keep their teeth longer, there are more problems that are likely to arise, which is why keeping up with regular dental visits is so important. Here are the most common problems, and what you can do about them:

Tooth Decay

Yes, people over 50 can get cavities. You can get them on the surfaces of teeth that have never been a problem before, but you can also get them around old fillings or at the root of your tooth. “As you age, the root of your tooth becomes softer and sometimes more exposed,” Jones explains.
The Fix: Fluoride is not just for kids, Jones says. “Fluoride is one of the 10 most important health measures developed in the 20th century.” Almost 80 percent of people in the United States have fluorinated water, but if you don’t, you should probably add a daily fluoride rinse to your brushing habit. Or ask your doctor about a stronger fluoride prescription gel. If you are starting to get cavities, even if your water has fluoride, consider a fluoride rinse. Ask your dentist if that’s right for you.

Dry Mouth

Saliva protects us against tooth decay. But if you’re not producing it, your teeth may be at risk. The calcium and phosphate present in saliva prevent demineralization of your teeth, Jones says. How do you know if you have dry mouth? You’ll have a sticky feeling in your mouth, trouble swallowing, dry throat, and dry, cracked lips. You may notice a metallic taste in your mouth or persistent bad breath. You may or may not feel thirsty. Dry mouth is often caused by medications, and as people age, they take more medications. It can also result from smoking or from a blow to the head that somehow damages the salivary glands.
The Fix: If you have dry mouth, you should try to stimulate saliva production. Jones says some people just sip water all day while others find that chewing sugar-free xylitol candies or gum helps. Your dentist may prescribe a prescription saliva substitute or recommend over-the-counter formulations for you to try.

Gum Disease

If your gums are swollen, red, or bleed easily, you’ve got gingivitis, an early form of gum disease that can progress and be dangerous. Untreated gingivitis often becomes periodontitis, which is when the gum pulls away from the tooth and creates pockets which can become infected. If this condition develops and continues unchecked, it could cause the loss of bones in your jaw and eventually, the loss of the teeth themselves.
The Fix: The best fix for this condition is regular dentist visits, Jones says. You may need to visit your dentist more frequently so that your teeth can be cleaned and your gums treated for the condition. People who don’t have good access to dental care are more likely to have gum disease, Jones says.

Oral Cancer

More than 43,000 Americans will be diagnosed with oral cancers this year, and more than 8,000 will die from it, according to The Oral Cancer Foundation. Oral cancer incidence definitely increases as you get older, Jones says, and is very often linked to smoking and heavy alcohol use. Recently, the number of cases has risen because doctors have discovered that the Human Papilloma Virus also can cause oral cancer.
The Fix: Only about half of people who develop oral cancer survive the disease, Jones says. The best hope for survival is to discover it at its earliest stages—in which case there is an 80 percent chance of surviving for five years. Your dental exam should include a check for oral cancer. Your dentist will hold your tongue and check the soft tissue in your mouth as well as your throat and jaw. If he or she does not, find another dentist, Jones says.

Tooth Crowding

Are you noticing that food is getting stuck in new places in your mouth? Or that the overlapping tooth that was cute in your teens now seems to be overlapping even more? You’re not imagining it. As you age, your teeth shift, according to Lee W. Graber, D.D.S., M.S., M.S., Ph.D., Past President of the American Association of Orthodontists. And that can be problematic, not because you’ll look different, but because it can make your teeth more difficult to clean, leading to more decay. It’s also of concern because misaligned teeth can lead to teeth erosion and damage to the supporting tissue and bone, Graber says. Add to that the tendency of older adults to have periodontal disease, and you could end up losing your teeth even faster.
The Fix: If your teeth have really shifted, you could see an orthodontist, who may fit you with a retainer, spacer, or even braces. This may not be necessary, but you should discuss with your dentist whether your teeth are shifting at your regular check up. If they are, it may mean only that you need to go to the dentist more regularly for more frequent cleanings.

Grinding and Clenching

This is not a habit that begins late in life, but it’s one whose effects might be most pronounced as you age. If you tend to grind your teeth or to clench them in your sleep, you may grind through the enamel to the dentin, which can cause pain and decay. Also, if you have crowns or bridges in your mouth, they may be damaged by such habits.
The Fix: Your dentist can give you a night guard, a small mouth piece that will protect your teeth while you sleep—and protect your investment in the dentistry that’s already there, Jones says.

By: Andrea  Atkins, The Huffington Post
http://www.huffingtonpost.com/entry/6-of-the-most-common-dental-problems-fixed_us_58346501e4b099512f84b510

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811