Periodontal Disease and Systematic Health

Research clearly shows that there is a strong correlation between oral (periodontal) infections and generalized (systematic) medical problems. There are over 300 different types of bacteria normally found in the human mouth, and the mouth is connected to the entire body.

A gum infection is similar to an infection that might occur elsewhere in your body. Bacteria are everywhere, including in our mouths. When the bacteria multiply past a critical number, problems begin. Why would the bacterial count change? Poor oral self-care, genetics, prescription medication, illness or systematic problems, and diminished salivary flow might contribute. When the body recognizes bacterial invaders, the immune system initiates a response to fight off the invader.

                                              

You might say, "My gums have always bled like this," and not seek treatment. Imagine seeing blood gushing from your eyes when you washed your face. You would seek immediate medical attention, perhaps even go to an emergency room!

Gum disease is an infection in your mouth, no different than an infection elsewhere in your body. The bacteria invade the soft tissues and the bone and get into the blood stream.  In this way, they are then able to circulate throughout the entire body. Along with bacteria are dead cells, metabolic by-products, toxins, food debris, and viruses.

Just as we know that smoking has adverse affect on our health, science is examining a link between gum disease and many systematic conditions such as cardiovascular and respiratory disease, chronic obstructive pulmonary disease, premature birth and low birth weight, stroke, diabetes mellitus, and possibly rheumatoid arthritis. Although the scientific data have yet to confirm the links as diagnostic indicators, it is important for us to recognize the possible implications. The oral cavity is part of the human biology linked to all other body systems and is a portal of entry for a host of infective organisms. It only makes sense to keep it as clean as possible to reduce the risk of not only oral infection but possibly systematic inflammation as well.

Thorough oral self-care need not be difficult or time-consuming. The benefits are more than just sweet breath and a great looking smile. Spending just a few minutes a day caring for your teeth and gums and coming in for the professional hygiene visits at the intervals we advise can make the difference between whole body health and disease. After all, the jaw bones are connected to all our other bones!

If you have any questions about periodontal disease, please call Omni Dental Group at (512) 250-5012.

Extraction

Reasons for Recommending Tooth Extraction

Teeth may need to be extracted for several reasons, including but not limited to:

• severe periodontal disease
• irreversible damage to the nerve tissue inside the tooth (and the patient decides against saving the tooth)
• failed endodontic therapy
• extreme fracture or decay of the tooth structure
• improper positioning of the tooth or for orthodontics purposes

To a great extent, the reason for the extraction will influence the amount of discomfort you might experience subsequent to the procedure. When the tooth is to be extracted for periodontal reasons, there will be reduced bone support for the tooth and the tooth might be removed more easily than if there were full bone support. In this case there might be lessened discomfort following the extraction.

Following the Extraction

We will tell you the reason for the extraction and let you know what to expect following the procedure. Please follow the instructions given to you. If antibiotics are prescribed, take them until the prescription is completely finished. If pain medication is prescribed, take it only if necessary. If the medication prescribed contains a narcotic component, such as codeine, do not drive a motor vehicle or operate machinery that could prove dangerous to yourself or others. Expect some bleeding to occur from the extraction site for the first 24 hours. Remember, there is now a hole in your jaw from which the tooth has been removed, and the hole can be quite large. Some bleeding is to be expected.

Some infrequent complications of routine oral surgical procedures include (but are not limited to):

• fracture of adjacent teeth or restorations (which of course would mean that these affected areas must be restored to normal function after the healing of the extraction site)
• separated root tips or root fragments
• temporary or permanent nerve damage to the area, resulting in anesthesia or paresthesia (numbness)
• incomplete healing, resulting in severe pain—a “dry socket”
• fracture of the surrounding bone

If you have any question about reasons for dental extraction, please feel free to call us @ 512-250-5012.

Smoking and Adult Periodontitis

If you are a smoker, you are at a higher risk for not only lung and circulatory problems but oral disease as well. Smoking causes cell death and may be responsible for more than 50% of cases of adult periodontics. It has been reported that more than 85% or all periodontal cases are present in people who spoke. And, more than 90% of gum infections that appear to be resistant to treatment (refractory gum disease) are found among smokers. Smokers are 2.6 to 6 times more likely to have periodontal disease. Former smokers are more likely to have periodontal disease. A person who smokes will not heal as well and does not respond as well to periodontal therapy as does a nonsmoker.

Thousands of chemicals are released during smoking, which causes a profound effect on the immune system that is responsible for helping us ward off infections. And since we now know that periodontal disease is an infection, it is easy to make the connection. Many smokers show few areas of bleeding during a periodontal charting because one of the effects of smoking is reduced circulation.

If you are reading this, you are most likely a smoker who has periodontal disease. Many smokers would like to stop this habit. Quitting is not as difficult as you may imagine. The thought of it is probably the most difficult aspect. There really are many aids today to help is to make that leap to a healthy decision about our dental and general well-being. Our office can be a great source for some suggestions to help you stop smoking. If you would like us to make suggestions for a healthier lifestyle, do not hesitate to ask!

If you have any questions, please give us a call @ 512-250-5012. 

Toothbrush Abrasion: Preventing Tooth Destruction

The Cause

Brushing improperly (especially with a hard-bristled toothbrush) can cause erosion/abrasion of your tooth or teeth. This is a very common problem. It begins as a small V- or U-shaped area of wear near the gingival (gum) tissue right next to the tooth, usually where the tooth and gum meet. Improper brushing causes the gum tissue to recede; and the tooth may become sensitive to heat, cold, or air stimulation. With time, more enamel wears away and a small horizontal notch is seen on the tooth at the gumline. This is not an area of decay, but a mechanical “cavity” cut in the tooth. Eventually the enamel is worn completely through and the dentin becomes exposed. When that occurs, some people experience severe tooth sensitivity. It may be so severe that it is painful to drink cold fluids, breathe in air, or just brush your teeth. However, others experience little to no extra tooth sensitivity.

Once enough of the gum is brushed away, the root of the tooth becomes exposed. The root surface is not covered with enamel and is much softer than the enamel. It can also be unsightly to have the tissue recede. Since the root surface is not protected by hard enamel, if the improper brushing continues, the root cementum will be worn through and notch will be made in the dentin. This notch will increase in size, weaken the tooth, and sometimes make the area more prone to decay.

Tooth Sensitivity  

Some patients with little loss of tooth structure experience extreme sensitivity. This problem can usually be corrected with the application of a dentin-bonding material or other desensitizing chemicals. The sensitivity problem is often completely cured. The treatment can last (depending on your brushing habits) for 6 months or longer. If necessary, the tooth can be re-treated if the sensitivity returns.

Some patients with a tremendous loss of tooth structure notice little tooth sensitivity. Whether or not the teeth become sensitive, it is advisable to correct the brushing problem to slow down or eliminate the wear process. It is also recommended that the notches be restored with a tooth-colored filling material. This will restore the appearance of the tooth and protect the previously exposed dentin. In this way, even if you continue to brush improperly, the tooth will be protected.

In cases of minor sensitivity, we might recommend the use of desensitizing toothpaste as a low-cost alternative to the placement of bonded materials. Some cases might also be managed through the use of topical fluoride applicants.

Preventing Abrasion

The problems of improper toothbrushing are easily and inexpensively corrected when they are diagnosed in the early stages of development. If allowed to progress, the tooth damage will increase, as the cost to repair it. The best solution is prevention!

Brush your teeth thoroughly but not abusively. Do not scrub them or cross brush them (an exaggerated horizontal brushing motion). We will select a method of toothbrushing that will best meet your needs and teach you to care for your mouth. Use a soft toothbrush. Change to a new tooth brush every 3 months. But if it happens that you are creating the problem of toothbrush abrasion, get it corrected as soon as it is diagnosed. 

Gingivitis

Almost everyone knows what a cavity is. Because of the far-reaching effects of advertising by toothpaste and oral rinse manufacturers, by 2004 almost everyone had heard of gingivitis. What may not be quite clear to you, however, is exactly what gingivitis. You may recognize it as a problem but not know how serious it might be. You may even know that this is a type of gum (periodontal) disease. You may also know that it is somewhere related to plaque and tartar (calculus) on teeth. But why should you be concerned about having it?

Gingivitis is an infection of the gum tissues surrounding the teeth. It is a very common infection and affects almost 95% of the world’s population. This infection can be characterized by redness, swelling, and bleeding of the gums around the teeth. This gum infection absolutely needs to be treated as soon as possible. Gum infections are almost always preventable with sound daily oral self-care.

Gingivitis is the mildest form of periodontal disease and is reversible. By definition, there is no loss of bone that supports the tooth. If treated early, gingivitis can be eliminated. If left untreated, it can progress into the more serious form of periodontal disease called periodontitis. In its more serious form, the bone and gum tissues can be permanently affected. Bleeding gums, one of the signs of gingivitis, are a sign of infection in the mouth. Your gum tissues should never bleed. It is not normal for blood to appear on your toothbrush when you have finished brushing. Gingivitis does not generally hurt, so you may not even know that you have it. It can be localized (around a few teeth) or generalized (around most of your teeth. Gingivitis is seen most often in patients who do not brush and floss well daily, but it can also be related to medications. Bad breath can be another sign of gingivitis. If you are using mouthwash to get rid of bad breath, you may need dental attention. While bad breath can be related to some medical problems, most often it is just debris that is not cleaned properly from your teeth, gums, and tongue that is decomposing in the dark, warm, and moist environment of your mouth—a perfect place to breed gums.

If you have bleeding gums, you should be concerned. Healthy tissue anywhere in our bodies does not bleed. So what can you do to stop the bleeding?

We can help you eliminate the gingivitis. It involves a good professional cleaning and good oral self-care habits. Plaque (soft debris made up of bacteria) and tartar (calculus or hardened debris) must be removed before the gum tissues can heal and the infection can be eliminated. If it has some time since you had your teeth cleaned properly, it may take more than one appointment to get you back into shape.

Get your teeth and gums cleaned on a regular basis. Keep then clean with daily brushing and flossing. The infection you have will be eliminated. If you keep your teeth and gums cleaned, they can be healthy and trouble-free for your whole life.

Enamel Recontouring

Most people want straight, beautifully aligned, white teeth. Unfortunately, most people are not naturally born that way. When teeth are in poor alignment, rotated, tilted, and/or crowned, one obvious way to correct the problem is by orthodontics (braces). However, there are situations where it may not be possible or desirable to use braces to straighten teeth. You might feel that you are too old (although this is rarely the case), the cost of the orthodontics may preclude their use, you may not want to wear braces, or perhaps there are only a few areas that need attention and full orthodontics are not indicated.

In certain select cases, the appearance of your top and bottom teeth can be slightly or dramatically improved by recontouring the enamel. The upper and lower incisors and canines can be routinely altered. Sometimes teeth further back in your mouth can also be cosmetically improved. Recontouring is useful when there is slight to moderate overlapping if the front teeth, uneven wear, or teeth that do not have their biting and incising edges in harmony, in effect, an uneven “picket fence” look. Enamel recontouring is a painless procedure and no local anesthetic is needed. The enamel that is overlapping or poorly shaped is removed, recontoured, and polished. Depending on your individual needs, one or several teeth may require some reshaping. Different amount of enamel may be removed from different teeth. The teeth do not become prone to decay, are not made more sensitive to temperature changes, and are not made significantly weaker or damaged by the procedure.

Many times, recontouring is all that is necessary to significantly improve your appearance. Other times, when the poor alignment is more pronounced, it may be done in conjunction with a bonding procedure. The extent of your treatment will depend on your present conditions and on what you would like to see changed.

The procedure is not difficult for the patient and can often be done in only one appointment. The resulting change is immediate and permanent. Is does not take and artistic approach on the part of the dentist to determine what possibilities for change exist. We need to determine what enamel needs to be removed, where we must add material, and where the orthodontics is the treatment of choice.

If you have any questions about enamel contouring, please give us a call at 512-250-5012.

Metal Sensitivity

It has become clear that many people can develop sensitivity to some of the metals commonly used in dental restorations. This may or may not have been the case in past years. Perhaps patients were not as sensitive to metals then, or may be the sensitivity was not recognized and diagnosed properly. There are many different kinds of metals used in dentistry. We in this office have, for years, limited your exposure to possible problems by using either materials that have fewer combinations of metals or metals that have a very low potential for sensitivity reactions.

Women appear to have more reactions to metals then men. Studies indicate that at least one woman in seven has an adverse reaction to metals. It may be related to the costume jewelry that women wear, especially earrings for pierced ears. The posts can be made of stainless steel that contains nickel. You might then notice, after some time wearing the jewelry, that your earlobes get red, dried out, or itchy. It can also be seen any place that jewelry comes into contact with your skin—wrist, neck, fingers, etc. If this is your case, you are having a metal sensitivity reaction. If you have any of these problems, it is probably advisable that you limit contact with the problem metals. This can include metals used in restoring your teeth.

At times, you could even notice a metallic taste in your mouth. This can come from silver amalgam fillings that are commonly used. Some studies show leakage of metal through the tooth into the tooth supporting structures (periodontal ligament) from the posts bonded into the tooth after the root canal treatment. These posts are entirely surrounded by tooth or restorations and are not at all in contact with the oral environment. Other oral signs of metal sensitivity include gum tissue that remains chronically red and swollen or bleeds easily where it comes into contact with the metal crown or filling.

Which metals are used in dentistry? Silver fillings (available since approximately 1816) can contain copper, silver, zinc, mercury, and other metals. At this time, we know that several countries have mandated reduced use of silver fillings because of health concerns. Crowns are composed of gold, silver, platinum palladium, and others. A post used to strengthen a tooth after a root canal is either stainless steel or titanium. Sensitivity to each of these metals has been exhibited—some more than others. Gold and titanium rank low. Titanium has been used for years for joint replacements. Pure gold is too soft to be used in dental restorations and titanium is too brittle. If you have a metal sensitivity and need a crown, it may be better to use a metal that is only gold and platinum—or perhaps a bonded ceramic material. While these options may prove to be more expensive than others, metal sensitivity should be avoided.

Nonmetal Options

Options to metal restorations include bonded resins, ceramics, and porcelain. While it is possible that you could have sensitivity to some of the bonding materials, these types of sensitivities are not at all common. The advantages of silver fillings are that they are quick to place and comparatively inexpensive. Advantages of cast metal used under porcelain crowns is similar; the metal/porcelain crowns are less expensive to make and easier to place then full ceramic varieties.

We would prefer not to use silver/mercury fillings, especially for children and women planning to have children. Bonded tooth-colored resins significantly reduce the need for drilling a tooth. They look better and help keep the tooth stronger than silver fillings. If you have a proven metal sensitivity, we will automatically choose materials with less potential for causing you problems.