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Posts for tag: gum disease

By Dr. Marvin Ernst General and Cosmetic Dentistry
December 01, 2018
Category: Dental Procedures
LasersCouldbetheFutureforGumDiseaseTreatment

We’ve developed a number of effective treatments for periodontal (gum) disease. Depending on how far and deep a patient’s infection has advanced, treatment can be quite invasive and even require surgery. The more invasive, the longer and more uncomfortable the healing process can be.

But using a medical laser could make that less so. Although its use for gum disease treatment is still in its infancy, the latest observations from the field seem to show patients undergoing laser treatment may have less tissue trauma and bleeding, less discomfort after the procedure and quicker healing times.

Gum disease is a bacterial infection mostly caused by dental plaque, a thin film of food particles that build up on teeth in the absence of effective oral hygiene. The infection can advance deep below the gum line, weakening gum attachment to teeth and destroying supporting bone. Ultimately the affected teeth can be lost.

Traditionally, the only way to stop the disease is to manually remove plaque buildup on teeth and gum surfaces, which is continuing to sustain the infection, with special hand instruments called scalers or ultrasonic equipment. Because it’s important to remove as much plaque and diseased tissue as possible, we may need to perform a surgical procedure called flap surgery to move some of the gum tissues out of the way to get to these deeper areas. As with any surgery, this can create tissue trauma that may cause discomfort during the healing process.

Our new alternative is to use an Nd:YAG medical laser in a procedure known as Laser Assisted New Attachment Procedure or LANAP. With light energy delivered through a small fiber no more than the width of three human hairs, the laser can pinpoint diseased tissue and destroy bacteria through intense heat. Because of the laser beam’s tiny width and pulsing action, healthy tissue is at less risk for trauma than with the traditional treatment.

Coupled with other techniques, LANAP procedures could remove as much infected tissue and plaque as traditional methods, but with less healthy tissue trauma. In the future, then, patients with advanced gum disease undergoing laser treatment could have less bleeding and discomfort and faster healing times.

If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Gum Disease with Lasers.”

By Dr. Marvin Ernst General and Cosmetic Dentistry
July 14, 2018
Category: Oral Health
Tags: oral health   gum disease  
YourGumTissueBiotypeCouldDetermineHowGumDiseaseAffectsYou

Periodontal (gum) disease can cause a number of devastating effects that could eventually lead to tooth loss. However, you may be more prone to a particular effect depending on the individual characteristics of your gums.

There are two basic types of gum tissues or “periodontal biotypes” that we inherit from our parents: thick or thin. These can often be identified by sight — thinner gum tissues present a more pronounced arch around the teeth and appear more scalloped; thicker tissues present a flatter arch appearance. While there are size variations within each biotype, one or the other tends to predominate within certain populations: those of European or African descent typically possess the thick biotype, while Asians tend to possess the thin biotype.

In relation to gum disease, those with thin gum tissues are more prone to gum recession. The diseased tissues pull up and away (recede) from a tooth, eventually exposing the tooth’s root surface. Receding gums thus cause higher sensitivity to temperature changes or pressure, and can accelerate tooth decay. It’s also unattractive as the normal pink triangles of gum tissue between teeth (papillae) may be lost, leaving only a dark spot between the teeth or making the more yellow-colored root surface visible.

While thicker gum tissues are more resilient to gum recession, they’re more prone to the development of periodontal pockets. In this case, the slight gap between teeth and gums grows longer as the infected tissues pull away from the teeth as the underlying bone tissue is lost. The resulting void becomes deeper and more prone to infection and will ultimately result in further bone loss and decreased survivability for the tooth.

Either of these conditions will require extensive treatment beyond basic plaque control. Severe gum recession, for example, may require grafting techniques to cover exposed teeth and encourage new tissue growth. Periodontal pockets, in turn, must be accessed and cleaned of infection: the deeper the pocket the more invasive the treatment, including surgery.

Regardless of what type of gum tissue you have, it’s important for you to take steps to lower your risk of gum disease. First and foremost, practice effective daily hygiene with brushing and flossing to remove bacterial plaque, the main cause of gum disease. You should also visit us at least twice a year (or more, if you’ve developed gum disease) for those all important cleanings and checkups.

If you would like more information on hereditary factors for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Genetics & Gum Tissue Types.”

By Dr. Marvin Ernst General and Cosmetic Dentistry
December 23, 2015
Category: Oral Health
DrTravisStorkDontIgnoreBleedingGums

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

By Dr. Marvin Ernst General and Cosmetic Dentistry
April 24, 2015
Category: Dental Procedures
PeriodontalFlapSurgeryAccessesHiddenInfectioninGumTissues

Periodontal gum disease is a relentless enemy to dental health that destroys gum tissue and the teeth’s attachment to the jaw. As it ravages these tissues it often creates periodontal pockets, hidden spaces between the teeth and bone that fill with infectious bacteria capable of accelerating damage to teeth and gums.

The primary treatment goal for gum disease is to create an environment that is cleansable below the gum tissues, in order to remove as much bacterial plaque from the tooth, gum and root surfaces as possible. Periodontal pockets pose a challenge to this goal as they are extremely difficult to access using standard cleaning and root planing techniques the deeper they become. Cleaning and treating these deep pockets, however, is made easier with a procedure known as periodontal flap surgery.

This procedure is not a cure, but rather a way to access the interior of a periodontal pocket to remove infection and diseased tissue. In effect, we create an opening — like the hinged flap of a letter envelope — to gain entry into the affected pocket. Not only does this opening enable us to clean out infection within the pocket, but it can also facilitate cleaning the tooth’s root surfaces.

It also provides an opening for us to insert grafting materials to regenerate lost bone and tissue. It’s nearly impossible for this tissue regeneration to occur if bacterial infection and inflammation persist in the affected area. Periodontal flap surgery provides us the critical access we need to effectively remove these contaminants that stymie healthy growth.

This procedure is normally performed with local anesthesia and usually results in little bleeding and minimal post-operative effects. Once we have finished any procedures to clean the pocket and other affected tissues, or installed grafts for future bone and tissue growth, we would then seal the flap back against the tooth using sutures and gentle pressure to promote blood clotting around the edges. We might also install a moldable dressing that re-secures the edges of the flap to their proper position and prevents food debris from interfering with healing.

Periodontal flap surgery is the result of years of research to find the best techniques for treating gum disease. It’s one of many weapons in our arsenal for winning the war against decay and gum disease, and helping you realize a healthier dental future.

If you would like more information on periodontal flap surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Flap Surgery.”

By Dr. Marvin Ernst General and Cosmetic Dentistry
June 17, 2014
Category: Oral Health
TakeCareofYourGumsandTheyWillTakeCareofYou

If your gums appear reddish, puffy and bleed easily — especially at the margins where they meet your teeth — instead of their normal pink, you have gingivitis (“gingiva” – gums; “itis” – inflammation). Gingivitis is one of the first signs of periodontal disease (“peri” – around; “odont” – tooth) that affects the tissues that attach to the teeth, the gums, periodontal ligament and bone. Other common symptoms of periodontal disease include bad breath and taste.

If periodontal (gum) disease is allowed to progress, one possible consequence is gum recession exposing the root surfaces of the teeth. This can cause sensitivity to temperature and touch. Another sign is that the gum tissues may start to separate from your teeth, causing pocket formation; this is detectable by your dentist or hygienist. As pocket formation progresses the bone supporting the teeth is destroyed leading to loose teeth and/or gum abscesses. Unchecked or untreated it leads to tooth loss.

Inflammation, a primary response to infection is actually your immune (resistance) system's way of mounting a defense against dental plaque, the film of bacteria that concentrates between your teeth and gums every day. If the bacteria are not removed, the inflammation and infection become chronic, which literally means, “frustrated healing.” Smoking is a risk factor for periodontal disease. Smokers collect plaque more quickly and have drier mouths, therefore, cutting down or quitting smoking can reduce the severity of gum disease. Stress has also been shown to affect the immune (resistance) system, so stress reduction practices can help here as well as in other parts of your life. Gum disease can also affect your general health especially if you have diabetes, cardiovascular or other systemic (general) diseases of an inflammatory nature.

Periodontal disease is easily preventable. The best way to stop the process is to remove each day's buildup of plaque by properly brushing and flossing your teeth. Effective daily dental hygiene has been demonstrated to be effective in stopping gingivitis. It sounds simple, but although most people think they're doing a good job, they may not be. Effective brushing and flossing requires demonstration and training. Come and see us for an evaluation of how well you're doing. Regular checkups and cleanings with our office are necessary to help prevent gingivitis and periodontal disease. In addition if you already have periodontal disease you may need a deep cleaning known as root planing or debridement to remove deposits of calcified plaque called calculus or tartar, along with bacterial toxins that have become ingrained into the root surfaces of your teeth.

Gum disease is often known as a silent disease because it doesn't hurt, so see our office for a periodontal exam today.

Contact us today to schedule an appointment or to discuss your questions about gingivitis and periodontal disease. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”



I. Marvin Ernst DDS, PA

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