If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.
That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.
Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.
During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.
Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.
If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.
Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.
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 article “Understanding Periodontal Pockets.”
In 2016, voters in three states—California, Massachusetts and Nevada—joined Alaska, Colorado, Oregon, Washington and the District of Columbia in legalizing the use of recreational marijuana. These referenda moved the country closer to what may soon be a monumental political showdown between the states and the federal government, which still categorizes marijuana as a controlled substance.
But there’s another angle to this story often overshadowed by the political jousting: is increased marijuana use a good thing for your health and overall physical well-being?
When it comes to your dental health, the answer might be no. The Journal of Periodontology recently published a study that included frequent marijuana users showing increased signs of periodontal (gum) disease. This harmful bacterial infection triggered by plaque buildup can cause weakening of gum attachment to teeth and create the formation of large voids between teeth and gums called periodontal pockets. Left untreated, the disease can also cause supporting bone loss and eventually tooth loss.
The study looked at the dental treatment data of over 1,900 adults of which around one-quarter used marijuana once a month for at least a year. Marijuana users in the study on average had 24.5% of pocket sites around their teeth with depths of at least eight millimeters (an indication of advanced gum disease). In contrast, non-users averaged around 18.9% sites.
To be sure, there are several risk factors for gum disease like genetics, oral hygiene (or lack thereof), structural problems like poor tooth position or even systemic conditions elsewhere in the body. This published study only poses the possibility that marijuana use could be a risk factor for gum disease that should be taken seriously. It’s worth asking the question of whether using marijuana may not be good for your teeth and gums.
Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.
That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.
Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.
The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.
It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.
What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.
How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”
If you’re facing cancer treatment, we wish you the best outcome possible. Treating this disease has advanced tremendously in recent decades, but the available options are still often challenging to endure. It will be your primary focus for the foreseeable future.
As a dental provider we also want you to be aware how the two main treatments, chemotherapy and radiation, could adversely affect your teeth and gums, especially if you’re receiving radiation therapy near the head and neck. The aim of cancer treatment is to attack and destroy cancer cells to prevent their growth. Unfortunately, it can also destroy neighboring healthy cells and lead to harmful consequences in different parts of the body, including the mouth.
Salivary glands, for example, are especially vulnerable to damage during cancer treatment. This could create a situation where the mouth no longer produces adequate saliva flow, leading to a condition called xerostomia or dry mouth. Besides a lot of discomfort, restricted saliva flow can also increase your risk of tooth decay and other dental diseases. This is because saliva is the body’s acid neutralizer (acid can erode tooth enamel) and its first line of defense against microbial infection.
To guard against this, it’s important to support salivary flow as much as possible if you experience dry mouth symptoms during treatment (as well as beyond—it’s possible the damage to these glands could be permanent). Since some medications also contribute to dry mouth, you should speak with your physician about the prescriptions you’re taking: if any have dry mouth side effects ask if there’s an alternative drug without these side effects. You should also drink more water during the day and especially when taking medications. And consider substances like xylitol gum that can help boost saliva flow.
Unfortunately, it may not be possible to fully avoid the effects of these treatments on your teeth and gums. So, be sure you keep up daily brushing and flossing and see your dentist regularly for cleanings and checkups. If necessary, there are a number of restoration options to restore your smile after you’ve completed your treatment.
When you're first startled awake in the middle of the night by a loud, gritting sound emanating from your child's room, you may have two questions: how can such a loud racket not be harmful to their teeth? And, how can they sleep through it?
While it sounds earth-shattering, teeth grinding (medically known as bruxism) is a common habit among children. It involves an involuntary grinding, clenching or rubbing of the teeth together, either during the day or during night sleep.
While certain medications or conditions could be factors, it's believed most teeth grinding arises from the immaturity of the part of the neuromuscular system that controls chewing. It's believed to trigger a night episode as the child moves from deeper to lighter stages of sleep toward waking. Older children and adults typically handle these sudden shifts without incident, but a young child's under-developed chewing response may react with grinding.
If a child's teeth are normal and healthy, teeth-grinding typically won't create any lasting damage. But because grinding does generate pressures greater than the teeth normally encounter, it can be harmful to decayed teeth or those with enamel erosion due to high acid from consumption of sports and soda drinks. And it's also a cause for concern if the habit continues into later childhood or adolescence.
To avoid these problems, it's best to keep your child's teeth as healthy as possible by practicing daily brushing and flossing, and regularly seeing a dentist for cleanings, treatments and preventive measures like topical fluoride or sealants. And be sure to limit sugar and acidic foods and drinks in their diet to protect against decay and erosion.
You can also take steps to minimize teeth grinding and its effects. Consult with your physician about any medications they're taking that might contribute to the habit. If there are psychological issues at play, seek therapy to help your child better manage their stress. Your dentist can also fashion a custom night guard worn while they sleep that will prevent their teeth from making solid contact during grinding episodes.
Most importantly, let your dentist know if your child grinds their teeth. Keeping an eye on this potentially harmful habit will help lead to appropriate actions when the time comes.
If you would like more information on teeth grinding, 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 “When Children Grind Their Teeth: Is the Habit of 'Bruxism' Harmful?”
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