405 Frederick Road, Suite 150, Catonsville, MD 21228
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 allÂ 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.” Â 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.
Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.
To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.
Â While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.
The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter.Â It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.
Â Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.
Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.
If you would like more information on your treatment options 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
Since their development in the laboratory over five decades ago, lasers have found increasing use in our everyday lives. In the field of medicine, it’s not uncommon to find lasers in the offices of dermatologists, ophthalmologists and surgeons, to name just a few. Now, some dentists are finding that lasers can offer an alternative means of treating gum disease — and one that may have advantages in certain situations.
You probably know that a laser produces a special kind of light — in fact, its name is an acronym for “Light Amplification by Stimulated Emission of Radiation.” Essentially, a medical laser uses electrical energy to produce an intense and narrow beam of concentrated light. This light can be directed to a particular area, often via a fiber-optic channel. The laser’s precision allows a doctor or technician to focus the light energy exactly where it’s needed — to remove diseased tissue, seal off blood vessels, and sterilize a wound, for example.
For several years, periodontists — dentists who specialize in treating diseases of the gums — have been researching the use of lasers for treating certain types of gum disease. In standard clinical practice, hand-held instruments and ultrasonic cleaning tools are used at regular time intervals (3 – 6 months) to remove the sticky bacterial biofilm, as well as calculus (tartar), that forms in between teeth and gums. If that still isn't effective, gum surgery may be required to access the affected area, remove diseased tissue, and reduce pocket depth (the space below the gum line that gets larger as bone loss occurs) to prevent reinfection.
Recently, however, several new procedures have been developed that use lasers to accomplish some or all of these goals. One type of therapy uses a special laser that emits pulses of light with a specific wavelength (color) of 1064 nanometers. This light passes through healthy cells like a sunbeam through a window — but when it encounters darkly-pigmented bacteria, it vaporizes them instantly!
One of the potential advantages of laser treatment is its precision: focused directly on the area where trouble occurs, it targets diseased tissue but leaves healthy tissue alone. Another is that laser treatment is less invasive: It requires less tissue removal, and may cause less discomfort and tissue shrinkage (gum recession) than conventional periodontal surgery. And because it produces small amounts of heat, it can seal blood vessels and help control bleeding.
While lasers have long shown promise for treating gum disease, until recently it wasn’t clear if they offered any advantages over traditional methods. Now, several studies have shown that certain laser treatments can be just as effective as traditional gum surgery in many cases — with the potential benefit of being less invasive. In the future, the use of lasers for periodontal procedures is likely to increase.
It’s important to remember that no single treatment — not even a laser — can “zap” gum disease in one fell swoop. Controlling periodontal disease requires effective at-home oral hygiene combined with regular professional care. If you have questions about periodontal disease, please call our office to schedule a consultation.
Billions of bacteria live in each of our mouths, sharing a common environment with teeth and soft tissues. Most of the time, they coexist in symbiotic balance. But sometimes that balance becomes disrupted, leading to a destructive condition known as periodontal disease.
From the Latin peri (“around”) and the Greek odont (“tooth”), periodontal refers to the tissues that are around the teeth. When they become diseased, it's a serious matter; and not just because of potential tooth loss — there is evidence that periodontal disease has links to cardiovascular disease and, for pregnant women, low birth weights in pre-term babies.
There are a number of factors that can increase your risk of developing periodontal disease, like smoking, poor nutrition, and your systemic health. The biggest factor, however, is increased bacterial plaque due to poor oral hygiene practices.
Periodontal disease is progressive. As unhealthy bacteria levels increase, the bacteria eventually cause bone loss, the gums separate from the teeth and create what is referred to as periodontal pockets. As the pockets deepen around the teeth, plaque and tartar become extremely difficult to remove, even if you resume a proper hygiene routine. At this stage, treating the disease will require a different approach. And if left untreated, the teeth will most likely continue to lose bone and eventually be lost.
Through a dental exam, we can determine the presence and extent of the disease and recommend a treatment strategy. Besides lifestyle changes and better hygiene habits, this strategy might also include treatment with antibiotics, a thorough mechanical cleaning to remove tartar and plaque, surgical techniques to remove infected tissue, or occlusal bite therapy.
Above all, prevention is the key. Through proper dental hygiene and regular dental exams and cleanings, stopping periodontal disease from beginning in the first place is your best defense.
If you would like more information on the treatment of periodontal 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 “Understanding Gum Disease.”
Adult teeth aren’t meant to be loose — it’s a sign that something is wrong. And while there are treatments, time is of the essence before permanent tooth or bone loss occurs.
Loose teeth can occur for many different reasons. Bite-related problems are fairly common, referred to as occlusal trauma (“occlusal” – bite; “trauma” – injury). This could be the result of excessive force placed on otherwise normal teeth and jaws — chronic clenching or grinding habits, for example. On the other hand, even normal biting or chewing can cause teeth to loosen if bone loss from gum disease has become excessive, reducing the remaining attachment to bone to inadequate levels. In some cases it can be a result of both excessive force and weakened bone levels.
Of these reasons, the most common cause is the weakened attachment of the teeth to the bone due to gum disease. If this is the case, it’s important first to treat the gum disease by an appropriate strategy for the disease present and then implement an effective dental hygiene program to inhibit reoccurrence.
As for the problem of loose teeth, there are measures to address it. Occlusal bite adjustment reduces the degree of force when biting or chewing by reshaping the biting surfaces through selective grinding. Splinting is another technique in which the teeth are joined together to make them more rigid and to redistribute the biting force among several teeth. This can be done with material bonded across the outside of several teeth or with a metal splint affixed within a pre-cut channel across the teeth. A more permanent option is to create a series of crowns to affix to the teeth and then fuse them together.
Although more complex, orthodontics to correct misaligned teeth is another option. Not only will it improve the bite and potentially reduce bite forces, it may also improve the health of the supporting periodontal attachment.
Before undertaking any treatment, you should first undergo a thorough exam to determine the true cause of your loose teeth and any underlying conditions. From there we can recommend the best approach for treating and preserving your teeth.
If you would like more information on treatments for loose teeth, 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 “Treatment for Loose Teeth.”