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Periodontal Disease: Understanding the Causes, Symptoms and Treatments

Posted on February 1, 2016 at 9:40 AM Comments comments (2)

Periodontal Disease: Understanding the Causes, Symptoms and Treatments



Periodontal disease is caused by a bacterial infection that can spread around the root of the teeth. The condition can cause tooth bone reduction and if left untreated can damage your teeth and cause tooth loss. Since it involves harm to the gums and the supporting bone structure beneath them, it is recommended to get treatment in its earliest stages. Research points to possible health effects of periodontal disease that go beyond your mouth and affects every sites and functions of a body.




Dental plaque, pale-yellow biofilm develops on teeth as a result of accumulation of bacteria that try to attach themselves to the tooth’s smooth surface. While brushing teeth should be able to get rid of plaque, it usually builds up naturally within a day or so, and over time, hardens into tartar which is much harder to remove. Cleaning the surface requires a professional help. The plaque then progressively damage teeth and surrounding tissue, causing gingivitis. This can further lead to the formation of pockets filled up with bacteria between the teeth and gums. The bacterial toxins thus become hazardous and our immune system destroys the bone and connective tissue that hold teeth together and in place. This leads to teeth becoming loose and eventually can fall out.




Healthy gums are pale pink and firm and with Periodontal Disease, you can note some of the changes, including:

•Bright red, purplish, or swollen gums

•Bad breath

•Tender or bleeding gums

•Receding gums

•Bad taste in mouth

•New spaces between teeth

•Sensitive teeth

•Loose teeth

•Painful chewing


You may also notice a change in the way your teeth fit together when biting.




Depending on the severity and the extent of the gum disease, both non-surgical and surgical treatments are available in order to control the infection.


Nonsurgical Treatments


Scaling: Involves the removal of tartar and bacteria from teeth and beneath the gum line, through a deep cleaning method.


Root planing: Involves smoothing the root surfaces to block further buildup of tartar and bacterial toxins that contribute to the disease.


Medications: Include topical antibiotics such as mouth rinses and gels in order to control bacteria and shrink periodontal pockets.


Surgical treatments


Flap surgery: Also called pocket reduction surgery, the procedure involves lifting back gum tissue and exposing the roots for an effective scaling and root planing treatment.


Soft tissue grafts: Tissue from the roof of the mouth is relocated to the gum line in order to prevent further gum loss. The treatment also ensures covering of exposed roots and improved appearance.


Bone grafting: Performed when the bone has been destroyed to prevent tooth loss by holding it in place and promote bone regrowth.


Guided tissue regeneration: Biocompatible fabric is placed between the bone and tooth to prevent unwanted tissue from growing and allowing bone regrowth.


Enamel matrix derivative: Involves the application of gel to a diseases root to stimulate healthy one and tissue growth.


The above mentioned treatment will only bring results if the patient keeps up with daily oral care at home. Also modifying certain behaviors, like quitting tobacco and smoking can improve the treatment outcome.


The Different Types of Floss & How to Floss Properly

Posted on January 25, 2016 at 10:15 AM Comments comments (0)

First, let’s go over some basics

What does floss do?

 Floss is used to remove all the food particles, bacteria, and plaque that is stuck in-between your teeth. Whether you can feel it or not, food gets stuck between your teeth. If you neglect to floss your teeth for a long period of time, plaque will buildup. Your toothbrush is not powerful enough (nor has the capability) to remove the plaque stuck between your teeth. You will be susceptible to gingivitis, a gum disease that has its own set of dental health problems.

 What is floss made from?

 Back in the 1800s, floss was made out of silk. We’ve come a long way since then. Most modern day floss is now made from plastic beads, believe it or not. They are melted down and the liquefied plastic is squeezed like toothpaste into long, thin strands. The floss is then stretched, making the molecules longer and stronger. Dental floss is supposed to be unbreakable, hence the use of plastic. Additional layers like wax and flavoring agents are added to make flossing a bit more bearable. Here’s a video on how dental floss is made.

 What happens if you don't floss?

 Consistent flossing will improve your oral hyiene because it removes plaque buildup. If you neglect to use dental floss, the food particles and plaque will cause gum irritation, which makes your gum tissue become sensitive. If it's your first time flossing in months, chances are your gums will bleed. If you don't floss, ease your way into it. Soon enough, you'll wonder why you never did it in the first place!

 Using dental floss is one of the most important elements of oral hygiene. As stated above, flossing removes plaque and decaying food that remains stuck between your teeth. Leaving the food particles will irritate the gums, which isn't good for your gum health. And eating acidic foods will also break down your enamel, demineralizing your teeth. This will lead to cavities.

 Types of Floss


Regular Floss

 We’re all familiar with the traditional type of stringed floss. However, there are several types of regular floss. There is waxed floss, unwaxed floss, mint flavored floss, etc. First off, there is no difference between wax and unwaxed floss. The main thing that determines the level of effectiveness if your flossing technique. A lot of people prefer wax coated floss because it slides in and out of your teeth a bit easier than unwaxed floss. And floss with mint coating is primarily used to a) give you the feeling of freshness and b) make the act of flossing more pleasant. There is no reason to be concerned over calories or sugar.

Floss Picks


Floss picks are a popular product nowadays. Floss picks hold the floss for you, making it extremely convenient since you only have to use one hand. While they may be convenient, they are not as effective as regular floss. Floss picks do not allow you to reach all the necessary angles that normal floss can. Why’s that? You’re supposed to complete a “C” around the tooth and go up and down to completely clean the tooth. So you won’t be able to clean your teeth as effectively. Regular floss is recommended, but floss picks are better than nothing for your oral health.


Oral Irrigators


oral-irrigator-flossAn oral irrigator (also known as a dental water jet) is a flossing device that uses a stream of pulsating water to remove plaque and food particles between teeth. It’s a new form of flossing that not only removes plaque, but improves your gingival health. The machine has a water reservoir that connects to a device resembling a toothbrush. To use it properly, you should lean over the sink and place it in your mouth. Then turn it on (and close your lips to prevent splashing), and allow the water to flow from your mouth into the sink. Pause briefly between teeth, and aim at the tip just above the gumline at a 90 degree angle. It only takes a minute or two.


How to Floss Properly

•Gather about 18 inches of floss and wind it around your two pointer fingers (or middle fingers), leaving a couple inches to floss with

•Slide the floss gently up and down between your teeth

•Curve the floss in a “C” shape around each tooth, and be sure to go below your gumline. Don’t force it, though, because that can damage your gums and cause bleeding

•Use a new section of floss as plaque/food debris builds up




The Importance of Dental X-rays

Posted on January 11, 2016 at 8:50 AM Comments comments (0)

Dentists want to provide the best possible dental care to their patients, but a visual examination doesn't tell them everything they need to know. Thanks to dental X-rays, dentists can accurately diagnose and treat dental problems early before they become more serious. And if after examining your mouth and reviewing these images, your dentist finds no cavities or growth issues, you can rest assured he or she has seen the whole picture.


Valuable Diagnostic Tool


X-rays, also called radiographs, give your dentist the ability to see between and inside your teeth. He can also view the tip of your roots and bone underneath your gums – places not normally visible to the naked eye. Although they are used as part of a routine examination to rule out dental disease, X-rays also aid your dentist in diagnosing any specific or isolated dental problems you might be experiencing.


Radiographs are used to check for cavities and evaluate the extent of decay. And because some X-rays show the root of the tooth, according to the Academy of General Dentistry (AGD), the presence of any cysts, abscesses and other masses can be diagnosed. Congenitally missing or impacted teeth such as wisdom teeth are often identified this way, and the presence and extent of bone loss due to periodontal disease is easily seen through dental X-rays as well.


Types of X-rays


Bitewing, periapical and panoramic radiographs are the most common X-rays used in the dental office. During routine exams, your dentist may take two to four bitewing x-rays – which show the crown portions of your teeth – to check for early signs of decay between your teeth. When he wants to get a good look at your teeth's bone height or root tips, periapical X-rays provide the best view. A panoramic X-ray, according to the Radiological Society of North America (RSNA), is taken from outside of your mouth and produces an image of the entire oral cavity on one large X-ray. Because the image shows all of the teeth, as well as the upper and lower jaws and sinus areas, this type of X-ray can identify impaction, cysts, tumors, jaw disorders and bone irregularities.


Other radiographs include occlusal X-rays, which are occasionally taken in children to evaluate their developing teeth; and cephalometric X-rays, used by orthodontists when planning orthodontic treatment.


How Often Are X-rays Needed?


Everyone's oral health varies, and as a result, the dentist will evaluate your needs and recommend an X-ray schedule accordingly. If you're a new patient, the dentist may advise taking a full series of X-rays or panoramic image to assess your current oral health state, and use this as a baseline going forward. As you continue your regular checkup visits, fewer X-rays are needed to monitor the status of your oral health.


Dental X-rays Safety


Because X-ray machines and other sources of dental radiographs are designed to minimize radiation, these processes are safe and your exposure is negligible. Many offices, in fact, are now using digital X-rays, which further reduces radiation exposure. Nonetheless, the American Dental Association (ADA) Mouth Healthy site recommends patients have the added protection of a leaded apron to cover the abdominal area and a leaded collar to protect the thyroid. Always let your dentist know if you're pregnant or breastfeeding, though necessary X-rays don't have to be avoided as long as you're wearing a fitted lead apron and thyroid collar.


Colds, Coughs??? and Cavities?

Posted on January 7, 2016 at 7:55 AM Comments comments (0)

You’re probably aware that candy leads to cavities and sugary drinks can also cause decay. But cough syrup? Unfortunately, it’s true – certain syrupy medications can cause tooth troubles, especially if they’re consistently taken over a long period of time.


The antihistamine syrups you can buy over-the-counter to help you and your kids combat the flu or allergies often have high acidity and low pH levels. These medications can also contain sugar to help with the taste. Combined, those factors are like a one-two punch for teeth, working together to dissolve tooth enamel and cause erosion.


Don’t worry – we’re not suggesting you suffer through seasonal ailments without any relief. Just follow these four tips to make sure the medicine doesn’t do more harm than good.

◾Avoid taking syrup medication right before bed. Since saliva flow naturally decreases at night, the residue won’t rinse away like it would during the day.

◾If there’s no way around a bedtime dose, make sure to rinse with water afterward.

◾Try to take medications with meals. Chewing increases saliva flow, which helps wash away sugars and acids.

◾Talk to your child’s dentist about a topical fluoride, which helps keep decay at bay.


With the proper precautions and good oral health habits, you’ll be able to keep colds, coughs and cavities away this season!


Smoking Causes More Than Bad Breath

Posted on December 30, 2015 at 11:00 AM Comments comments (0)

Refrain From Smoking



Quitting smoking isn’t easy, but here’s another reason you should make the effort: Smoking is more than just a cause of bad breath — it significantly raises your risk of developing oral cancer, which includes cancer of the mouth, throat, salivary glands, tongue or lip.


In the early stages, oral and throat cancers can have symptoms similar to a toothache or they are painless. Many cases of oral cancer are seriously advanced by the time they are detected. That’s why it is important to examine your mouth periodically—if oral cancer is identified early, it is almost always treatable.


Bad breath is an early sign of oral cancer, whether or not you are a smoker. Other early signs of oral cancer include lumps or white, red or dark patches inside the mouth, difficulty chewing, swallowing or moving the jaw, feeling that something is stuck in the throat, numbness in the mouth, thickening of the cheeks, or voice changes.


Tobacco use is the top risk factor for oral cancer, so the best way to reduce risk is to quit smoking or using other tobacco products. But other keys to oral cancer prevention and the promotion of oral health include seeing a dentist regularly and following a complete oral care routine that includes twice-daily tooth brushing and daily flossing.


"New" Periodontal Disease and Cardiovascular Disease

Posted on Comments comments (1)

Periodically, there are news stories claiming to demonstrate an association between periodontal disease and one or more forms of cardiovascular disease. Epidemiologic studies have found an association between periodontal disease and functional or morphological markers of coronary heart disease, and that those with periodontal disease have higher coronary heart incidence than those without periodontal disease.1,2 However, both periodontal disease and cardiovascular disease are complex conditions that share common risk factors.


The mechanism by which periodontal disease affects coronary heart disease has not been established, though there are numerous theories, ranging from the actions of periodontal pathogens in the coronary arteries or endothelium to periodontal pathogens leading to systematic inflammation, with subsequent detrimental effects on cardiovascular health. The current position of the American Heart Association and the American Dental Association is that while periodontal disease and heart health have an association, additional research is needed to establish whether one causes the other.1,3


A recent doctoral thesis publicized in the ADA’s Morning Huddle analyzed data from the STABILITY trial.4 This was a randomized, prospective, placebo-controlled, double-blind, multi-center trial designed to test the efficacy of darapladib (an inhibitor of the proinflammatory enzyme Lp-PLA2) in adults with chronic coronary artery disease. The study assessed known risk factors for cardiovascular disease as well as two factors of interest to dentists: self-reports of subjects’ number of teeth and how frequently their gums bleed during toothbrushing or other activities. All study subjects had coronary artery disease, and they reported a high overall prevalence of tooth loss (16.4% reported having no teeth, and 40.9% had less than 15 remaining teeth) and gum bleeding (25.6% reported that their gums bled during teethbrushing or other activities at least some of time). For every five teeth lost, the risk of cardiovascular death within the study period (median of 3.7 years) rose 17%, risk of all-cause death rose 16%, and stroke rose 14%.


Subjects with no teeth had the highest risks of stroke, cardiovascular death, and all-cause death. Additionally, higher levels of tooth loss were accompanied by progressively higher levels of inflammatory biomarkers (hs-CRP, IL-6, and Lp-PLA2) and higher levels of biomarkers of cardiovascular events (growth differentiation factor 15, high sensitivity troponin T, and N-terminal pro B-type natriuretic peptide). Statistical models that adjusted for these biomarkers still found a significant association between tooth loss and cardiovascular death, which may indicate that tooth loss does not lead to cardiovascular death via the pathways related to these biomarkers. Also, there did not appear to be a significant association between tooth loss and risk of heart attack.


Overall, this analysis found mixed results with respect to tooth loss as a risk factor for cardiovascular outcomes. Higher levels of tooth loss were associated with the highest risk of stroke, cardiovascular death or all-cause death, but the pathway by which tooth loss led to these outcomes remains unclear, since inflammation, myocardial injury, or heart attack did not appear to lie in the causal pathway between tooth loss and cardiovascular death.


Similar to previous studies, this study presents evidence that tooth loss and adverse cardiovascular health are associated with each other. It is important to note that this study does not demonstrate that tooth loss causes poor cardiovascular health, nor that periodontal treatment improves cardiovascular health.