Posts for: August, 2013

By Orthodontics for Children and Adults
August 29, 2013
Category: Oral Health
Tags: gum disease   genetics  
GeneticsandyourGums

It is sometimes hard to believe all of the features and characteristics that we inherit from our parents. Whether you're tall, short, blue-eyed or blonde, you can usually attribute some of these features to your mother and father. Of course, the downside of genetics is that diseases and disorders are also linked to genes.

Well, you can add gum tissue to that list as well! Genetics actually determines whether you have what we call “thin” or “thick” gum tissue. How does this work? Well, the type of gum tissue you have relies heavily on the shape of your tooth, which indeed is genetically-coded. If you have a triangular tooth shape, you'll likely have thin gums. If you have a squarer tooth shape, you'll usually have thick gums.

So, what can you expect from each tissue type?

If you have a thin gum tissue type, you are more likely to have gum recession. Watch out for the following signs of gum recession:

  • Sensitivity to hot or cold, even without the presence of dental decay
  • If you have crowns on your teeth, you may see a dark gray line at the gum line from the metal casting beneath the crown
  • Small dark triangular spaces between teeth

On the other hand, if you have a thicker tissue type, your gums are more vulnerable to dental disease through a condition called “pocketing.” This happens when bacterial plaque causes your tissue to become inflamed, lose its attachment to the teeth and develop a pocket. Pocketing can result in bone loss, and, in worst-case scenarios, tooth loss.

It's important to note that while we use these terms to categorize different tissue types for treatment decisions, your tissue may also fall somewhere in between the two varieties.

So, how can you prevent gum disease? Daily oral hygiene is the best way to ensure proper care of your gums, no matter what type you have. Be sure to brush twice daily (use a soft toothbrush) and floss regularly at night. Floss gently until you hear a squeak, but watch out for your gum line. And of course, continue to visit us two times a year, so that we can assess whether you are in danger of developing gum disease.

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


By Orthodontics for Children and Adults
August 22, 2013
Category: Dental Procedures
ActorEdHelmsTooth-YankingTrickItWasaDentalImplant

The lengths that some comedians will go to for a laugh! Actor Ed Helms, as dentist Stu Price, pulled out his own tooth in the movie The Hangover. Or did he? Turns out Helms really is missing a tooth, which never grew in. When he was in his late teens, he received a dental implant to make his smile look completely natural.

Helms told People magazine he wasn't exactly eager to remove the implant crown that had served him so well for almost 20 years, but there was no better way to do the famous tooth-pulling scene.

“We started to do different tests with prosthetics and blacking it out and nothing worked,” Helms told the magazine. Helms' dentist said it would be okay to take the implant crown out. “My dentist was really into it,” Helms said. The rest is movie history!

Congenitally missing (“con” – together with; “genital” – relating to birth) teeth are inherited and actually quite common. More than 20% of people lack one or more wisdom teeth, for example. These would not usually be replaced if missing (in fact, wisdom teeth are often removed) but it's a more serious issue when the missing tooth is in the front of the mouth — and not just for aesthetic reasons.

When a particular type of tooth is missing, it disrupts the pattern and function of the teeth. If left alone, sometimes the existing teeth will shift to close the gap. It's like removing a brick from an arch — the rest of the bricks would fall together in a different formation (or collapse entirely). And when upper and lower teeth don't come together properly, they can't function well.

The best treatment for this type of situation is the one Ed Helms had: a dental implant. They look and function like real teeth and do not attach to or damage adjacent teeth as other tooth-replacement options might.

It is important that a child with a congenitally missing tooth wait until jaw growth is complete — different for every person but usually in the late teens — before getting an implant. Otherwise, the artificial tooth might eventually appear too short when the person has stopped growing. In the meantime, there are temporary tooth replacements that can be made.

If you would like more information about options for congenitally missing teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow.” Dear Doctor also has more on “Teenagers & Dental Implants.”


By Orthodontics for Children and Adults
August 14, 2013
Category: Dental Procedures
Tags: oral hygiene   oral health  
MoreThanaScalingButNotPeriodontalSurgeryItsRootPlaning

Root planing is a procedure that allows us to achieve your — and our — basic goal in dentistry: healthy, clean gums and teeth.

At a level in between scaling by your hygienist and periodontal (from peri, around and odont, tooth) surgery, root planing is a conservative treatment that attempts to eliminate the need for gum surgery.

The Problem:
Plaque is a film of bacteria (a biofilm) that adheres to your teeth at the gumline. This is what you try to remove with daily brushing and flossing. Plaque that is not removed can form a hard coating called calculus or tartar. These substances irritate your gums and cause inflammation, which in turn causes your gum tissues to lose their attachment to your teeth. The resulting gaps between the teeth and gums are called pockets, and they act just like pockets in your clothing.

Your teeth are fastened in your jaws by a combination of bone and soft tissue including the gums and the periodontal ligament, tissues that holds each tooth in place. When pockets form and bacteria move into them, the bacteria and the toxins they emit can become ingrained into the surface of the roots of your teeth (the bottom parts that are below the gumline) and cause further inflammation and infection. This can lead to loss of attachment of the gum tissues and bone that anchor your teeth. In the worst cases you can lose the teeth.

The Solutions:
1. The first level of defense is your own daily brushing and flossing. Ask us to check your technique to make sure you are effectively removing plaque.

2. Second, your dental hygienist can remove superficial collections of calculus by scaling, using hand tools or a sonic scaler.

3. Third, root planing actually planes the surface of the roots of your teeth, in the same way as a carpenter planes a piece of wood. It removes calculus, bacteria and toxins ingrained into the root surfaces so that the infected gum tissues can heal.

Root planing is usually done using local anesthesia to numb the teeth and surrounding soft tissues. The planing may be done first with an ultrasonic device that cleans by vibrating particles off the root surfaces and simultaneously flushes the pockets with water. The root planing is finished with delicate hand instruments called curettes. The area may then be flushed with antibacterial medication to fight infection.

The response to root planing is usually evaluated three to four weeks later. The gum tissues are checked for healing, and probing measurements of the pockets are retaken. Depending on the results, additional root planing may be needed.

4. Finally, in cases of the worst periodontal infections, you may need periodontal surgery. Each person's situation is unique and should be based on an examination and evaluation.

Contact us today to schedule an appointment to discuss your questions about dental hygiene and root planing. You can also learn more by reading the Dear Doctor article, “Root Planing.”


By Orthodontics for Children and Adults
August 06, 2013
Category: Oral Health
Tags: orthodontics   braces   retainer  
WearinganOrthodonticRetainerPreservesYourWell-EarnedSmile

Orthodontic treatment (commonly known as braces) can be a lengthy process to re-align your teeth to a more functional and aesthetic position. Once the orthodontic devices are removed, however, the treatment isn't finished. Wearing a retainer is the final step to ensuring that the re-alignment doesn't eventually fail. It's designed to do just what its name implies — to “retain” the teeth's new position and prevent a relapse to the old.

This can happen because of the way teeth fit into the jaw bone. The teeth are joined to the bone by the periodontal ligament, which works somewhat like a hammock: the ligament's fibers act like threads that fit into the tooth on one side and into the bone on the other, and hold the teeth in place.

As living tissue, the ligament's cell structure is dynamic and can adapt to the gentle pressure applied by an orthodontic device. However, once this pressure subsides after the device is removed “muscle memory” can cause the ligament to resist the new position and pull the teeth back to their original setting. The retainer helps hold the teeth in the new position while the bone and ligament continue to mature and stabilize around the teeth.

There are two basic types of retainers; the one recommended for you will depend on your age and the extent of your orthodontic treatment. One type is a removable device that is typically worn around the clock initially, but may eventually only need to be worn at night or for even a lesser interval of time. The other type is attached permanently behind the teeth and can only be removed by an orthodontist. Permanent retainers have the benefit of not being as visible as the removable type, and there's no bother with putting them in and taking them out.

You may consider wearing a retainer a nuisance especially after months of orthodontic treatment. But consider it the last lap in a long race — only by finishing can you achieve that winning smile.

If you would like more information on the use of a retainer, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?