There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause for gum disease, from all tooth and gum surfaces.

The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They're also time-consuming: full treatment can take several sessions, depending on how extensive the infection has spread.

In recent years, we've also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.

Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.

Dentists who have used lasers in this way do report less tissue damage, bleeding and post-treatment discomfort than traditional treatments. But because research is just beginning, there's not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.

At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.

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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

On your way to a more attractive smile, you’ll have to deal with some inconveniences while wearing braces like avoiding certain foods or habits or dealing with possible embarrassment about your new “metal smile.” But there’s one consequence of wearing braces that could dramatically affect your dental health: the difficulty they pose for keeping your teeth clean of dental plaque.

Dental plaque is a thin film of bacteria and food particles that if allowed to build up on tooth surfaces could trigger tooth decay or periodontal (gum) disease. Brushing and flossing thoroughly every day helps prevent this buildup.

Unfortunately, metal brackets and wires can get in the way and cause you to miss areas while performing these hygiene tasks. This could cause plaque buildup in those isolated areas that could trigger an infection. And if you (or someone you love) are also a teenager, the natural adolescent surge in hormones can increase your infection risk.

If while wearing braces you notice your gums are reddened, swollen or bleeding when you brush, these are all signs of infection and the body’s inflammatory response to it. The longer the infection continues, the weaker the tissues become, causing them to gradually detach from the teeth. Along with bone deterioration (another effect of the disease), this can ultimately lead to tooth loss.

To prevent this from happening, you’ll need to be as thorough as possible with daily brushing and flossing. To help make it easier, you can use special tools like an interproximal brush that can maneuver around the braces better than a regular brush. For flossing you can use a floss threader to more readily guide floss between teeth or a water flosser that uses a pressurized stream of water rather than floss thread to remove plaque.

This extra cleaning effort while wearing braces can greatly reduce your disease risk. But you’ll still need to keep an eye out for any symptoms like swollen or bleeding gums, and see your dentist as soon as possible. If the symptoms become severe you may need your braces removed until the disease can be brought under control. The health and future vitality of your teeth and gums is what’s of primary importance.

If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”

Periodontal (gum) disease is a progressive bacterial infection caused primarily by bacterial plaque on tooth surfaces not adequately removed by daily oral hygiene. In fact, nearly all of us will develop gingivitis (inflammation of the gum tissues) if we fail to clean our teeth and gums for an extended period of time.

Some people, however, have a greater susceptibility for developing gum disease because of other risk factors not related to hygiene. Patients with diabetes are at particular high risk for acute forms of gum disease.

Diabetes is a chronic condition in which the body can’t adequately regulate the bloodstream’s levels of glucose, the body’s primary energy source. Type 1 diabetes is caused by inadequate production in the pancreas of the hormone insulin, the body’s primary glucose regulator. In Type 2 diabetes the body develops a resistance to insulin’s effects on glucose, even if the insulin production is adequate. Type 1 patients require daily insulin injections to survive, while most Type 2 patients manage their condition with medications, dietary improvements, exercise and often insulin supplements.

Diabetes has a number of serious consequences, including a higher risk of heart disease and stroke. Its connection with gum disease, though, is related to how the disease alters the body’s response to infection and trauma by increasing the occurrence of inflammation. While inflammation is a beneficial response of the body’s immune system to fight infection, prolonged inflammation destroys tissues. A similar process occurs with gum disease, as chronic inflammation leads to tissue damage and ultimately tooth loss.

Researchers have found that patients with diabetes and gum disease may lessen the effects of inflammation related to each condition by properly managing both. If you’ve been diagnosed with either type of diabetes, proper dental care is especially important for you to reduce your risk of gum disease. In addition to effective daily brushing and flossing and a professional cleaning and checkup every six months (more frequent is generally better), you should also monitor your gum health very closely, paying particular attention to any occurrence of bleeding, redness or swelling of the gums.

If you encounter any of these signs you should contact us as soon as possible for an examination. And be sure to inform any dental professional that cares for your teeth you’re diabetic — this could affect their treatment approach.

If you would like more information on dental care for patients with diabetes, 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 “Diabetes & Periodontal Disease.”

It’s bad enough the diseases caused by poor dental hygiene or lack of dental checkups could be leaving your teeth and gums more at risk. But current scientific research seems to indicate those same dental diseases may also cause you problems in other parts of your body.

The connection is especially pronounced with periodontal (gum) disease, a family of disorders that can eventually lead to tooth loss. Gum disease is caused by plaque, a thin film of bacteria and food particles that builds up on tooth surfaces due to a lack of daily brushing and flossing. Even skipping one day of hygiene increases the level of oral bacteria that cause these infections.

As it spreads, the infection causes the gum tissues to become inflamed and ulcerated. The gums weaken to the point where they easily bleed even when mildly brushed. This allows access for bacteria and other toxins to enter the bloodstream where they may eventually affect other organ systems. We’re now finding that conditions as varied as cardiovascular disease, osteoporosis, diabetes or rheumatoid arthritis (which all share a common thread with inflammation) may be affected by gum disease — and vice-versa.

If you have any of these or similar conditions, it’s important for you to stay vigilant in maintaining healthy teeth and gums. It's necessary to brush and floss daily to remove plaque buildup as well as dental checkups at least twice a year. You should also keep a close eye out for early signs of gum disease, like bleeding, swollen or reddened gums. If so, call us for an appointment as soon as possible.

Keeping your teeth and gums disease-free and healthy could have a positive impact on your treatment for other health conditions. You’ll be doing your mouth and the rest of your health a favor.

If you would like more information on how periodontal (gum) disease affects the body, 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 “Good Oral Health Leads to Better Health Overall.”

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.