If you think periodontal (gum) disease is something that only happens to the other guy (or gal), you might want to reconsider. Roughly half of adults over age 30—and nearly three-quarters over 65—have had some form of gum disease.
Gum disease isn't some minor inconvenience: If not treated early, a gum infection could lead to bone and tooth loss. Because it's inflammatory in nature, it may also impact the rest of your health, making you more susceptible to diabetes, heart disease or stroke.
Gum disease mainly begins with dental plaque, a thin film of food particles on tooth surfaces. Plaque's most notable feature, though, is as a haven for oral bacteria that can infect the gums. These bacteria use plaque as a food source, which in turn fuels their multiplication. So, the greater the plaque buildup, the higher your risk for a gum infection.
The best way to lower that risk is to reduce the population of bacteria that cause gum disease. You can do this by keeping plaque from building up by brushing and flossing every day. It's important for this to be a daily habit—missing a few days of brushing and flossing is enough for an infection to occur.
You can further reduce your disease risk by having us clean your teeth regularly. Even if you're highly proficient with daily hygiene, it's still possible to miss some plaque deposits, which can calcify over time and turn into a hardened form called tartar (or calculus). Tartar is nearly impossible to remove with brushing and flossing, but can be with special dental tools and techniques.
Even with the most diligent care, there's still a minimal risk for gum disease, especially as you get older. So, always be on the lookout for red, swollen or bleeding gums. If you see anything abnormal like this, see us as soon as possible. The sooner we diagnose and begin treating a gum infection, the better your chances it won't ultimately harm your dental health.
If you would like more information on the prevention and treatment of 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 “How Gum Disease Gets Started.”
Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!
The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”
We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.
Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.
We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.
The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.
If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.
Dental patients have amazing options for tooth replacement. Dental implants, for example, can replace the entire tooth, root and crown, giving patients a new tooth nearly as good as the old one.
Nearly—but not exact. Even implants can't match the full benefits of a natural tooth, including one in less than perfect shape. Our first goal as dentists, then, is to save a diseased tooth if at all practical before considering replacing it.
That often involves a root canal treatment to address decay threatening a tooth's interior. The procedure requires drilling into the tooth to access its innermost pulp, cleaning out the pulp and root canals, and then filling the empty spaces. Since all dentists are trained in basic root canal treatment, your general dentist may be able to perform it.
But some dental situations call for more advanced endodontics, the dental specialty for treating disease and other problems inside a tooth. So, in what situations would you see an endodontist?
When your dentist refers you. Your dentist wants you to receive the level of treatment necessary to save your tooth. After examination, they may determine your situation would be better served by the advanced training, equipment and techniques (including surgery) of an endodontist.
When your tooth has complications. Patients often need an endodontist when existing factors complicate treatment of advanced tooth decay. A patient may have dental pain that's difficult to pinpoint, requiring the diagnostic resources of an endodontist. It's also common for a tooth's root canal network to be highly intricate, and which respond better to treatment with specialized endodontic tools and techniques.
When root canal treatment fails. Most root canal treatments are successful in protecting the tooth from further infection. That said, it's still possible for a root-canaled tooth to become re-infected or develop more problems. Again, an endodontist and their “tool chest“ re-treating a root-canaled tooth may be the best option for saving it.
You also don't have to wait for a referral—you can see an endodontist if you believe they would be best to treat your decayed tooth. You can find one near you by visiting an online endodontist directory at www.aae.org/find. An endodontist may be the lifesaver your diseased tooth needs.
Most dental problems are caused by tooth decay or periodontal (gum) disease, easily preventable with dedicated daily hygiene and regular dental care. But there are a few other rare conditions to be on alert for that could pose just as serious a threat to your dental health.
One of these is a phenomenon called root resorption. Put simply, certain cells arise within a tooth root that eat away and dissolve (resorb) tooth structure. Left unchecked, it could eventually lead to the tooth's demise.
Although its exact cause remains elusive, we suspect root resorption is associated with trauma to the gum ligaments earlier in life, perhaps from an injury or too much force applied during orthodontics. Other possible contributing factors include teeth-grinding habits or internal tooth bleaching procedures.
Root resorption in adults isn't that common, so your chances of experiencing it are low. But it is still possible, so you should be on the lookout for potential signs: Early on, it may appear as faint pink spots on teeth where the enamel has filled with the destructive cells eating away at the tooth. In time, these spots can increase to form cavities.
More than likely, though, your dentist may detect the problem during a dental exam. That's why regular dental cleanings and checkups are essential—a routine exam is a prime opportunity to uncover conditions like root resorption that silently undermine your teeth.
If found early, we can often treat root resorption effectively. We can often expose a small affected area with minor gum surgery, remove the harmful cells and fill any cavities with a tooth-colored filling. In some cases, we may recommend orthodontics beforehand to encourage a buildup of bone around the root by moving the affected tooth outward from the jawbone. If the resorption has affected the tooth pulp, you may also need a root canal treatment.
There is also the possibility with advanced resorption that the best course of action is to remove the tooth and replace it with a dental implant. So, keep up your regular dental visits—early detection and intervention can stop this destructive dental condition from destroying your tooth.
If you would like more information on root resorption, 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 “Root Resorption: An Unusual Phenomenon.”
The New Year: Time to put away those holiday decorations, collect tax records and—if you're a pro hockey player—get chummy with your dentist. That's right! After a disrupted 2020 season due to COVID-19, the NHL is on track to start again sometime in January. Before you know it, players will be hitting the biscuit (puck), while trying to avoid getting their chicklets (teeth) knocked out.
It's true that hockey has a roughhousing kind of reputation, which tends to lead to, among other things, chipped, fractured or knocked-out teeth. But to be fair, hockey isn't the only sport with a risk for orofacial injuries. It's not even top on the list: Of all contact sports, basketball has the highest incidence of mouth and facial trauma.
With over a half-million amateur and professional players, hockey still has its share of teeth, gum and jaw injuries. Fortunately, there's an effective way to reduce sports-related oral trauma—an athletic mouthguard.
Although there are different styles, most mouthguards are made of a soft plastic that helps cushion teeth against hard contact. You can sort most mouthguards into two categories: “boil and bite” and custom.
You can buy mouthguards in the first category online or in retail sporting goods stores, and they're relatively inexpensive. They're called “boil and bite” because they're first immersed in hot or boiling water to soften them. While the guard is still soft, the wearer places it in their mouth and bites down to create somewhat of an individual fit. On the downside, though, “boil and bite” mouthguards tend to be bulky with a fit that isn't as exact as it could be. This can make for uncomfortable wearing, which could tempt players not to wear them as often as they should. Also, because the materials are softer, they move with jaw movement and your teeth can move with them. Over time, teeth could loosen.
A custom-made mouthguard, on the other hand, is created by a dentist. We begin the process with a detailed mouth impression, which we then use to fashion the mouthguard. Custom mouthguards are more streamlined and fit better than their “boil and bite” counterparts. Because of this better fit, players may be more apt to wear them. They are more expensive, but compared to the cost of dental injury treatment, a custom mouthguard is a wise investment. For the best and most comfortable teeth, gum and mouth protection, you can't go wrong getting a custom mouthguard for the hockey players (as well as football and basketball players) in your family.
If you would like more information about athletic mouthguards, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards: One of the Most Important Parts of Any Uniform.”
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