Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.
Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.
Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.
A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.
The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.
The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.
We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.
The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.
A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.
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 “What are Furcations?”
This year's Carol Burnett Award, presented at the Golden Globes, goes to Ellen DeGeneres for her “outstanding contributions to the television medium on or off the screen.” This is the latest in a long list of honors for the comedienne, talk show host and activist that includes Emmys, Grammys and Teen Choice Awards. And one not quite as well-known: a 2004 “Flossy” award.
DeGeneres received this honor from the National Flossing Council in recognition of her passionate promotion of oral hygiene, particularly flossing. She wrote about its virtues in her 2003 book, The Funny Thing Is…., saying, among other things, “Don't even think for a second that you can get away with not flossing.”
DeGeneres's motivational cheerleading for flossing is helpful and necessary because, well, many of us just don't like doing it. It requires more manual dexterity than its more popular sibling, brushing. And the tendency for the floss to gunk up with plaque residue for some is simply unpleasant.
Mainly, though, many folks think brushing is enough. Not so fast, according to dental professionals. While brushing removes disease-causing bacterial plaque from broad tooth surfaces, it can't effectively get into the spaces between teeth. It takes flossing to clear plaque from these more difficult areas.
But don't fret: There are ways to make flossing an easier—and more pleasant—task.
Ask us for help. As we said before, flossing does take some hand dexterity and coordination to perform. You may also wonder if you're doing it effectively. We can provide training and tips on how to be a more effective flosser at your next visit.
Practice, practice, practice. You probably think nothing of riding a bicycle, and yet it probably took you weeks or months as a kid to become proficient. Similarly, your first attempts at flossing might feel awkward, but you'll improve with practice, so don't give up.
Brush before you floss. Most people floss before brushing, but if you tend to encounter a lot of soft plaque debris that makes flossing “icky” for you, then try brushing first to clear a good portion of it out of the way before you floss. Just be aware, most professionals believe that flossing first is better because it loosens up debris between teeth so the bubbles from the toothpaste can carry it away. But any flossing is better than no flossing!
Try flossing tools. For some people, floss picks, small pre-threaded tools you can use with one hand, seem easier to maneuver than regular floss thread. If you have issues with manual dexterity, an oral irrigator can make the task easier: This handheld device uses a stream of pressurized water to loosen and flush away plaque between teeth.
So, follow Ellen DeGeneres's advice she gave Tulane University graduates during a commencement speech: “Remember to exfoliate, moisturize, exercise…and floss.” The latter, along with brushing, will certainly help keep your teeth and gums healthy.
Keeping your teeth and gums healthy isn't always easy—and it's even more of a challenge if you're wearing orthodontic appliances like braces. That's why a fair percentage of patients wearing braces also contend with tooth decay or periodontal (gum) disease.
The reason is simple: The orthodontic hardware makes it difficult to fully reach all parts of teeth surfaces with your toothbrush or floss. As a result, you can miss removing some of the accumulated plaque, the thin film of bacteria and food particles most responsible for dental disease. And it only takes a short amount of time (just days with gum disease) for a bacterial infection to begin.
But while avoiding dental disease is difficult while wearing braces, it's not impossible. Here are 4 ways you can minimize your dental disease risk while undergoing orthodontic treatment.
Be diligent with your daily hygiene. Even though it's more difficult, don't slack on daily brushing and flossing. It does require more time to work the brush around and between the wires and brackets, but taking the time will help you clear away more plaque you might otherwise miss. It may also help to switch to a multi-tufted, microfine bristled toothbrush if you're not already using one.
Use a water irrigator. If straight thread flossing is proving too difficult (and even with a floss threader), try using a water irrigator. This device emits a pulsating spray of pressurized water that loosens and flushes away plaque between teeth. Clinical studies consistently show water flossing is effective for reducing plaque in orthodontic patients.
Lower your sugar intake. Sugar left over in the mouth is a prime food source for bacteria that cause tooth decay or gum disease. Reducing sugary foods and snacks can help reduce bacterial populations and lower your disease risk. You can also fortify your oral health with healthier foods that contain calcium and other minerals.
Keep up regular dental visits. In addition to your orthodontic adjustments, don't neglect your regular visits with your family dentist. Semi-annual cleanings help remove any plaque and calculus (calcified plaque) you may have missed. Your dentist can also monitor your health and boost your disease prevention through topical fluoride treatments or prescribed antibacterial mouth rinses.
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 “Caring for Teeth During Orthodontic Treatment.”
Entering your “sunset” years doesn't mean you're washed up—you still have a lot to offer the world. That's why the theme for this May's Older Americans Month (sponsored by the Administration for Community Living) is “Make Your Mark.” And to really make that difference, you'll have to maintain your health—including protecting your teeth from loss.
Once upon a time, it was considered the norm for older adults to experience tooth loss and the resulting consequences on their overall well-being. Today, though, not only can advanced restorations lessen the impact of lost teeth, it's also more likely that you can keep your teeth intact for the rest of your life.
To give your teeth their best chance for survival in your later years, here are 3 things you can do to promote their continuing health.
Brush and floss every day. Ridding your teeth of disease-causing plaque on a daily basis is important at any age, but perhaps even more so as you get older. However, hand weakness caused by arthritis or another health condition can make it more difficult to brush and floss. It may help to use a larger-handled toothbrush or an electric toothbrush, and a threading device may help with flossing. If manual flossing is still too difficult, you can try a water flosser that emits a water stream to loosen and flush plaque away.
Relieve chronic dry mouth. Older adults are more prone to chronic dry mouth because of increased use of medications, many of which interfere with saliva flow. It's more than an unpleasant feeling: Deprived of the protective properties of saliva, your mouth is at increased risk of dental disease. If dry mouth is a problem for you, speak with your doctor about alternatives to any saliva-inhibiting medications you're taking. Also, drink more water and use saliva boosters to promote better saliva flow.
Keep up dental visits. Regular dental visits become even more important as you age. Dental cleanings are especially necessary, particularly if you have dental work that can interfere with plaque removal during brushing and flossing. Disease monitoring and screening are more in-depth for older adults who are more prone to tooth decay, gum disease and oral cancer. And if you wear dentures, you should have them checked regularly for fit and overall condition.
If you've already enjoyed decades of dedicated dental care, you need only stay the course. But even if you haven't, adopting new dental care habits now can boost your teeth's health and longevity. To get started, make an appointment with us: We'll assess your current dental health and offer a care strategy for keeping your teeth healthy through the next exciting season of your life.
If you would like more information about dental care for older adults, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Understanding Aging Makes Beauty Timeless.”
A tooth with deep decay is in real peril. If the disease isn’t stopped, it can eventually infect the bone and greatly increase the risk of losing the tooth. But tooth decay removal and a root canal treatment can stop advancing decay and resulting infection in its tracks.
During this common procedure we first drill into the tooth to access the inner pulp. After removing the infected pulp tissue, we disinfect and fill the empty chamber and root canals with gutta percha. We then seal the tooth and crown it to protect against re-infection.
But while most root canals are successful and long-lasting, sometimes the tooth becomes re-infected. Here are 3 factors that could affect the long-term success of a root canal treatment.
Early treatment. Like many health problems, the sooner we detect decay and treat it, the better the outcome. A tooth in which the infection has already advanced beyond the pulp is at greater risk for re-infection than one in which the infection is localized in the pulp. Keeping up your regular dental visits as well as seeing the dentist at the first sign of abnormality—spots on the teeth or pain—can increase your chances of early diagnosis.
Tooth complications. Front teeth with their single roots and canals are much easier to access and treat than a back molar with an intricate root canal network. Root canals can also be extremely narrow making them easy to miss during treatment. In cases like this the expertise and advanced equipment of an endodontist (a specialist in root canal treatment) could help increase the odds of success in complex situations.
The aging process. Teeth do wear over time and become more brittle, making them increasingly susceptible to fracture. A previous root canal treatment on an aging tooth might also increase the fracture risk. To avoid this, it’s important for the tooth to receive a crown after the procedure to protect the tooth not only from re-infection but undue stress during chewing. In some situations, we may also need to place a post with a bonded composite buildup within the tooth to give it extra support.
Even if a tooth has these or similar complications, a root canal treatment may still be advisable. The benefits for preserving a decayed tooth often far outweigh the risks of re-infection.
If you would like more information on root canal treatments, 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 Canal Treatment.”
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