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Posts for tag: gum disease

By Todd G. Yoshino DDS
February 08, 2019
Category: Oral Health
Tags: gum disease  
YourRegularDentalVisitsMightChangeifYouvehadGumDisease

Periodontal (gum) disease is as common as it is destructive. Almost half of all adults 30 and older have some form—and those numbers increase to nearly three-quarters by age 65.

Fortunately, we have effective ways to treat this bacterial infection, especially if we catch it early. By thoroughly removing all plaque, the disease-causing, bacterial biofilm that accumulates on tooth surfaces, we can stop the infection and help the gums return to normal.

Unfortunately, though, you're at a greater risk for a repeat infection if you've already had gum disease. To lower your chances of future occurrences, we'll need to take your regular dental exams and cleanings to another level.

Although everyone benefits from routine dental care, if you've had gum disease you may see these and other changes in your normal dental visits.

More frequent visits. For most people, the frequency norm between dental cleanings and exams is about six months. But we may recommend more visits for you as a former gum disease patient: depending on the advancement of your disease, we might see you every three months once you've completed your initial treatment, and if your treatment required a periodontist, we may alternate maintenance appointments every three months.

Other treatments and medications. To control any increases in disease-causing bacteria, dentists may prescribe on-going medications or anti-bacterial applications. If you're on medication, we'll use your regular dental visits to monitor how well they're doing and modify your prescriptions as needed.

Long-term planning. Both dentist and patient must keep an eye out for the ongoing threat of another gum infection. It's helpful then to develop a plan for maintaining periodontal health and then revisiting and updating that plan as necessary. It may also be beneficial to perform certain procedures on the teeth and gums to make it easier to keep them clean in the future.

While everyone should take their oral health seriously, there's even greater reason to increase your vigilance if you've already had gum disease. With a little extra care, you can greatly reduce your chances of another bout with this destructive and aggressive disease.

If you would like more information on preventing recurring 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 “Periodontal Cleanings.”

By Todd G. Yoshino DDS
September 11, 2018
Category: Oral Health
Tags: gum disease  
FAQsforNationalGumCareMonth

Gum disease is a bigger problem than you might think. More than half of all adults over age 30 have it, and that figure jumps to 70% of adults over 65. If left untreated, gum (periodontal) disease can eventually loosen teeth and cause them to fall out. It can also cause health issues outside of the mouth, including an increased risk of heart disease and other systemic health conditions.

But the good news is that gum disease can be treated—and even better, prevented! Since September is National Gum Care Month, it’s a good time to answer some frequently asked questions about gum disease:

What causes gum disease?
Gum disease is caused by certain types of harmful oral bacteria that live in a sticky film called dental plaque that collects on teeth both above and below the gum line. If this film is not cleaned effectively each day, it can eventually harden into a substance called tartar that can only be removed by a dental professional.  As your body tries to fight the bacteria and the toxins they produce, your gums can become inflamed and may start to pull away from the teeth. Eventually, bone beneath the gums can start to break down and with continued bone loss, the teeth could be lost.

How do I know if I have it?
Gum disease doesn’t always produce symptoms—especially in smokers. Smoking hides the symptoms of gum disease because nicotine reduces blood flow to the area. However, there are things you should look out for. Gingivitis, a mild form of gum disease, can produce red and/or puffy gums that bleed when you brush or floss. Signs of periodontitis, a more serious form of the disease, include gum recession, bad mouth odors or tastes, and tooth looseness. But the only way to truly know if you have gum disease is to come in for an exam.

What can I do about it?
If you have gingivitis, a professional teeth cleaning and a renewed commitment to oral hygiene at home—including daily flossing and rinsing with antibacterial mouthwash—may be all you need to turn the situation around. Periodontitis may require a variety of treatments, ranging from special cleaning procedures of the tooth root surfaces to gum surgery. The first step toward controlling gum disease is visiting the dental office for an exam.

How can I prevent it?
Regular professional teeth cleanings and meticulous oral hygiene at home are your best defenses against gum disease. Avoid sugary drinks and snacks—which feed the disease-causing bacteria in your mouth—and tobacco in all forms. If you have diabetes, do your best to manage it well because uncontrolled diabetes can worsen periodontal disease.

If you’d like more information on fighting gum disease, contact us or schedule a consultation.

By Todd G. Yoshino DDS
May 24, 2018
Category: Oral Health
Tags: gum disease  
TreatingGumAbscessesandtheUnderlyingGumDisease

If you have periodontal (gum) disease, you’ve no doubt experienced red and swollen gums. If, however, you notice an especially inflamed area next to a tooth, you may have developed a gum abscess.

An abscess is a pus-filled sac that develops as a result of chronic (long-standing) gum disease, an infection caused by bacterial plaque that’s built up on tooth surfaces from inadequate oral hygiene or from a foreign body (food debris) getting stuck below the gums. The abscess, which typically develops between the tooth and gums, may be accompanied by pain but not always (the affected tooth may also be tender to bite on). Abscesses may grow larger, precipitated by stress or by a general infection like a common cold, and then abate for a time.

As with other abscesses in the body, a gum abscess is treated by relieving the pressure (after numbing the area with local anesthesia) and allowing it to drain. This is often followed by cleaning any infected root surfaces of bacterial plaque and then irrigating the area with a saline and/or antibacterial solution. We may also prescribe antibiotics afterward and some form of pain control (usually a non-steroidal anti-inflammatory drug like ibuprofen) to help with discomfort.

Although the results of this procedure can be dramatic, it’s just the first step in treating the overall gum disease. After a few days of healing, we continue with a complete examination and recommend further treatment, usually starting with removing bacterial plaque and calculus (hardened plaque deposits), the underlying cause for the infection and inflammation, from all tooth and gum surfaces. This may take several sessions before we begin seeing the gum tissues return to a healthier state.

The key to preventing an abscess recurrence (or any symptom of gum disease) is to remove plaque everyday through proper brushing and flossing, and visiting us twice a year (or more if you’ve developed chronic gum disease) for cleanings and checkups. Doing so will raise your chances of avoiding an uncomfortable and often painful gum abscess in the future.

If you would like more information on gum abscesses, 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 “Periodontal (Gum) Abscesses.”

By Todd G. Yoshino DDS
March 15, 2018
Category: Oral Health
Tags: gum disease  
PeriodontalProbingIncreasesAccuracyinDiagnosingGumDisease

If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.

That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.

Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.

During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.

Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.

If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.

Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.

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 article “Understanding Periodontal Pockets.”

By Todd G. Yoshino DDS
October 07, 2017
Category: Dental Procedures
LasersPoisedtoTransformCurrentTreatmentforGumDisease

While lasers still seem like science fiction, they’ve been used commercially (and medically) for decades. But there’s still room for growth in practical applications with this developing technology. One promising area is in the treatment of periodontal (gum) disease.

Gum disease is a bacterial infection triggered by plaque, a thin film of bacteria and food particles caused by inadequate oral hygiene. The disease is highly destructive and can eventually lead to both tooth and bone loss. Treatment procedures vary widely, but they all have the same goal: remove the offending plaque and calculus (tartar) from tooth and gum surfaces. Without plaque the infection subsides and the gums can heal.

For decades now, dentists have removed plaque and calculus manually with special hand instruments or ultrasonic equipment. If the disease has advanced below the gum line or formed deep voids filled with infection called periodontal pockets, the dentist may also employ surgical techniques to access the infected areas.

While all these techniques have a long track record for effectiveness, they can cause the inadvertent destruction of healthy tissue, as well as create discomfort for some patients afterward. This is where a new protocol called Laser Assisted New Attachment Procedure (LANAP®) may be able to make a difference in the future.

With the LANAP® protocol, surgeons direct a laser beam of light through a fiber optic the width of three human hairs onto diseased tissue. The particular color of light interacts with the tissue, which contains the darkly-pigmented bacteria causing the disease, and “vaporizes” it. The beam, however, passes harmlessly through lighter-pigmented healthy tissue; as a result diseased tissue is eradicated with little to no harm to adjacent healthy tissue.

With these capabilities, trained dentists using LANAP® for gum disease treatment might be able to achieve conventional results with less tissue removal and bleeding, less discomfort for patients, and less tissue shrinkage than traditional procedures — and without scalpels or sutures. And some post-surgical studies have indicated LANAP® might also encourage gum tissue regeneration in the months following.

LANAP®, however, is still developing and requires further research. Thus far, though, the results have been encouraging. As laser technology advances, it’s quite possible tomorrow’s patient may experience less discomfort and more effective healing with their gum disease treatment.

If you would like more information on gum disease treatment, 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 “Treating Gum Disease with Lasers.”