Periodontal disease: what it is and how to avoid it

Periodontal disease is an infection of the tissues that support your teeth.

There is a very slight gap (called a sulcus) between the tooth and the gum.

Periodontal diseases attack this gap and cause a breakdown in the attachment of the tooth and its supporting tissues.

When the tissues are damaged, the sulcus develops into a pocket and, as the disease gets more severe, the pocket usually gets deeper.

The two major stages of periodontal disease are gingivitis and periodontitis.

Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to periodontitis, which is a more serious, destructive form of periodontal disease.

There are several factors that have been shown to increase the risk of developing periodontal disease:
– Systemic diseases such as diabetes
– Some types of medication
– Crooked teeth
– Bridges that no longer fit properly
– Fillings that have become defective
– Smoking
– Pregnancy

And there are a number of warning signs that can suggest a possible problem:
– Gums that bleed easily
– Red, swollen, tender gums
– Gums that have pulled away from the teeth
– Persistent bad breath or taste
– Permanent teeth that are loose or separating
– Any change in the way your teeth fit together when you bite
– Any change in the fit of partial dentures

However, its also possible to have periodontal disease with no warning signs.

Its therefore important to have regular dental checkups and periodontal examinations.

If you have developed periodontal disease, the treatment will depend on how far it has progressed.

You can take steps to prevent periodontal disease from becoming more serious or recurring.

Good dental hygiene practices such as brushing twice a day, cleaning between your teeth, eating a healthy diet and having regular visits to the dentist will make a huge difference.

The power of panoramic x-rays

X-rays are extremely valuable for helping dentists identify issues that may not show up on normal oral examination.

The three most common types of dental X-rays are the bitewing, periapical and panoramic X-rays.

Panoramic X-rays give a broad overview of the entire mouth – supplying information about the teeth, upper and lower jawbone, sinuses, and other hard and soft tissues of the head and neck.

Unlike other X-rays, where the film is placed inside the patient’s mouth, the panoramic film is contained in a machine that moves around the patient’s head. So they are very easy to use.

Panoramic X-rays are often used to check wisdom teeth but they will also reveal deep cavities and gum disease. They are also useful to help patients with past or present jaw problems or those who require full or partial removable dentures, dental implants, or braces.

They can also be valuable in assisting people who are suspected of having oral cancer or have had recent trauma to the face or teeth.

Panoramic X-rays play an important role in thorough dental examinations and are recommended at least every five years or so for most patients.

How older adults can handle dry mouth and taste problems

Reduced saliva flow that results in a dry mouth is a common problem among older adults.

It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Some of the common problems associated with dry mouth include:
– Constant sore throat
– Burning sensation
– Problems speaking
– Difficulty swallowing
– Hoarseness or dry nasal passages

Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form.

Your dentist can recommend various methods to restore moisture. For example, sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

Another issue that can affect older adults is a loss of appetite due to a change in your sense of taste. Besides an age-related decrease in the sense of taste and smell, certain diseases, medications and dentures can contribute to a decrease in your sense of taste.

Whether you are suffering from dry mouth or problems with your sense of taste, your dentist will be able to make suggestions to help.

Diagnosing jaw problems and pains – TMD and TMJ

More than fifteen percent of American adults suffer from chronic facial pain.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ’s.

The TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and gliding action when chewing and speaking.

Several muscles help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side.

Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Often, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear.

Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding.
They’ve been successful for many and your dentist can recommend which is best for you.

Taking care of removable partial dentures

If you have removable plastic dentures, it’s important to look after them carefully.

You should brush them each day to remove food deposits and plaque. This also helps prevent them from becoming permanently stained.

It’s best to use a brush that is designed for cleaning dentures as it has bristles arranged to fit the shape of the denture. But a regular, soft-bristled toothbrush is also acceptable.

Avoid using a brush with hard bristles as these can damage the denture.

When you are handling a denture, hold them carefully. Try standing over a folded towel or a sink of water with them in case you accidentally drop them.

It’s advisable to use a denture cleanser which has the American Dental Association seal of acceptance. However hand soap or mild dishwashing liquid are also acceptable for cleaning dentures.

Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures.

A denture can lose its proper shape if it is not kept moist. So it should be placed in soaking solution or water at night though one with metal attachments could be tarnished if placed in soaking solution.

As you age, your mouth naturally changes, which can affect the fit of the denture so, if they no longer fit properly, they should be adjusted by your dentist.

See your dentist promptly if your denture becomes loose as this can cause sores or infections.

Don’t try to adjust or repair your denture yourself as this can damage the appliance beyond repair.

When you wear a partial denture, you need to continue brushing twice a day and cleaning between your teeth daily. This will help prevent tooth decay and gum disease.

Pay special attention to cleaning the teeth that fit under the denture’s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Your dentist or dental hygienist can demonstrate how to properly brush and clean between teeth.

Regular dental check-ups and having your teeth professionally cleaned are vital for maintaining a healthy smile.

Making the most of your smile

Your smile is a major factor in the impression people get when they meet you.

And the good news is that you now don’t have to settle for a smile spoiled by stained, chipped, or misshapen teeth.

Advances in dental treatment mean there is a wide range of choices to help you get the smile that you want. Here are some of the options:
– Tooth whitening (bleaching) can help brighten teeth that have become discolored or stained. It can be done in the dental office or with a system the dentist can give you to use at home
– Bonding improves the appearance of teeth that have become chipped, broken, cracked or stained. This is done by bonding tooth-colored materials to the tooth surface
– Enamel shaping involves modifying teeth to improve their appearance by removing or contouring enamel
– Veneers are thin custom-made shells of tooth-colored materials designed to cover the front side of teeth. They are used to treat spaces between teeth and teeth that are chipped, stained or poorly shaped.
– Braces may be needed if teeth are crooked, crowded or do not meet properly – and not just for kids

Even small changes can have a big impact on your smile and so make a huge difference to how you look and how you feel about yourself.

If you’d like an even better smile, your dentist will be able to give you information about the options available.

You might have gum disease without even knowing it

Gum disease – also known as periodontal disease – is an infection of the tissues surrounding and supporting the teeth and it’s a major cause of tooth loss in adults.

But it’s usually painless so you may not even know you have it.

It’s caused by plaque – a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

The early stage of gum disease is called gingivitis. In this stage, the gums can become red, swollen and bleed easily. At this stage, you can usually still reverse the disease by daily brushing and flossing.

The more advanced stage of gum disease is known as periodontitis. At this stage, the gums and bone that support the teeth can become seriously damaged. The teeth may then become loose, fall out or have to be removed by a dentist.

It’s therefore very important to look out for any signs of gum disease. These signs include:

– Gums that bleed when you brush your teeth
– Red, swollen or tender gums
– Gums that have pulled away from the teeth
– Bad breath that doesn’t go away
– Pus between your teeth and gums
– Loose teeth
– Change in the way your teeth fit together when you bite
– Change in the fit of partial dentures

If you notice any of these signs, contact you dentist quickly and they’ll help you take action to make improvements.

How dental implants can give you a better smile

If you have missing teeth, you don’t just have to rely on crowns, conventional bridges and dentures.

Many people are now choosing dental implants as the best way to restore their smile and solve dental problems.

Implants are placed below the gums during a series of appointments. They fuse to the jawbone and provide a base for individual replacement teeth, bridges or a denture.

As they are fused to the bone, they offer greater stability. And, because they are integrated into your jaw, your replacement teeth will feel more natural.

This secure fit often also makes them more comfortable than other solutions.

In order to have implants, you need to have healthy gums and adequate bone to support the implant.

To find out whether you could be a candidate for dental implants, talk to your dentist about what they could do for you.

What to do if you have problems with your dentist

Choosing the right dentist for your needs is an important part of giving yourself the best oral health possible.

Sometimes you may find that things are not working out for the best and it’s important to take steps to resolve any problems rather than just put off your dental care.

First, talk to your dentist about any concerns. They will probably be able to accommodate your needs if you tell them what you are looking for.

In some situations, you may feel that you want to look around at alternative options – maybe there are other dentists who meet your needs better, taking into account factors such as location, office hours, fees and emergency arrangements.

If you are comparing fees, ask for estimates on full-mouth x-rays and a preventive dental visit that includes an oral exam and tooth cleaning.

If you have any doubts about treatment your dentist has recommended, it may be a good idea to set your mind at rest by getting a second opinion from another dentist.

However, even in the best dentist-patient relationship, problems can sometimes occur. If your dentist is not able to resolve your concerns, you can contact your state or local dental association.

They have established systems of peer review that provide an impartial and easy way to resolving misunderstandings regarding the appropriateness or quality of care.

If you are not completely satisfied with the dental treatment you are getting, it’s important to take steps to put it right – whether you sort it out with your own dentist or find another one.

Crowns and how they improve your teeth

To make sure you have the best smile possible, you may need a crown to cover a tooth and restore it to its normal shape and size.

A crown is a tooth-shaped “cap” that is placed over a tooth to restore its shape, size and strength, or to improve its appearance.

The reasons you may need a crown include:

– Protecting a weak tooth
– Holding together parts of a cracked tooth
– Restoring an already broken tooth
– Supporting a tooth with a large filling when there isn’t a lot of tooth left
– Attaching a dental bridge
– Covering badly-shaped or severely discolored teeth
– Cover a dental implant

If your dentist recommends a crown, it’s probably to correct one of these conditions.

Your dentist’s primary concern, like yours, is helping you keep your teeth healthy and your smile bright.

How to make visiting the dentist easy for kids

Your child should have their first trip to the dentist by the time they are 18 months old and it’s good to make the process as easy as possible for them from the start.

Dental staff are used to dealing with young children and they will know how to make them feel comfortable.

Sometimes, children under three may be treated on the parent’s lap. In this case, the parent sits in the dental chair facing the dentist, and the child is on their lap.

The dentist will tell the child what he or she is going to do in terms they can understand. They will usually have fun dental toys they can use to help.

They will start with an oral examination checking the teeth present and looking at the development of the jaw, gums and soft tissues.

Naturally, as in any new situation, some children are initially unsettled but this is usually short-lived as they get used to it.

Parents can help by ensuring they are calm and relaxed as any anxiety will transfer to the child.

With older children, the parents may stay in the background though sometimes children behave better when the parent is not in the room!

Work with your children and your dentist to find the best way of ensuring they get the treatment they need with minimum worries for everyone.

How cosmetic dentistry can change your smile – and your life

Modern cosmetic dentistry has created many opportunities that did not exist before for people to improve their appearance and change the way they feel about themselves.

Although cosmetic dentistry really did not exist a few yaears ago, it now attracts interest from a wide range of people.

There are few people who don’t want to improve their appearance by making their teeth straighter and whiter so that they look better when they smile.

New technology and procedures have created many more opportunities for dentists to help patients look better.

One of the most important opportunities for doing this is porcelain veneers.

These are custom-made wafers that the dentist places over the front of the teeth to repair damage and make them look better.

They can overcome many cosmetic dental problems such as whitening stained or discolored teeth, closing gaps between teeth or correcting a crooked smile without the need for braces.

They can also cover up chips and imperfections so that the smile looks much better.

Another important cosmetic trend is the increased use of white fillings.

White fillings now are more lifelike than ever and they last longer than previously.

They have become the material of choice for many dentists as they blend in with teeth and look better.

If you feel your smile is less than perfect, talk to your dentist about how it could be better.

Solving the problem of bad breath

Bad breath – which is also known as halitosis – is a worrying problem that can also be embarrassing.

But there’s no need to put up with it. If you suffer from bad breath, your dentist will be able to suggest a range of solutions.

Your dentist will be able to spot problems such as gum disease, dry mouth or other disorders. That’s why it’s important to maintain good oral hygiene, schedule regular visits to the dentist and have professional cleaning.

Make sure you brush your teeth twice a day and clean between your teeth each day using floss or interdental cleaners. Don’t forget to brush your tongue, too!

If your dental check up shows that your mouth is healthy, your dentist may refer you to your family physician as sometimes bad breath can be a sign of other health problems.

If the odor is due to periodontal (gum) disease, sometimes professional periodontal cleaning is needed to remove the bacteria and plaque that accumulate. And your dentist may recommend a special antimicrobial mouth rinse.

Keeping your mouth healthy and stopping periodontal disease are essential to reducing bad breath.

So make sure you schedule regular dental visits for a professional cleaning and checkup.

How sedation and general anesthesia can make your visit to the dentist easier

While local anesthetics are often used in dental treatment, there is sometimes a need for anti-anxiety agents – such as nitrous oxide – or sedatives to help people relax during dental visits.

Dentists may use these agents to induce “minimal or moderate sedation”.

In this case, the patient reaches a relaxed state during treatment but can respond to speech or touch.

Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.

More complex treatments may require drugs that can induce “deep sedation”.

This reduces consciousness and causes a loss of feeling which helps to reduce both pain and anxiety.

Sometimes patients undergo “general anesthesia” where the drugs lead to a temporary loss of consciousness.

A dentist may recommend deep sedation or general anesthesia for certain procedures with children or with adults who have severe anxiety or for people who have difficulty controlling their movements.

While these techniques to control pain and anxiety are used to treat tens of millions of patients safely every year, it’s important that you let your dentist know anything that might affect your ability to benefit from them for example, tell them about any illnesses or health conditions, whether you are taking any medications and if you’ve had any problems with allergic reactions to medications.

Is bottled or tap water better for your teeth?

With many people concerned about the taste and purity of tap water, the sales of bottled water have increased significantly in recent years.

Tap water goes through a process of purification designed to eliminate suspended materials, remove tastes and odors and kill microorganisms.

Fluoride is added to most tap water supplies with the aim of reducing cavities.

Fluoride becomes incorporated into our teeth as they develop and makes them more resistant to decay. It can reverse the progress of early cavities and reduce the need for dental treatment.

Mass water fluoridation has played an important role in reducing tooth decay.

The problem with bottled waters is that they usually don’t contain fluoride.

So there is a risk that drinking bottled water can increase the risk of cavities for some people.

If you drink a lot of bottled water, you can make up for this by using fluoride toothpaste and mouth rinse.

Your dentist may even suggest a fluoride supplement if they notice an increase in cavities.

The early years of dentistry and teeth

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes “tooth worms” as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first “dentist”, dies. An inscription on his tomb includes the title “the greatest of those who deal with teeth, and of physicians.”

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of “silver paste,” a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade sharp knives and razors were useful for surgery. Following the edicts, barbers assume the monks’ surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

Taking care of removable partial dentures

If you have removable plastic dentures, it’s important to look after them carefully.

You should brush them each day to remove food deposits and plaque. This also helps prevent them from becoming permanently stained.

It’s best to use a brush that is designed for cleaning dentures as it has bristles arranged to fit the shape of the denture. But a regular, soft-bristled toothbrush is also acceptable.

Avoid using a brush with hard bristles as these can damage the denture.

When you are handling a denture, hold them carefully. Try standing over a folded towel or a sink of water with them in case you accidentally drop them.

It’s advisable to use a denture cleanser which has the American Dental Association seal of acceptance. However hand soap or mild dishwashing liquid are also acceptable for cleaning dentures.

Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures.

A denture can lose its proper shape if it is not kept moist. So it should be placed in soaking solution or water at night though one with metal attachments could be tarnished if placed in soaking solution.

As you age, your mouth naturally changes, which can affect the fit of the denture so, if they no longer fit properly, they should be adjusted by your dentist.

See your dentist promptly if your denture becomes loose as this can cause sores or infections.

Don’t try to adjust or repair your denture yourself as this can damage the appliance beyond repair.

When you wear a partial denture, you need to continue brushing twice a day and cleaning between your teeth daily. This will help prevent tooth decay and gum disease.

Pay special attention to cleaning the teeth that fit under the denture’s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Your dentist or dental hygienist can demonstrate how to properly brush and clean between teeth.

Regular dental check-ups and having your teeth professionally cleaned are vital for maintaining a healthy smile.

The power of panoramic x-rays

X-rays are extremely valuable for helping dentists identify issues that may not show up on normal oral examination.

The three most common types of dental X-rays are the bitewing, periapical and panoramic X-rays.

Panoramic X-rays give a broad overview of the entire mouth – supplying information about the teeth, upper and lower jawbone, sinuses, and other hard and soft tissues of the head and neck.

Unlike other X-rays, where the film is placed inside the patient’s mouth, the panoramic film is contained in a machine that moves around the patient’s head. So they are very easy to use.

Panoramic X-rays are often used to check wisdom teeth but they will also reveal deep cavities and gum disease. They are also useful to help patients with past or present jaw problems or those who require full or partial removable dentures, dental implants, or braces.

They can also be valuable in assisting people who are suspected of having oral cancer or have had recent trauma to the face or teeth.

Panoramic X-rays play an important role in thorough dental examinations and are recommended at least every five years or so for most patients.

Choosing the right toothbrush for your needs

It would be easy to get overwhelmed by the huge range of dental care products now available.

Even looking just at toothbrushes present a wide range of choices.

There are hundreds of manual and powered toothbrushes to choose from.

Start by looking for products that carry the American Dental Association Seal of Acceptance – this is an important symbol of a the product’s safety and effectiveness.

When you buy a toothbrush, replace it every three to four months. Replace it sooner if the bristles become frayed as a worn toothbrush will not clean your teeth properly.

Make it easy for your children to brush their teeth by choosing a child-sized toothbrush and make it more interesting for them by selecting fun colors and designs.

Often people who have difficulties with hand, arm or shoulder movements find that powered toothbrushes are the best choice. However, it’s also possible to make a few small changes to modify a manual toothbrush and make it easier to use.

For example, you can:

– Enlarge the handle with a sponge, rubber ball, or bicycle handle grip
– Lengthen the handle with a piece of wood or plastic
– Bend the handle slightly while running it under hot water

Your dentist will give you tips on what toothbrushes would be right for your needs.

Common mouth sores: causes and cures

Mouth sores can be very annoying and painful and can have many causes.

The causes can range from infections – bacterial, viral or fungal – to a loose orthodontic wire or a denture that doesn’t fit or a sharp edge from a broken tooth or filling.

But mouth sores may be symptoms of an underlying disease or problem.

So, if you’ve had any mouth sore that lasts a week or longer, it’s a good idea to get your dentist to check it out.

Here are some of the most common mouth sores:

Canker sores: These are small ulcers with a white or gray base and a red border. They appear inside the mouth and are not contagious though they often return. Problems such as poor immune systems, viruses or fatigue and stress may be involved. They usually heal on their own after a week or two.

Cold sores: Cold sores are annoying and painful. They are also known as fever blisters or Herpes simplex and are groups of fluid-filled blisters. They often erupt around the lips and sometimes under the nose or around the chin. Cold sores caused by herpes virus type 1 are very contagious and the virus stays in the body. Cold sore blisters usually heal in a week by themselves.

Candidiasis: This fungal infection (also called moniliasis or oral thrush) occurs when the yeast Candida albicans reproduce in large numbers. It is common among denture wearers and people who have dry mouth syndrome are very susceptible to it. The focus is on preventing it or controlling the conditions that caused the outbreak.

Any mouth sores that last more than a few days should be checked with your dentist.