By Mario A. Vilardi, DMD
June 16, 2021
Category: Oral Health
Tags: gum disease  
GumDiseaseCanBeStoppedbutYouCouldBeinForaLongFight

It often begins without you realizing it—spreading ever deeper into the gums and damaging tissue attachments, teeth and supporting bone in its way. In the end, it could cause you to lose your teeth.

This is periodontal (gum) disease, a bacterial infection caused by dental plaque, a thin biofilm that accumulates on tooth surfaces. It in turn triggers chronic inflammation, which can cause the gum attachments to teeth to weaken. Detaching gum ligaments may then produce diseased voids—periodontal pockets—that can widen the gap between the teeth and the gums down to the roots.

There is one primary treatment objective for gum disease: uncover and remove any and all plaque and tartar (hardened plaque). If the infection has advanced no further than surface gum tissues, it may simply be a matter of removing plaque at or just below the gum line with hand instruments called scalers or ultrasonic equipment.

The disease, however, is often discovered in more advanced stages: The initial signs of swollen, reddened or bleeding gums might have been ignored or simply didn't appear. Even so, the objective of plaque and tartar removal remains the same, albeit the procedures may be more invasive.

For example, we may need to surgically access areas deep below the gum line. This involves a procedure called flap surgery, which creates an opening in the gum tissues resembling the flap of an envelope. Once the root or bone is exposed, we can then remove any plaque and/or tartar deposits and perform other actions to boost healing.

Antibiotics or other antibacterial substances might also be needed for stopping an infection in advanced stages. Some like the antibiotic tetracycline can be applied topically to the affected areas to directly stop inflammation and infection; others like mouthrinses with chlorhexidine might be used to fight bacteria for an extended period.

Although effective, treatment for advanced gum disease may need to continue indefinitely. The better approach is to focus on preventing a gum infection through daily brushing and flossing and regular dental cleanings. And at the first sign of problems with your teeth and gums, see us as soon as possible—the earlier in the disease progression that we can begin treatment, the better the outcome.

If you would like more information on preventing and 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 “Treating Difficult Areas of Periodontal Disease.”

SmileEnhancementsThatCouldMakeYourWeddingDayLikeNoOther

Each of life's moments are precious—but some are more precious than others. For one like your wedding day, you want to look your very best.

Be sure your teeth and gums are also ready for that once in a lifetime moment. Here are a few cosmetic enhancements that can transform your smile appearance.

Dental cleanings. Having your teeth cleaned professionally not only boosts your dental health, but it can also enhance your smile's brightness. A dental cleaning removes plaque and tartar that can yellow and dull teeth. With plaque out of the way, your teeth's natural translucence can shine through.

Teeth whitening. For an even brighter smile, consider teeth whitening. We apply a bleaching solution that temporarily whitens your teeth. With a little care on your part and occasional touchups, your brighter smile could last well beyond your wedding day.

Tooth repair. A chipped or cracked tooth can ruin an otherwise perfect smile. We can often repair mild flaws by bonding tooth-colored composite resins to the defective area, usually in one visit. Porcelain veneers or crowns can mask more moderate imperfections, but they must be undertaken well in advance of your big day.

Teeth replacements. We can restore those missing teeth ruining your smile with dental implants. An implant replaces the tooth root as well as the crown to create a stable and durable hold that can last for years. But similar to porcelain restorations, an implant restoration could take months—so plan ahead.

Orthodontics. Correcting a bite problem through orthodontics can have a huge impact on your smile. Straightening teeth isn't just for teenagers—you can undergo treatment at any age. And if you opt for clear aligners, no one but you and your orthodontist need know you're wearing them.

Cosmetic gum surgery. Even if your teeth look perfect, too much of your gums showing could detract from your smile. If your “gummy smile” is caused by excess gum tissue, there are a number of plastic surgical techniques that can restructure the gums so that they appear in right proportion with the teeth.

If you want a more attractive smile on your wedding day, see us as soon as possible for a full evaluation and assessment of your needs. Depending on what you need, we have the means to make your smile live up to that moment of moments.

If you would like more information on smile enhancements, 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 “Planning Your Wedding Day Smile.”

ThisOrthodonticDeviceCouldStopaPoorBiteFromDeveloping

“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.

A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.

The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.

Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.

For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.

As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.

These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.

If you would like more information on interceptive orthodontics, 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 “The Herbst Appliance.”

WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

4ReasonsDentalImplantsAreaWiseChoiceforToothReplacement

You've lost some teeth, and now you have to decide how to replace them. A fixed bridge or a partial denture are certainly good options. But the best choice today that dentistry has to offer is dental implants.

Implants have exploded in popularity among both dentists and patients, offering exceptional quality in life-likeness and durability. But they do have one drawback that might cause you to hesitate in choosing them: They're usually more expensive than other common tooth replacement systems, even more so if you're replacing each individual missing tooth with an implant.

But before you pass on them for something more affordable, take another look at dental implants. Here are 4 reasons why implants could be the wiser option for tooth replacement.

Life-like and functional. Other restorations can effectively mimic the appearance of real teeth, and they're reasonably functional. But implants score at the top in both categories because they replace more of the tooth—not just the crown, but the tooth root as well.

Bone friendly. Other restorations can't stop the gradual bone loss often caused by missing teeth, and dentures in particular can accelerate it. But implants are made of titanium, a bio-compatible metal that's also bone-friendly—bone cells readily grow and adhere to its surface. This accumulated growth around the implant site helps slow or stop bone loss.

Long-term savings. The integration of bone and implant creates a durable hold that can last for several years, possibly outlasting other restorations in the same situation. Taking into account all the costs—installation, maintenance and possible replacement—that can occur over the life of a restoration, implants could actually cost less in the long run.

Versatile. Implants can be used for more than single tooth replacements—they can be incorporated with other restorations like bridges or dentures to provide better support. Marrying implants with traditional tooth replacement systems can be less costly than implants individually while enhancing benefits like durability and bone strength.

Dental implants may not be right for everyone, particularly those who've experienced advanced bone loss. But if a thorough dental exam shows you're a good candidate, dental implants could be well worth the investment in your health and appearance.

If you would like more information on dental implant restorations, 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 “Dental Implants: Your Best Option for Replacing Teeth.”





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