Over the years, dentists have become quite proficient in treating even the most severe periodontal (gum) disease. Many of these positive outcomes are achieved through manual effort using simple hand instruments called scalars and conventional periodontal surgery.
But that might be changing soon: Periodontists (specialists who care for the gums and other supporting dental structures) are starting to use a different kind of tool for gum disease treatment—surgical lasers.
Although lasers are more commonplace in other fields of medicine, recent developments hint at a more prominent future role for them in dentistry. One of these developments is a laser procedure called Laser Assisted New Attachment Procedure (LANAP®) that treats deep spaces of infection called periodontal pockets, which develop advanced gum disease.
These pockets form as infected gums gradually detach from a tooth as the supporting bone is lost. This widens the normally narrow gap between the teeth and gums. The ensuing pocket fills with infection that must be removed to adequately treat the gum disease. As the pocket extends down to the root, it's often necessary to perform a surgical procedure through the adjacent gum tissue to fully access it.
But with the LANAP® procedure, the dentist can use a laser to access a deep pocket without opening the gums. Moving from above into the gap between the tooth and gums, the light from the laser has the ability to remove diseased tissue without damaging healthy tissue.
The dentist follows this with ultrasonic equipment and manual scalers to further decontaminate the tooth root surface. The laser is then employed once again to facilitate the formation of a blood clot between the teeth and gums to seal the area with a fibrin clot. Once treated, the dentist will monitor the tooth to ensure maximum bone regeneration and gum reattachment.
Although outcomes are the same for the most part, this laser technique for periodontal pockets may have some advantages over conventional surgery. Studies so far show that LANAP® causes less tissue removal and bleeding, less potential for gum recession and less discomfort experienced by patients.
It's not likely that lasers will fully replace conventional gum disease treatments any time soon. But if the encouraging evidence thus far continues, the laser will one day become as commonplace alongside the other tools used for gum disease treatment.
If you would like more information on treatments for 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 Gum Disease With Lasers.”
Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.
Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).
Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.
So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.
There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.
And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.
Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.
If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.
While anyone can lose a permanent tooth, the cause often varies by age group. Adults usually lose their teeth to disease, while those under twenty lose a tooth to accidents.
For adults, a dental implant is usually the best way to replace a missing tooth. Teenagers and younger, on the other hand, must wait to get implants until their jaws fully develop. An implant placed on an immature jaw will eventually look and feel out of place.
For most, their jaws won't reach full maturity until their early twenties. Even so, they still have a couple of good options for restoring their smiles in the meantime, albeit temporarily.
One is a removable partial denture or RPD, a device with the replacement prosthetic (false) tooth or teeth set in a gum-colored acrylic base. Of the various types of RPDs, most teenagers do well with a rigid but lightweight version called a “flipper,” called so because it can be flipped in and out of place with the tongue.
These RPDs are affordable, their fit easily adjusted, and they make cleaning the rest of the teeth easier. But they can break while biting down hard and—because they're dentures—aren't always well accepted among teenagers.
The other option is a bonded bridge. Unlike a traditional bridge secured with crowns cemented to natural teeth, a bonded bridge uses a strip of dental material affixed to the back of the prosthetic tooth with the ends of the strip extending outward horizontally. With the prosthetic tooth inserted into the empty space, these extended ends are bonded to the backs of the natural teeth on either side.
Though not as secure as a traditional bridge, a bonded bridge is more aesthetic and comfortable than an RPG. On the other hand, patients who have a deep bite or a teeth-grinding habit, both of which can generate abnormally high biting forces, run a higher risk of damaging the bridge. A bridge can also make hygiene tasks difficult and time-consuming, requiring a high degree of self-discipline from the patient.
Whichever you choose, both options can effectively replace a teenager's missing tooth while waiting for dental implants. Although temporary, they can make the long wait time for a teenager more bearable.
A New Year's resolution can be just about anything, from losing weight to visiting every major league baseball park. But a resolution you're more likely to keep ought to have two things going for it: It's doable and it changes your life for the better. Here's one that meets those criteria—taking better care of your smile. So we hope that made your 2021 list.
Resolving to pursue more committed dental care can have a double benefit. It can improve your dental health and it could help you gain a more attractive smile. What's more, it's not hard to do—it takes only about five minutes of your time each day, along with a couple of dental visits a year.
Here's how you can make better smile care in 2021 one of your best New Year's resolutions ever.
Brush and floss daily. Your mouth's biggest enemy is dental plaque, a thin film of bacteria and food particles on tooth surfaces. The bacteria in plaque can cause both tooth decay and gum disease. But by removing accumulated plaque with brushing and flossing, you can drastically reduce your risk for dental disease. The key is to do it every day without fail—no holidays!
Have your teeth cleaned. Even if you're an oral hygiene ninja, you can still miss some plaque, which may then harden into calculus (or tartar). This calcified form (which is just as harmful as softer plaque) is nearly impossible to remove by brushing or flossing. But we can at the dental office—which is why having your teeth professionally cleaned every six months makes it even less likely you'll encounter dental disease.
Give your teeth a better diet. If you're also resolving to eat more nutritiously, here's an extra incentive: Your diet can impact your dental health. On one hand, diets high in certain carbohydrates (particularly sugar) increase your risk for disease. On the other hand, a balanced diet of fresh fruits and vegetables, whole grains, and dairy products can strengthen your teeth and help them stay healthy.
Update your dental work. You may have fillings, crowns or bridges that fixed a dental problem in the past but may have since fallen into disrepair. If so, now is the time to update them—and putting it off could increase your risk for disease or other serious dental problems. Taking care of needed renovations to older dental work promotes better oral health, and may also improve your smile.
Want to start the New Year off right in regard to your teeth and gums? See us for a complete checkup and evaluation of your dental health. Together, we can develop just the right care plan to help you achieve your resolution of a healthier mouth and a more attractive smile.
Each year, millions of children and teenagers wear braces or clear aligners to straighten a crooked smile. But there may be a way to treat some of these bite problems and avoid braces—by intercepting the problem at an earlier age.
This can often be done if the bite problem stems from abnormal jaw development rather than misaligned teeth. An example of this occurs when the upper jaw growth outpaces the lower jaw, causing the upper teeth to protrude beyond the lower teeth. Aside from the effect on appearance, protruding front upper teeth may extend beyond the protection of the lip and be more prone to injury.
A device called a Herbst appliance could prevent this from happening. The top of the device has two hinged metal tubes that connect to elastic bands bonded to the back teeth on both sides of the upper jaw. The bottom also has tubes affixed in the same way to the bottom teeth, except they're slightly smaller and fit within the upper tubes.
The lower tubes sliding within the upper tubes produces slight pressure against the lower jaw to ease it forward. This gradually influences the lower jaw to grow at a pace equal with the upper jaw to decrease the chances of poor bite development. Unlike other corrective methods, the Herbst appliance fixed in place and out of the way won't interfere with sports or other physical activities.
An installed Herbst appliance may change a patient's sensations during swallowing, eating or speaking, but most children adapt to the changes within a few days. And, because the device can create challenges for keeping the back teeth clean, many dentists recommend adding a fluoride rinse to daily brushing and flossing as an added boost against tooth decay.
The Herbst appliance is most effective during the period of most rapid physical growth between the ages of 11 and 14, but if the teeth are already beginning to protrude it can be undertaken as early as 8 or 9. Either way, this important orthodontic tool could help address a complicated bite problem and reduce the need for more costly orthodontic treatment later on.
If you would like more information on early interventions for poor bites, 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.”
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