Surgical treatment for periodontal (gum) disease can go a long way toward restoring your mouth to good health; however, it does not change your susceptibility to the disease. That’s why we recommend that you come in regularly for periodontal cleanings after your treatment. Here are some frequently asked questions about keeping your mouth healthy after gum disease treatment.
How often do I have to come in for periodontal cleanings?
There’s no “one-size-fits-all” answer to that question: It really depends on your individual situation. For example, some individuals may have a more aggressive form of periodontal disease that requires more frequent periodontal maintenance (PM) treatments to maintain control. Others may have greater success controlling the buildup of disease-causing plaque with at-home oral hygiene measures, and therefore need PM less often. However, for people with a history of periodontal disease, getting PM treatments at a three-month interval may be a good starting point.
What happens at a periodontal maintenance appointment?
A thorough cleaning of the crown and root surfaces of the teeth, aimed at removing sticky plaque and hardened dental calculus (tartar), is a big part of PM treatments — but there’s much more. You’ll also receive a thorough clinical examination (including oral cancer screening), a review of your medical history, and x-rays or other diagnostic tests if needed. The status of any ongoing periodontal disease will be carefully monitored, as will your success at maintaining good oral hygiene. Decisions about further treatment will be based on the results of this examination.
What else can I do to keep gum disease at bay?
Keeping your oral hygiene in top-notch condition — which includes effective brushing and flossing every day — can go a long way toward controlling gum disease.Â In addition, you can reduce risk factors by quitting tobacco use and eating a more balanced diet. And since inflammatory conditions like diabetes, arthritis and cardiovascular disease can make periodontal disease worse (and vice versa), keeping these conditions under control will greatly benefit both your oral health and your overall health.
If your tooth sustains damage that compromises its structure — typically through decay or trauma — you have several options depending on the extent of the damage: One of them is a crown. This method saves the tooth and its root and completely conceals the visible portion of the tooth, or crown, under a natural-looking cap made to mimic as closely as possible the size, shape and color of the original tooth.
Crowns also hide imperfections in the original tooth like discoloration, chipping, fractures, excessive wear (from bruxism, or tooth grinding, for example), or abnormalities in the way the tooth formed. And they’re used following root canal treatments, which treat infected pulp at the center (canal) of a tooth root by removing the pulp and replacing it with an inert, rubber-like material.
Saving the natural tooth has long been the goal of dentistry because normal micromovements of the tooth root, which is suspended in its jawbone socket by elastic ligaments, stimulate the surrounding bone to rejuvenate. Without that stimulation, the bone continues to lose old cells, but no longer replaces them. Crowns are also designed to restore tooth function.
The function and location of the damaged tooth can determine what material the crown will be made of. If the damaged tooth is clearly visible when you smile, porcelain, the most realistic-looking material, is almost always used. If the tooth receives significant bite force, a stronger material is considered — either, a gold/porcelain combination, or a high-strength ceramic. If you are restoring a second molar, an all-gold crown may be considered.
With the advent of dental implants, saving a damaged tooth is no longer the only option for preserving the health of the bone surrounding the tooth root. The implant — a tiny biocompatible, titanium screw-like artificial root — is placed in the jawbone and is then capped with a natural-looking crown of course!
If you would like more information about dental crowns, 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 “Crowns & Bridgework.”
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”
Daily fatigue or complaints of your snoring from family have led you to see your doctor about the problem. After an exam and a test session in a sleep lab, your problem now has a name — obstructive sleep apnea.
This common sleep-related breathing disorder (SRBD) occurs when the soft tissues in the back of the throat over-relax during sleep. The relaxed tissues obstruct air flow to the trachea (windpipe) and cause “apnea,” where you cease to breathe. The lack of oxygen causes you to wake, even for a micro-second, to begin breathing again. This may occur multiple times throughout the night, diminishing the quality of your sleep and leading not only to drowsiness and daily fatigue but also contribute to cardiovascular disease or other systemic conditions.
The most effective treatment for sleep apnea is the use of a Continuous Positive Airway Pressure (CPAP) machine while you sleep. The machine delivers pressurized air to a face mask you wear while you sleep; the additional pressure keeps the airway open. However, a CPAP machine does have a few disadvantages, including discomfort while attached to the machine, nasal congestion and dryness, or claustrophobia. These effects can be so pronounced for some patients, they’re unable to adjust themselves to the machine.
If you have mild to moderate sleep apnea, there may be an alternative — a custom-fitted oral appliance we manufacture for you to wear in your mouth while you sleep. The appliance pulls the lower jaw forward resulting in a wider opening of the airway. In addition to being less cumbersome than a CPAP mask, an oral appliance is easier to wear, compact in size for easy travel and doesn’t require electricity.
While an oral appliance is an effective alternative to a CPAP machine for many patients, it does have a few disadvantages including problems with saliva flow (too much or too little), muscle or teeth soreness and minor tooth or jaw movement. Still, an oral appliance might be the right solution to relieve your sleep apnea over the long-term.
If you would like more information on treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Sleep Apnea FAQs.”
Dental implants are considered today’s premier method for restoring missing teeth. Obtaining an implant, though, is often a long process and the implants themselves must be surgically placed within the jaw bone. Nothing to worry about, though: implant surgery is a minor to moderate procedure akin to a surgical tooth extraction.
Still like any surgery, this procedure does involve cutting into the soft tissues of the gums and could allow oral bacteria to enter the bloodstream. While most bacteria in the mouth are harmless (and even beneficial) a few strains can cause disease. For some people, especially those with certain heart conditions or joint replacements, this could potentially cause serious issues in other parts of their body that might be highly susceptible to infection.
To guard against this, it’s been a long-standing practice in dentistry to prescribe antibiotics to certain high risk patients before a procedure. Although this departs from the normal use of antibiotics for already occurring infections, due to the circumstances this has been deemed an acceptable measure to prevent disease.
In the past, the categories of patients for which preventive antibiotics were appropriate had been more extensive. In recent years, though, both the American Dental Association and the American Heart Association have adjusted their recommendations. Today, your dental provider may recommend antibiotic pre-treatment if you have a prosthetic (artificial) heart valve, a history of infective endocarditis (inflammation of the inner linings of the heart), a heart transplant or certain congenital heart conditions.
While physicians may still recommend premedication with antibiotics for patients with joint replacements, it’s not as blanket a standard as it might once have been. It’s now only recommended for certain cases, such as patients who’ve received a prosthetic joint within the last two years.
There’s still an ongoing debate about the effectiveness of antibiotic pre-medication. However, there’s evidence medicating before procedures with antibiotics can be beneficial in avoiding infection. If you fall into one of the categories just mentioned or are concerned about infection, feel free to discuss with your dentist if using antibiotics before your implant surgery is wise move for you.
If you would like more information on antibiotic treatment before oral surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”
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