Posts for category: Oral Health

By Suzanne Boyle DMD
February 17, 2019
Category: Oral Health
Tags: gum disease  
StopGumDiseaseBeforeitHarmsYourHealth

If you're over 30 your chances for developing periodontal (gum) disease are better than half. And it's not a minor matter—untreated gum disease can lead not only to tooth loss, but to an increased risk of cardiovascular disease and other inflammatory conditions.

Fortunately, we have effective ways to treat gum disease, even in advanced stages. But the best approach by far in avoiding a devastating outcome for your teeth is to prevent gum disease from developing in the first place.

It helps first to know how gum disease begins. The most common cause is dental plaque, a thin biofilm of food particles on tooth surfaces that harbors the bacteria that triggers the disease. If you keep your teeth clean of built-up plaque and tartar (calcified plaque) with daily brushing and flossing and regular dental cleanings, you'll minimize the growth of disease-causing bacteria.

If you don't practice effective oral hygiene, however, within a few days you could develop an initial infection called gingivitis. This form affects the outermost layers of the gums and triggers a defensive response from the body known as inflammation. Ordinarily, inflammation helps protect surrounding tissues from infection spread, but it can damage your gums if it becomes chronic. Your weakened gums may begin to detach from the teeth, forming voids filled with inflammation known as periodontal pockets. Eventually, the infection can spread to the supporting bone and lead to tooth loss.

In addition to a dedicated oral hygiene and dental care program, you should also be on the lookout for early signs of gingivitis. Infected gums can become red, swollen and tender to the touch. You may notice they bleed easily while brushing and flossing, or a foul taste or breath that won't go away even after brushing. And if some of your teeth feel loose or don't seem to bite together as they used to, this is a sign of advanced gum disease that deserves your dentist's immediate attention.

Practicing preventive hygiene is the best way to stop gum disease before it starts. But if gum disease does happen, catching it early can be a game-changer, both for your teeth and your smile.

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 “How Gum Disease Gets Started.”

FifthHarmonysCamilaCabelloChipsaToothbutConcertStillWorthIt

Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand. Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.

Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.

A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.

Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.

If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.

If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”

FlossingDailyAroundImplantswillHelpPreventLosingYourBridge

Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.

Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.

To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.

This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.

To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.

You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.

You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.

Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.

If you would like more information on implant-supported bridges, 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 “Oral Hygiene for Fixed Bridgework.”

PracticeDailyOralHygienetoPreventCalcifiedPlaqueFormation

If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.

Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.

Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush.  Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.

Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.

In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.

If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.

Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.

If you would like more information on reducing plaque buildup, please contact us or schedule an appointment for a consultation.

By Suzanne Boyle DMD
November 29, 2018
Category: Oral Health
Tags: retainers  
RetainYourNewSmileAfterBraceswithaRetainer

It’s been a long road with your braces, but now they’re finally off. Hopefully the first glimpse of your new smile more than made up for the time and effort they required.

But while braces removal is a big milestone, it’s not the end of your treatment—not, that is, if you want to keep that new smile! You’ll now need to wear an appliance called a retainer for a few years or, in some cases, from now on.

Orthodontic retainers are a must after braces for the same reason braces work in the first place—your teeth can move. While the teeth attach to the jawbone via the roots, they’re firmly held in place by an elastic gum tissue network called the periodontal ligament. This tough but elastic tissue lies between the teeth and gums and attaches securely to both with tiny fibers.

While the ligament provides stability, it’s also dynamic—constantly remodeling to allow the teeth to move in response to biting pressure and other mouth factors. Orthodontists use this mechanism when moving teeth to better positions. The braces apply pressure on the teeth in the desired direction and the periodontal ligament responds as the teeth move.

Afterward, however, the ligament can still retain a kind of “muscle memory” for a time of the teeth’s old positions. Free of the pressure once supplied by the braces the teeth have a tendency, especially early on, to “rebound” to where they were.

A retainer helps prevent this by exerting just enough pressure to “retain” the teeth in their new positions. In the beginning this may require wearing the appliance around the clock, but you may be able later to reduce wear time to just a few hours a day. Rebounding is unpredictable, so you should continue to follow your orthodontist’s recommendations on retainer wear.

Wearing a retainer may seem like a drag, but it’s absolutely essential. Being diligent about it will help ensure that the beautiful smile you and your orthodontist worked so hard to obtain stays with you for years to come.

If you would like more information on getting a new smile through 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 Importance of Orthodontic Retainers.”



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Suzanne Boyle DMD

182 Thomas Johnson Dr # 205 Frederick, MD 21702