Periodontal (gum) disease can cause a number of devastating effects that could eventually lead to tooth loss. However, you may be more prone to a particular effect depending on the individual characteristics of your gums.
There are two basic types of gum tissues or “periodontal biotypes” that we inherit from our parents: thick or thin. These can often be identified by sight — thinner gum tissues present a more pronounced arch around the teeth and appear more scalloped; thicker tissues present a flatter arch appearance. While there are size variations within each biotype, one or the other tends to predominate within certain populations: those of European or African descent typically possess the thick biotype, while Asians tend to possess the thin biotype.
In relation to gum disease, those with thin gum tissues are more prone to gum recession. The diseased tissues pull up and away (recede) from a tooth, eventually exposing the tooth’s root surface. Receding gums thus cause higher sensitivity to temperature changes or pressure, and can accelerate tooth decay. It’s also unattractive as the normal pink triangles of gum tissue between teeth (papillae) may be lost, leaving only a dark spot between the teeth or making the more yellow-colored root surface visible.
While thicker gum tissues are more resilient to gum recession, they’re more prone to the development of periodontal pockets. In this case, the slight gap between teeth and gums grows longer as the infected tissues pull away from the teeth as the underlying bone tissue is lost. The resulting void becomes deeper and more prone to infection and will ultimately result in further bone loss and decreased survivability for the tooth.
Either of these conditions will require extensive treatment beyond basic plaque control. Severe gum recession, for example, may require grafting techniques to cover exposed teeth and encourage new tissue growth. Periodontal pockets, in turn, must be accessed and cleaned of infection: the deeper the pocket the more invasive the treatment, including surgery.
Regardless of what type of gum tissue you have, it’s important for you to take steps to lower your risk of gum disease. First and foremost, practice effective daily hygiene with brushing and flossing to remove bacterial plaque, the main cause of gum disease. You should also visit us at least twice a year (or more, if you’ve developed gum disease) for those all important cleanings and checkups.
If you would like more information on hereditary factors 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 “Genetics & Gum Tissue Types.”
The primary goal of dental care is to preserve teeth. But there are circumstances in which removing a tooth, even a relatively healthy one, could prove best in the long run.
A malocclusion (poor bite) related to crowding might fit such a circumstance. Crowding occurs when the size of the jaw is too small for the teeth coming in. With not enough space, some teeth could erupt out of their proper positions. Removing certain teeth frees up space to eventually allow braces or other orthodontic devices to re-align the teeth.
The teeth most frequently removed are the first bicuspids, located between the cuspid (the "eyeteeth" directly under the eyes) and the back teeth, and the second premolar. Removing these won't normally affect appearance or functionality once orthodontic or cosmetic treatments are complete.
Because of the mechanics of jaw development it might be necessary to perform these extractions several years before orthodontic treatment. This could create another potential problem: the time lag could adversely affect bone health.
This is because bone, as living tissue, has a life cycle with cells forming, functioning and then dissolving, and new cells taking their place. When teeth are chewing or in contact with each other they generate force that travels through the tooth roots to the bone and stimulates cell growth at a healthy replacement rate.
But when a tooth is missing, so is this stimulation. This slows the replacement rate and eventually leads to decreased bone volume. Too much bone loss could create obstacles for orthodontic treatment or a future dental implant.
To avoid this, the dentist will often place a bone graft with processed bone mineral within the empty tooth socket right after extraction. The graft serves as a scaffold for bone cells to grow upon. The graft (plus any other added growth boosters) can help maintain a healthy level of bone volume to facilitate future orthodontic or restorative treatments.
Since targeted extraction for orthodontics is time-sensitive, you should have your child's bite evaluated by an orthodontist by age 7 to see if any action is necessary. The earlier a malocclusion is detected, the more likely a more attractive and healthy smile will be the ultimate outcome.
If you would like more information on correcting 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 “Tooth Removal for Orthodontic Reasons.”
You’ve lived most of your life with crooked teeth and an imperfect smile. You feel you should have done something about it years ago, but now you’re approaching your golden years — what would be the point?
Here’s the point: there’s a growing trend of older adults undergoing orthodontic treatment. People are discovering the life-changing benefits of straightening their teeth — even if they’re no longer teenagers.
So, what’s really holding you back?
I’m too old to have my teeth straightened. Not true — teeth can be straightened at any age, not just during childhood or adolescence. If anything would prevent orthodontic treatment it would be the state of your oral and general health, not your age. Your teeth’s supporting bone must be reasonably sound and healthy; likewise, systemic problems like bleeding disorders, leukemia and uncontrolled diabetes can make orthodontics difficult. But if you and your mouth are reasonably healthy, you can have your teeth straightened.
It’s too much to spend just to look better. Yes, orthodontic treatment can transform your smile — but it can also improve your oral health. Misaligned teeth are harder to keep clean, increasing the risks for tooth decay and periodontal (gum) disease; they also don’t work well together so chewing is more difficult. By correcting your bite, you can reduce your chances of dental disease and improve overall mouth function.
I’d look silly at my age in braces. Self-consciousness about wearing these traditional appliances is common at any age. It’s understandable — the glint of metal is the first thing people see when you smile. But there’s a good chance you may be able to wear an alternative appliance that’s barely noticeable: clear aligners. These are a series of removable, clear plastic trays that you wear in sequence to gradually move your teeth. Not only are they less noticeable than braces, you can take them out for special occasions.
Don’t let these or other excuses keep you from a more attractive smile and healthy mouth. Visit your dentist for an examination to see if orthodontics can work for you.
If you would like more information on transforming your 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 “Orthodontics for the Older Adult.”
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
If you've undergone treatment for periodontal (gum) disease, you know how involved it can be. After several sessions of plaque and calculus (hardened plaque deposits) removal, your swollen, red gums finally begin to regain their healthy pink color.
But with gum disease, the battle may be over but not necessarily the war. If we don't remain vigilant, there's a high chance you'll experience a re-infection.
That's why periodontal maintenance (PM) is so important for gum disease patients after treatment. Plaque, the thin film of bacteria and food particles responsible for the infection, can grow again on your tooth surfaces as it did before. You'll have to practice diligent, daily brushing and flossing to curb that development.
But it's also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For most people that's usually twice a year, but for gum disease patients it could be up to four times a year, especially just after treatment. And there's more to these visits than cleaning.
Since our goal is to reduce the chances of re-infection as much as possible, we'll thoroughly examine your teeth, gums and any implants for signs of disease (we'll also include an oral cancer screening). We want to assess the health of your teeth and gums and to see how well you're doing hygiene-wise with plaque control.
If we find signs of gum disease, we'll discuss this with you and schedule a new round of treatment. The sooner we initiate treatment, the better your outcome. In some cases, we may perform procedures that make it easier to access and clean areas where plaque tends to build up.
Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it re-occurs. Keeping up diligent PM will help ensure your gums continue to stay healthy.
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