PromptTreatmentforGumDiseaseCouldUltimatelySaveYourTeeth

Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.

Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.

Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.

As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.

But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.

While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.

And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.

If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Periodontal Plastic Surgery.”

YoumayNeedOrthodonticWorkBeforeGettingaDentalImplant

For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.

But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.

We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.

But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.

Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.

There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.

If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.

If you would like more information on restoring your smile after losing teeth, please contact us or schedule an appointment for a consultation.

By Carol Haddad, DMD
January 21, 2018
Category: Oral Health
Tags: oral hygiene  
HowtoGettheMostfromYourDailyBrushingandFlossing

Twice a year dental cleanings are an important aspect of optimal oral health. But if you’re not brushing and flossing every day, your dental visits could change from regular maintenance to teeth rescue missions.

These two hygiene tasks don’t take long—a single trip with floss around each tooth and a couple of minutes of brushing at least twice a day—but you’ll need to perform them effectively to get the most out of them. Not to worry, though: with a little practice and helpful advice from us, this small investment in time and effort could save your teeth—and your money.

The first thing to know, though, is the reason behind brushing and flossing: to remove disease-causing bacterial plaque that can build up daily on teeth. Bacteria produce acid, which at elevated levels can erode enamel and lead to decay; and some bacterial strains can cause periodontal (gum) disease. These infections could ultimately lead to gum recession, bone deterioration and tooth loss.

Daily brushing and flossing lowers your risk of this occurring. It’s your preference in what order you do them, but for now let’s start with flossing.

There are a number of techniques—and tools—for effective flossing. If you’re using thread floss, simply cut off about 18 inches and wrap each end around the middle finger from each hand. Use the remaining fingers to create a small amount of floss between the two best fingers for a particular area of the mouth and gently pull the floss in between the tooth gap. Form a “C” shape around one of the tooth sides and rub up and down until you hear a squeak (which you’ll only hear if you use un-waxed floss). Now, repeat the action with the adjacent tooth, then move to the next and each succeeding gap and do the same until you’ve cleaned each side of each tooth.

When brushing, hold your toothbrush gently like a paintbrush or pencil at about a 45-degree angle with just a small amount of toothpaste on the end bristles. All it takes is a gentle scrubbing or wiggling motion and the abrasives and detergents in the toothpaste will do the rest.  Just make sure you fully brush all your teeth and gum surfaces, which should take about two minutes.

Along with regular dental visits and a low-sugar diet to discourage bacterial growth, brushing and flossing will help you avoid disease and enjoy the best oral health possible.

If you would like more information on keeping your teeth and gums clean, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

CoaxingImpactedTeethtotheRightPositioncanImproveYourSmile

What makes an attractive smile? Of course, shiny, straight and defect-free teeth are a big factor. But there’s another equally important element: all your teeth have come in.

Sometimes, though, they don’t: one or more teeth may remain up in the gums, a condition known as impaction. And if they’re in the front like the upper canines (the pointed teeth on either side of the front four incisors) your smile’s natural balance and symmetry can suffer.

Impaction usually happens due to lack of space on a small jaw. Previously erupted teeth crowd into the space of teeth yet to come in, preventing them from doing so. As a result the latter remain hidden within the gums.

While impaction can interfere with the smile appearance, it can cause health problems too. Impacted teeth are at higher risk for abscesses (localized areas of infection) and can damage the roots of other teeth they may be pressing against. That’s why it’s desirable for both form and function to treat them.

We begin first with an orthodontic examination to fully assess the situation. At some point we’ll want to pinpoint the impacted teeth’s precise location and position. While x-rays are useful for locating impacted teeth, many specialists use cone beam CT (CBCT) technology that produces highly detailed three-dimensional images viewable from different vantage points.

If the tooth is in too extreme a position, it might be best to remove it and later replace it with a dental impact or similar restoration once we’ve completed other necessary orthodontic treatment. But if the tooth is in a reasonable position, we might be able to “move” the tooth into its proper place in the jaw in coordination with these other tooth-movement efforts to make room for it.

To begin this process, an oral surgeon or periodontist surgically exposes the tooth crown (the normally visible portion) through the gums. They then bond a small bracket to the crown and attach a small gold chain. An orthodontist will attach the other end to orthodontic hardware that will exert downward pressure on the tooth to gradually bring it into normal position.

Dealing with impacted teeth of this nature is often part of a comprehensive effort to correct the bite. If we’re successful, it could permanently transform both the smile and overall dental health.

If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”

By Carol Haddad, DMD
December 22, 2017
Category: Dental Procedures
Tags: gum recession  
GumDiseasecanPreventYourGumsfromProtectingYourTeeth

Your mouth is a lot like the Wild West — home to millions of bacteria and other microbes, some of which are definitely not “the good guys.” But your teeth are well-protected from these hostile forces and their acidic waste products: with enamel shielding the visible part of your tooth, your gums protect the parts you can’t see.

As effective as they are, though, your gums aren’t invincible: their greatest threat is periodontal (gum) disease. This bacterial infection arises from plaque, a thin film of bacteria and food particles accumulating on teeth due to inadequate brushing and flossing.

The infected tissues soon become inflamed (red and swollen), a natural defensive response from the immune system. The longer they’re inflamed, however, the more likely they’ll begin detaching from the teeth. The gums may eventually shrink back or recede from the teeth, often causing them to appear “longer” because more of the tooth is now exposed to view.

Gum recession doesn’t bode well for your teeth’s survival: the exposed tooth and underlying bone can become even more susceptible to infection and damage. In the end, you could lose your tooth and portions of the supporting bone.

Treatment depends on the severity of the gum recession. In mild to moderate cases, we may only need to perform the standard gum disease treatment of removing plaque and calculus from all gum and tooth surfaces (including below the gum line) with special instruments. This helps reduce the infection and allow the gums to heal and re-establish attachment with the tooth. In more advanced cases, though, the recession may be so extensive we’ll need to graft donor tissue to the area using one of a variety of surgical techniques.

Although the right treatment plan can help restore your gum health, there’s another approach that’s even better — preventing gum disease in the first place. You can reduce your disease risk by practicing daily brushing and flossing and visiting your dentist regularly or when you see symptoms like gum swelling or bleeding. Taking care of your gums won’t just save your smile — it might also save your teeth.

If you would like more information on diagnosing 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 “Gum Recession.”





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