Periodontal (gum) disease can lead to serious infection and even loss of teeth; but it can easily be prevented. Here are seven things you can do to prevent gum disease — or stop it in its tracks if you already have it.

1. Understand the causes of gum disease. Diseases of periodontal (from the root words meaning “around” and “tooth”) or gum tissues start with bacteria collecting on your teeth, in the areas where the teeth and gums meet. The bacteria, called plaque or biofilm, irritate the surrounding tissues and cause them to become inflamed and swollen, and to bleed easily on contact. This condition is called gingivitis.
2. Brush correctly and effectively. Brushing twice a day is not just to polish your teeth to pearly whiteness. An important reason to brush is to remove the daily coating of plaque from your teeth. At your next dental appointment, ask me or our staff to show you the most effective way to brush.
3. Floss every day. Daily flossing removes the plaque that settles in between your teeth, in places where your brush can't reach.
4. Have regular professional cleanings. Our hygienist will remove plaque that you missed by brushing and flossing. This plaque hardens into a material called calculus or tartar. In a professional cleaning your hygienist uses special tools to scrape these materials away. The hygienist also measures the distances between your gums and teeth to make sure that inflamed gums have not separated from the teeth, forming pockets in which the bacteria continue to grow.
5. Recognize the signs of developing gum disease. These signs include any of the following: gums that bleed easily when you brush or floss; bad breath; red or swollen gums; and sensitive teeth.
6. Stop smoking. If you haven't stopped smoking for your heart or lungs, here is another reason to quit. Smokers are more likely to develop periodontal disease than nonsmokers. Smoking masks the effects of gum disease, so smokers are less likely to notice the symptoms, allowing the disease to progress to a greater degree before they seek help.
7. See our office right away if your teeth become loose or your gums become red and swollen. If inflamed gum tissues do not heal, the disease continues to progress. The tissues that attach your teeth to your bone, called ligaments, are lost as pockets deepen as the infection advances. Your gums may also become red, swollen, and painful. As the infection gets worse it eats away the bone around your teeth, causing the teeth to loosen and fall out.

So start with prevention and stop periodontal disease in its early stages.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine article “Warning Signs of Periodontal (Gum) Disease.”

It is important to brush your teeth every day to remove plaque (that sticky white film, composed of bacteria, on your teeth near your gums), but it is possible to overdo it — particularly if you find that your teeth are becoming sensitive to hot and cold or to variations in pressure.

Brushing your teeth too hard or too many times per day can aggravate tooth sensitivity, which can range from a mild twinge to a severe pain. You can accomplish the goal of tooth brushing — plaque removal — by using a soft brush with a very gentle action. Repeated aggressive brushing with a hard brush is not required and can even be harmful to your teeth and gums.

To understand how teeth become sensitive, you need to know about the internal structure of your teeth. Teeth are covered by enamel, a hard mineralized coating that protects them from changes in temperature and pressure. If the enamel is worn away, it exposes the next lower layer of the tooth, the dentin. The dentin is a living tissue containing nerve fibers that connect to the nerves in the tooth's root.

Excessive tooth brushing can irritate your gums and cause them to shrink away from your teeth, particularly if you have thin gum tissues. The thickness or thinness of your gum tissues is something you inherit from your parents, so you can't change it. Hard brushing can begin to wear away the enamel covering of your teeth. Exposure to acids or sugars in the foods you eat and drink can continue the damage.

Acidic foods and drinks such as fruit juices dissolve some of the minerals in your teeth by a process called “demineralization.” Fortunately, your saliva can interact with the enamel and bring back minerals that are leaving the tooth's surface. This process is called “remineralization.” It is important to let your healthy saliva wash your teeth's surfaces for a while before brushing so that dissolved minerals get a chance to be returned to your enamel. It takes between twelve and twenty-four hours for plaque to form on your teeth, so you don't need to brush more than twice a day.

The best way to make sure you are brushing your teeth properly is to have us evaluate your brushing technique at your next dental appointment. We will be able to tell you whether you need to change the angle of your brush or the pressure you are applying for the most effective removal of plaque with the least wear on your teeth and gums. Tooth brushing serves an important purpose, but remember that you can actually have too much of a good thing.

Contact us today to schedule an appointment to discuss your questions about tooth brushing and oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Sensitive Teeth.”

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is an interesting condition because it can be hard to diagnose and often mimics many other conditions. It arises when there are problems inside the temporomandibular joint, and the muscles attached to it, causing pain. When treating TMD, we typically start by relieving the symptoms of pain and discomfort with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. We feel that it is critical to address your pain issues as soon as possible before preceding any further with treatment.

Once we have provided some pain relief and after having completed a thorough history and examination, we can move to the next phase of treatment. This may include the introduction of a bite guard or some form of oral appliance therapy. A bite guard is an unobtrusive yet rigid plastic horseshoe-shaped appliance that fits snuggly over the biting surfaces of the upper teeth. When in place and properly adjusted, this custom-made appliance allows your muscles and therefore jaw joints to relax. And it will prevent you from grinding your teeth, another contributing factor to TMD. We will probably ask you to wear it when sleeping or in times when you are feeling stressed when clenching or grinding habits may be active. We may also suggest that you obtain some relaxation therapy and/or biofeedback from a licensed therapist, as this can prove helpful in treating TMD.

If you have suffered from frequent jaw pain in the past and suspect that you may have TMD, please let us know so that we can address it at your next appointment. Or if you are currently in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

When it comes to your oral healthcare, we strive to provide state-of-the-art care along with education to both our patients and community. One way we do this is by taking a moment to answer some of the questions we are most often asked about a certain topic. And one topic that almost always ignites questions is the subject of lumps and bumps in the mouth.

Help! I just found a small lump in my mouth — what should I do?
Not to alarm you, but your first priority is to contact us as soon as possible to schedule an appointment so that we can review it. Most often, we will know what it is by taking a history, knowing how long it's been there and what it looks like. Depending on what we find, we may want to take a biopsy so that we can determine exactly what it is and how we need to treat it.

What is involved in having a biopsy performed?
A biopsy is a normal and routine procedure that is used to definitively diagnose and confirm exactly what the abnormal lump, bump or other tissue is. It is typically performed with local anesthesia so that a small tissue sample can be removed without any pain for examination under a microscope. Depending on the size of the wound, it may require two to three sutures (stitches), leaving a flat and flush surface that heals in a few days to a week. The procedure usually lasts between 10 and 15 minutes with the lab results processed within a few days.

Does this mean I have cancer?
No, the chances are slim that you actually have cancer. However any change or sore in the mouth that does not heal in a week or two should be evaluated by a dentist and if necessary biopsied. If it is pre-cancerous and removed, it could save your life. The most important fact you need to remember is that no one can tell for sure what the abnormal tissue growth is until an expert in oral pathology (“patho” – disease; “ology” – study of) examines it under a microscope. While it is human nature to be concerned, until you have the facts, you are suffering needlessly.

To learn more about this topic, continue reading the Dear Doctor magazine article “Common Lumps and Bumps In The Mouth.” Or you can contact us today to schedule an appointment to discuss your specific questions so that we can put your mind at ease.

Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”