Complete Family Dentistry Blog - Waukesha , WI
Posts for: August, 2014
Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.
A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.
If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.
The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.
Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.
These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.
If you would like more information on treatments 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 “Treating Difficult Areas of Periodontal Disease.”
Dental implantation is the premier option for tooth replacement available today. While acquiring dental implants does involve a surgical procedure, don’t let that deter you — with proper preparation the procedure is relatively minor and routine.
Implants are root replacements inserted directly into the jawbone to which a life-like, artificial crown is secured (strategically placed implants can also support fixed bridges or removable dentures). They’re typically made of titanium, which is osseophilic or “bone-loving”: bone will grow and adhere to the implant over a few weeks time.
Pre-planning can help minimize discomfort during and after the implantation procedure. We first conduct a radiographic examination of the site with x-rays or CT imaging; this enables us to assess the site’s bone quality and quantity. We can also create a surgical guide from the imaging to pinpoint the precise location for an implant to ensure a successful outcome.
Before beginning the procedure, we numb the area with a local anesthesia (we can also administer a sedative or other relaxation medication if you’re experiencing mild apprehension). The procedure often begins by creating a flap opening in the gum tissue with a few small incisions to access the bone. Using the surgical guide, we then begin a drilling sequence into the bone that progressively increases the size of the hole until it precisely matches the size and shape of the implant.
When the site preparation is complete, we remove the implant from its sterile packaging (which minimizes the chance of infection) and immediately insert it into the prepared site. We verify proper positioning with more x-rays and then suture the flap opening of the gum tissue back into place.
Thanks to both the pre-planning and care taken during surgery, you should only experience minimal discomfort. While narcotic pain relievers like codeine or hydrocodone may be prescribed, most often non-steroidal anti-inflammatory drugs like aspirin or ibuprofen are all that’s needed. We may also prescribe an anti-bacterial mouthrinse (with chlorhexidine) to assist healing.
In just a few weeks your custom-made restorations will be attached to the implants. It’s the completion of a long but not difficult journey; the resulting smile transformation, though, can last for many years to come.
If you would like more information on dental implants, 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 “Dental Implant Surgery.”