A woman as gorgeous and funny as Sofia Vergara surely planned to be a model and actress from the get-go, right? Wrong! Sofia’s first career choice actually was to be… a dentist! That’s right, the sexy star of TV’s Modern Family actually was only two semesters shy of finishing a dental degree in her native Columbia when she traded dental school for the small screen. Still, dental health remains a top priority for the actress and her son, Manolo.
“I’m obsessed,” she recently told People magazine. “My son thinks I’m crazy because I make him do a cleaning every three months. I try to bribe the dentist to make him to do it sooner!”
That’s what we call a healthy obsession (teeth-cleaning, not bribery). And while coming in for a professional cleaning every three months may not be necessary for everyone, some people — especially those who are particularly susceptible to gum disease — may benefit from professional cleanings on a three-month schedule. In fact, there is no one-size-fits-all approach to having professional teeth cleanings — but everyone needs this beneficial procedure on a regular basis.
Even if you are meticulous about your daily oral hygiene routine at home, there are plenty of reasons for regular checkups. They include:
- Dental exam. Oral health problems such as tooth decay and gum disease are much easier — and less expensive — to treat in the earliest stages. You may not have symptoms of either disease early on, but we can spot the warning signs and take appropriate preventive or restorative measures.
- Oral cancer screening. Oral cancer is not just a concern of the middle aged and elderly — young adults can be affected as well (even those who do not smoke). The survival rate for this deadly disease goes up tremendously if it is detected quickly, and an oral cancer screening is part of every routine dental visit.
- Professional teeth cleaning. Calcified (hardened) dental plaque (tartar or calculus) can build up near the gum line over time — even if you brush and floss every day. These deposits can irritate your gums and create favorable conditions for tooth decay. You can’t remove tartar by flossing or brushing, but we can clear it away — and leave you with a bright, fresh-feeling smile!
So take a tip from Sofia Vergara, and don’t skimp on professional cleanings and checkups. If you want to know how often you should come in for routine dental checkups, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “Dental Hygiene Visit” and “Dental Cleanings Using Ultrasonic Scalers.”
Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.
One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.
It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.
We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).
Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.
Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.
For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.
This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.
In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.
One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.
If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.
If you would like more information on forming new bone for implants through sinus surgery, 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 “Sinus Surgery.”
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.”
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
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