Additional Home Care Tips

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1. Always brush your tongue or use a tongue scraper daily. Your tongue retains approximately 80% of the bacteria in your mouth.
2. Replace your toothbrush or other home care products if they appear worn out. Toothbrushes should not look flattened or spread out. They should be replaced every six to eight weeks.
3. Toothpastes for sensitive teeth or fluorides are very useful for sensitive root surfaces. Use as directed.
4. Prescription fluoride gels are used to prevent decay, reduce sensitivity and decrease microbial (bacteria) count. After brushing, place gel on a dry toothbrush, proxabrush, or rubber tip and use for one minute, followed by swishing remaining gel for one minute. Do not swallow the fluoride as it may upset your stomach. Fluoride rinses (non-alcohol) you can purchase over the counter such as Act, can also help decrease sensitivity and strengthen teeth. Use one to two times a day. Do not eat or drink for thirty minutes after using.

Periodontal Disease Facts and Reminders

Periodontal Disease Facts and Reminders
1. Plaque forms 20 seconds after eating and 20 minutes after brushing. It hardens into tartar in 24 hours and stays on your teeth.
2. Healthy gums DO NOT BLEED. If you have bleeding gums, pay more attention to your home care instructions. Salt water rinses can help sensitive and swollen gums (1 tsp. salt dissolved into one cup water). If your gums continue to bleed after a thorough home care routine, please contact our office. Go to www.lajolladental.com
3. Experiencing a bad taste or odor is a sign of gum disease/infection.
4. Mouthwashes have no effect on periodontitis. Some mouthwashes can reduce gingivitis.
5. When subgingival plaque reaches a certain threshold level, it produces periodontal disease. Periodontal Disease, therefore, occurs in episodes of activity and quiescenece. That is why daily removal of the bacteria in your mouth is important in reducing your risk of periodontal disease.

Active Periodontal Therapy

Active Periodontal Therapy (Treatment for Periodontal Disease)

How do we treat gum disease (periodontal disease)? See my website at http://www.lajolladental.com/Procedures_Treatment_42712.aspx It depends where you are at with the progression of the disease. A major component of dental health is what we do for ourselves everyday – homecare. Brushing three times a day (after breakfast, midday, and after dinner) and flossing after dinner are the minimum you should be doing to get back to dental health. The other major component is regular dental visits. Cleaning and check-up at least every six months. With early gum disease (gingivitis) this may be enough. Let the dental team clean your mouth up twice a year and you maintain it daily.
Once we slip to a more advanced stage of gum disease, periodontitis, we have receding gums and/or bone loss. Here, the dental team will need to be more aggressive in their treatment of you. They will take a complete medical-dental history to identify any underlying or predisposing conditions, and do a complete clinical exam. The dental team will take X-rays, a full set is usually indicated. They will also evaluate the depth of the pockets around each tooth using a calibrated probe.
Most patients at this point will require Active Periodontal Therapy and/or a referral to a gum specialist. We treat most patients here and refer out only the surgical needs. the Active Periodontal Therapy consists of scaling and root planing, debridement, irrigation of the pockets with a medicated rinse, and perhaps placement of antibiotics in specific isolated pockets.

Active Periodontal Therapy is similar to the scaling normally done during a routine oral hygiene visit, however, it differs in several significant ways. Infection and the resulting deep pockets exist around your teeth requiring deeper than normal scaling. Since vision is blocked into the tooth structure, small scaling devices (either manual or ultrasonic) will be placed carefully into the pockets and a systematic smoothing of the tooth root surfaces will be performed. Debris that has collected on the tooth surfaces will be removed along with the diseased soft tissue. This procedure (called curettage) requires significant time and expertise. Usually, only one area of your mouth will be done per appointment. The number of the one-hour appointments needed will depend on the severity of your infection. You will be anesthetized for your comfort during these procedures.

Your gum tissue may shrink somewhat as it heals. This is desirable because it reduces the depth of the pockets allowing you to better remove bacteria and debris during your home care. Active Periodontal Therapy is the most conservative way to treat gum disease.

Periodontal Disease is a Silent Disease

Knowing all that we know about Periodontal Disease (PD), how is it that 75-80% of us are affected by it?
Periodontal Disease is a silent disease in that it does not hurt (until advanced stages) and can go undetected in its earliest stage. Too often, people don’t go to the dentist regularly and start to build up plaque between their teeth. If the person is not a flosser, the plaque starts to accumulate more and more between their teeth. The once healthy gums, pink and firm around each tooth, now start to become inflamed between the back teeth where the plaque is building up. With gingivitis now established, the bacteria residing in the plaque produce toxins that start to break down the attachment of the gums to the teeth. The body’s inflammatory response is to bring increased amounts of blood to those areas to fight off the toxins. The gums become puffy, tender and swollen, and can bleed easily with brushing and flossing (not likely any flossing is occurring in this person).
A cleaning at the dental office at this point could start to turn things around. Flossing and brushing would go a long way toward health. Of course, this person doesn’t have any pain, and is unaware of this situation.
Periodontitis sets in as the plaque by-products, the toxins, destroy the tissues that hold the teeth in the bone. The attachment of the gum to the root surfaces start to be destroyed and pockets develop between the gum and the teeth. The gums pull away from the teeth and recede. More plaque is now accumulating below the gum line in these pockets. Some of the plaque on the root surfaces is hardening into tartar. Like the barnacles forming on the piers at the ocean, the tartar is rough and more plaque sticks to the rough surfaces and become hardened. As the disease progresses, bone under the gums that anchors the teeth begins to dissolve away. The person may notice an unpleasant odor coming from their mouth – bad breath. The gums may bleed when brushing. At this point, with less bone anchoring the teeth and less gum tissue covering the roots, the teeth appear longer and are sensitive to cold and are more susceptible to decay.
In advanced periodontitis, the toxins deep in the pockets continue to destroy the periodontal ligaments and bone, causing the teeth to lose more support. Unless treated, the affected teeth become more mobile and may fall out.
The key, is to not let this all get started. Should you find yourself progressing down the path described above, work hard on brushing and flossing and get into the dental office for evaluation and necessary treatment. You do not have to lose teeth to periodontal disease!

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Periodontal Disease Symptoms

Periodontal Disease (PD) does not usually show up until people are in their 30s. Certainly the milder form, gingivitis, can occur even in teenagers who don’t do much brushing, or who have braces that trap and harbor the plaque and food particles.

Periodontal Disease is a silent disease – it doesn’t hurt until it is in an advanced stage. But there are ways to detect it. My favorite is to visit the dentist for check-up and periodontal evaluation. Ways that you may detect it at home are:

* Gums that are red and/or swollen and tender

* Gums that bleed when brushing or flossing

* Spaces opening up between your teeth – as if they were moving

* Loose teeth

* Breath that no longer feels fresh – you constantly want to rinse with a mouthwash

* Gums that have pulled away from the teeth

* Pus between the gums and teeth

* Your bite no longer feels solid – you feel as though your bite has changed

Any or all of these indicate some level of gum inflammation/infection. Don’t delay in calling for a dental evaluation, because it won’t get better on its own.

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Gingivitis

Gingivitis is inflammation of the gums caused by the prolonged presence of plaque and tartar on the teeth. The gums become red, puffy and swollen. Gingivitis is a mild form of gum disease that can be reversed with professional dental cleanings by our hygienist and daily brushing and flossing. The gums may bleed during the cleaning and initially when flossing. Gingivitis can be reversed (the inflammation eliminated) because it does not involve bone loss or gum recession.
When the gums are not treated (the person may be brushing but not flossing) the inflammation increases to a point in becomes periodontitis. Here, the plaque builds up below the gums forming pockets. The body’s natural immune system creates enzymes that fight the bacterial toxins within the pockets, but mechanical removal of the plaque and tartar are essential. Left untreated, with time the pockets become deeper, bone loss around the teeth occurs, and the gums recede. Sooner or later the teeth become loose.

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Periodontal Disease

We talked previously about periodontal disease and its effect on our overall health. Let’s take some time to explain what is periodontal disease (PD). Periodontal Disease ranges from simple gum inflammation (gingivitis), to serious disease that results in major damage to the soft tissue and bone that support the teeth (periodontitis). An estimated 75-80% of adults in America have some level of PD (epidemic proportions). Because there is no pain until the condition is at a very advanced stage, most people are not aware they are infected with PD. Our mouths are full of bacteria, which along with mucus and other particles (tissue particles, food particles), constantly form a sticky, colorless “plaque” on our teeth. Brushing and flossing help get rid of plaque which, if not removed, can harden into bacteria-harboring “tartar”. The tartar cannot be brushed away. It must be removed by a professional dental cleaning (Thank goodness for dental hygienists!)

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Periodontal Disease and Cardiovascular Disease

Cardiovascular disease kills more Americans each year than cancer. Most people are aware that lifestyle choices such as quitting smoking, eating right, and getting enough exercise can lessen one’s risk of cardiovascular disease. But, what most may not know, is that by just brushing and flossing their teeth each day, they can also prevent this potentially lethal condition.
Periodontal patients whose bodies show evidence of a reaction to the bacteria associated with periodontitis (gum disease) may have an increased risk of developing cardiovascular disease, according to the Journal of Periodontology (December 2007). Thus, it is important to understand that simple activities like brushing and flossing your teeth everyday, and periodic professional cleanings at the dental office can help lower your risk to cardiovascular disease and other conditions.

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