Gum disease (also called periodontal disease) is an infection of the tissues that support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. At each regular checkup the hygienist will measure the depth of the shallow v-shaped crevice (called a sulcus) between your tooth and gums to identify whether you have gum disease.
Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.
Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket; generally, the more severe the disease, the greater the depth of the pocket.
Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis.
In the early stage of gum disease, called gingivitis, the gums become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily flossing and brushing and regular professional cleanings.
In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. Whereas healthy gums and bone anchor teeth firmly in place, infected gums can cause teeth to become loose, fall out, or have to be removed.
Some factors increase the risk of developing periodontal disease:
- Tobacco smoking or chewing
- System-wide diseases such as diabetes
- Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives
- Bridges that no longer fit properly
- Crooked teeth
- Fillings that have become defective
If you notice any of the following signs of gum disease, see the doctor immediately:
- Gums that bleed easily
- Red, swollen, tender gums
- Gums that have pulled away from the teeth
- Persistent bad breath or bad taste
- Pus between your teeth and gums
- Permanent teeth that are loose or separating
- Any change in the way your teeth fit together when you bite
- Any change in the fit of partial dentures
It is possible to have periodontal disease and have no warning signs.
That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed.
Good oral hygiene at home is essential to keep periodontal disease from becoming more serious or recurring. You don’t have to lose teeth to periodontal disease. Brush regularly, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk of decay, so Dr. Deiglmeier or Dr. Bannerot may recommend removal and replacement with a bridge or implant. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, the dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within your jawbone in a “tooth socket,” and your tooth is held in that socket by a ligament. In order to extract a tooth, either Dr. Deiglmeier or Dr. Bannerot must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with your doctor any concerns or preferences for sedation.
Once a tooth has been removed, neighboring teeth may shift causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth.
Newer dental fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are usually used on the front teeth where a natural appearance is important. They can be placed on the back teeth as well depending on the location and extent of the tooth decay.
What’s Right for Me?
Several factors influence the performance, durability, longevity and expense of dental restorations:
- the components used in the filling material
- the amount of tooth structure remaining
- where and how the filling is placed
- the chewing load that the tooth will have to bear
- the length and number of visits needed to prepare and adjust the restored tooth
There have been many advances in modern dental material and technology. This gives dentists more ways to create pleasing, natural looking smiles. Dentists and patients have several choices when it comes to selecting material to repair missing, worn, damaged or decayed teeth.
In the past, if you had a tooth with a diseased nerve, you’d probably lose that tooth. Today, with a special dental procedure called root canal treatment, you may save that tooth. Inside each tooth is both the pulp and the nerve. The nerve is the vestige of the tissue that originally formed the tooth. Once the tooth has been in the mouth for a time, the functioning of the nerve is no longer necessary.
When a tooth is cracked or has a deep cavity, bacteria can enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tip in the jawbone, forming a “pus-pocket” called an abscess. An abscess can cause the pulp tissue to die. When the infected pulp is not removed, pain and swelling can result. Certain byproducts of the infection can injure your jawbones and your overall health. Without treatment, your tooth may have to be removed.
Treatment often only involves one visit. During treatment, the dentist will remove the diseased pulp. Next the pulp chamber and root canal(s) of the tooth are cleaned and sealed. Often posterior teeth that have endodontic treatment should have a cast crown placed in order to strengthen the remaining structure. Then, as long as you to continue to care for your teeth and gums with regular brushing, flossing, and checkups so that the root(s) of the restored tooth are nourished by the surrounding tissues, your restored tooth can last a lifetime.
Most of the time a root canal is a relatively simple procedure with little or no discomfort. Best of all, it can save your tooth and your smile!
Sometimes brushing is not enough. Everyone has hard-to-reach spots in their mouth and brushing doesn’t always fully clean those difficult places. When that happens, you are at risk of tooth decay. Using sealants on your teeth gives you an extra line of defense against tooth decay.
Dental sealant is a plastic resin that bonds to the deep grooves in your tooth’s chewing surface. When sealing a tooth, the grooves of your teeth are filled and the tooth surface becomes smoother — and less likely to harbor plaque. With sealants, tooth brushing becomes easier and more effective against tooth decay.
Sealants are usually applied to children’s teeth as a preventative measure during the years of most likely tooth decay. However, adults’ teeth can also be sealed. It is more common to seal “permanent” teeth rather than “baby” teeth, but every person has unique needs. Your dentist will recommend sealants on a case by case basis.
Sealants generally last from 3 to 5 years. However, it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact so if your sealant comes off you must let your dentist know.
The removal of wisdom teeth has become so commonplace that is almost a right of passage for young adults. Wisdom teeth are a type of molar that is found in the very back of your mouth. There are four wisdom teeth: upper left, upper right, lower left, and lower right. These teeth usually appear in late teens or early twenties but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. The most common type of impacted wisdom tooth is “mesial”, meaning that the tooth is angled forward toward the front of your mouth.
When a tooth is impacted, it may need to be removed. If it is not removed, you may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease. Each patient’s situation is unique and the dentist will take x-rays and discuss your particular needs with you. If your dentist recommends removal of your wisdom teeth, it is best to have them removed sooner than later. As a general rule, wisdom teeth are removed in the late teens or early twenties because there is a greater chance that the teeth’s roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier.
Once the teeth have been extracted, the healing process begins. Healing time varies depending on the degree of difficulty related to the extraction. Dr. Deiglmeier Dr. Bannerot or Dr. Radkey will share with you what to expect and provide instructions for an efficient healing.