Periodontal (gum) diseases are sometimes called “silent” because those who have them may not experience painful symptoms. But certain signs point to the existence of these common diseases. If you are experiencing any of the symptoms below, it is time to visit our office so these problems can be treated before they lead to serious infection and loss of teeth.

Gums that bleed during the brushing of teeth. Some people think that gums bleed from brushing too hard. In fact, healthy gum tissues will not bleed with normal brushing. The usual cause of bleeding gums is an accumulation of dental plaque in the areas where your teeth meet your gums. Plaque is a film of bacteria, called a biofilm, which accumulates on your teeth. If you are not brushing and flossing effectively, plaque irritates your gum tissues and causes an inflammation and swelling called gingivitis. This causes your gums to bleed easily on contact with a toothbrush or floss.

Gum tissues that appear red and swollen. If plaque is allowed to accumulate for 24 hours or more, the inflammation in your gum tissues becomes chronic. The continuous presence of bacteria makes it impossible for your body's natural defenses to fight the infection. Chronic inflammation leads to a breakdown of the normal attachment between the teeth and the gums, causing the formation of “pockets.” Inside these pockets the infection continues to attack the tissues that support your teeth. Eventually this can lead to a breakdown of the bone that surrounds your teeth.

Bad breath. Bad breath is another sign of accumulated plaque. The bacteria in plaque may emit gases that have an unpleasant odor.

Gums that are sensitive to hot or cold. Chronic inflammation can also cause the gums to recede, exposing the roots of the teeth in which nerves may be close to the surface, leading to sensitivity to heat and cold.

Teeth that are getting loose, or a painful area in the gums. If you experience these symptoms, the infection has progressed a long way from the “silent” stage. It is time to seek immediate professional help.

If you answered “yes” to any of the above questions, a professional dental examination is in order. With daily removal of plaque by effective brushing and flossing, along with frequent professional cleanings to remove any plaque that you were unable to catch, you will go a long way to preventing periodontal disease. Also, be aware that smoking tends to mask the effects of gum disease. Generally, if you smoke your gums will not bleed when brushing or flossing, nor will they show signs of swelling.

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 articles “Bleeding Gums” and “Warning Signs of Periodontal (Gum) Disease.”

For many people, starting a chewing tobacco habit begins as something you do with “all the guys” to be cool and fit in. It often starts when playing sports such as baseball. And because it is smokeless tobacco, many people think it is harmless; thus they slowly start “dipping” more often until they are chewing tobacco throughout each day, every day.

The truth about chewing tobacco is that it isn't harmless. It is extremely dangerous and contains more than 30 chemicals known to cause cancer. It also contains nicotine, the highly addictive-forming drug found in cigarettes. Sure, it may not have the odorous (and dangerous) impact of cigarettes, cigars and pipes that can negatively impact others nearby, but it can destroy both your oral and general health and even kill you.

Steps You Can Take to Quit

Once a person decides to stop using chewing tobacco, it can be a difficult process and even more difficult to quit cold turkey. If the latter describes your situation, try a smoking cessation program or talk with your doctor about prescription medicines available to help you kick the habit. You may also find free counseling (via telephone) or other groups and organizations created to help people break free from their tobacco addiction. This is often a great way to start the quitting process.

Two of the most important steps you can take are to involve your physician and our office in your strategy to kick this habit. In addition to encouraging and supporting your decision, we can closely monitor your oral health during the process.

If you suffer from snoring or think you may have Obstructive Sleep Apnea (OSA), did you know that your dentist could play an important role in treating your condition? For most people this is surprising; however, we can provide both education and some treatment options. And as needed, we will work with your other healthcare professionals to get an accurate diagnosis so that you can improve both your sleep and your health.

Oral Appliance Therapy: These devices may look like orthodontic retainers or sports mouthguards, but they are designed to maintain an open, unobstructed, upper airway (tissues at the back of your throat) during sleep. There are many different oral appliances available but less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. Depending on your specific condition, we may use it alone or in combination with other means of treating your OSA. Here’s how they work. They reposition the lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize the lower jaw and tongue; and increase the muscle tone of the tongue — unblocking the airway.

Continuous Positive Airway Pressure (CPAP): CPAP bedside machines generate pressurized air delivered through a tube connected to a mask covering the nose and sometimes mouth. Pressurized air opens the airway (windpipe) in the same manner as blowing into a balloon; when air is blown in, the balloon opens and gets wider. This treatment option is generally not used for snoring, but rather for the more serious condition, OSA.

Surgery: Specially trained oral and maxillofacial surgeons may include more complex jaw advancement surgeries. Additionally, an Ear, Nose & Throat (ENT) specialist (otolaryngologist) may consider surgery to remove excess tissues in the throat. It also may be necessary to remove the tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate.

The first step towards getting a great night's sleep if you are a snorer that has never been diagnosed or treated for your condition is to obtain a thorough examination by a physician specifically trained in diagnosing and treating sleep disorders. And depending on the seriousness of your condition, he or she may strongly encourage you to participate in a sleep study. The results from this “study” can provide your dentist and other healthcare professionals with precise data about your snoring, breathing and sleeping habits. This information is key to treating OSA, if you are in fact diagnosed with this condition. Learn more when you read, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

As the Boy Scouts say, it's best to be prepared. You may never have a traumatic injury to your teeth. But what if you do? Here are four questions and answers about such injuries and their treatment that may be helpful some day.

What are traumatic injuries?
We are talking about physical damage caused by a fall, an accident, or a blow to the face. The word trauma comes from the Greek root meaning “wound.”

A traumatic injury can also cause broken, cracked, or split teeth, or a fracture to the root of the tooth. A tooth may be dislodged from its proper position, pushed sideways, out of or deeper into its socket. It may even be completely knocked out of your mouth.

What should you do if your tooth is knocked out?
With proper treatment, the tooth can be restored to its original place. You must handle the tooth gently and seek professional help as soon as possible. Rinse the tooth in cold water if it is dirty, but do not use any cleaning agent. Avoid touching the root. While hurrying to your dentist, keep the tooth from drying out by keeping it in a container of milk or of your saliva, or by holding it in your mouth between gum and cheek. It is vital to keep the tooth's living tissues moist until it can be professionally assessed and replanted in its socket. If a tooth has been dislodged but not knocked out, it must be repositioned in its socket and may be stabilized with a splint.

Who can treat a tooth that is damaged by a traumatic injury?
A general dentist, an oral surgeon or an endodontist is trained to treat such injuries. An endodontist is trained to treat the root canal(s) inside a tooth. The word comes from “endo” the Greek word for “inside,” and “odont,” the word for “tooth.” After a tooth is replaced in its socket and stabilized, root canal treatment is often needed.

What is root canal treatment?
A tooth is composed mostly of dentin, a living tissue. The top part or crown is covered by hard mineralized enamel. The soft tissue inside the tooth, the pulp, contains blood vessels, nerves and connective tissues. It extends from the crown to the tip of the roots. Treatment of dental pulp injuries is called root canal or endodontic treatment and is usually needed to treat teeth that have been dislodged or fractured.

Contact us today to schedule an appointment to discuss your questions about injuries to teeth and related nerve damage. You can also learn more by reading the Dear Doctor magazine article “Trauma & Nerve Damage to Teeth.”

Periodontal (gum) disease, though it may be invisible to everyone but your dentist, can have a powerful effect on your entire body. Not only is it dangerous to your teeth and jaws, but it can increase your risk of heart attack and stroke, cause preterm births in pregnant women, and affect blood sugar control in diabetics.

Diabetics are our subject for today. Symptoms of diabetes include abnormally high levels of glucose (a form of sugar) in the blood, leading to frequent urination, excessive thirst, blurred vision, unexplained weight loss, and loss of energy. The disease can also cause severe complications in various parts of the body.

Normally, glucose, your body's main energy source, is kept under control by a hormone called insulin, which is made by an organ called the pancreas. In type 1 diabetes, a person's pancreas does not produce enough insulin to deal with all the glucose in his or her blood. In type 2 diabetes — a condition related to increased age, physical inactivity, overweight, and heredity — the pancreas may produce enough insulin, but the body is not able to use it effectively. This condition is called insulin resistance.

People with type 1 diabetes need insulin to survive. Type 2 may be treated with exercise, diet, medications, and insulin supplements.

Serious complications of diabetes range from kidney failure, blindness, and nerve damage to infections that do not heal, gangrene and amputation of limbs.

Diabetes and periodontal disease seem to have reciprocal effects on each other. Diabetics are more likely to have periodontal disease than non-diabetics; and those with periodontal disease are likely to face worsening blood sugar control over time.

Periodontal disease (from “peri”, meaning around and “odont”, meaning tooth), is caused by dental plaque — a film of bacteria that settles on your teeth and gums every day. It's what you remove with daily brushing and flossing. Any bacteria that remain cause inflammation, which can lead in the worst cases to loss of bone and eventual loss of teeth.

The close relationship of diabetes and periodontal disease probably results from changes in the function of immune cells responsible for healing. Inflammation is a part of normal wound healing — but chronic or prolonged inflammation can destroy the tissues it was meant to heal. This may be a major factor in the destructive complications of diabetes.

Many of these complications begin in the blood vessels. Like the eyes and the kidneys, gum tissues are rich in blood vessels. Gum tissues are also under constant attack from bacteria. If you are a diabetic, effective plaque control, along with regular professional dental cleaning, can have positive effects not only on periodontal disease, but also on control of your blood glucose level.

Contact us today to schedule an appointment to discuss your questions about periodontal disease and its connections with diabetes. You can also learn more by reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.”