Friday, February 22, 2019

Implant rescue

So, you went for your regular dental cleaning appointment, and the implant that you paid so much for is exhibiting bone loss. You dentist is kind of in a quandary of what to do, so he sends you to a surgeon who offers you an expensive bone graft or just removing or replacing the implant. You really don't want to have to pay for this all over again with the uncertainty of how long a bone graft or another implant will last. Well, there is another alternative, LAPIP. The Laser-assisted Peri-implant Procedure offers a way to get your existing implant healthy again. This is a short, comfortable way to restore a healthy environment around your existing implant.  It even helps grow back bone that has been lost around your implant, all without incisions, sutures, or bone grafts. Our patients seldom have to take any pain medicine beyond just some ibuprofen, and you can go about your regular activities the rest of that day. If you have ailing implants, give our office a call, and we can tailor a treatment plan for you that may save your implant and your wallet. 

Wednesday, February 6, 2019

Desquamative gingivitis

This is a group of autoimmune diseases characterized by blisters, sloughing, and ulceration of the gums. Only a special biopsy can determine which of these diseases you have. The treatment is topical steroids with or without oral medication. These diseases can be very painful and can also involve the skin or even the eyes, in which case blindness is possible if severe enough and left untreated. If you think that you may have something like that described above, see a periodontist for a proper diagnosis and treatment. 

Wednesday, January 23, 2019

More periodontal diseases

The one periodontal disease that seems to be increasing in my practice is Lichen planus. This is an autoimmune disease that can be a minor nuisance, a source of significant discomfort, or even a precursor to oral cancer. Generally, there are red and white areas that can be on the gums, tongue or inside the cheeks that may or may not be painful and sometimes have spontaneous bleeding. One hallmark of the disease are white lines called Wickham's striae, but they are not always present. The disease process is not well understood, but it falls somewhere between an allergy and an overactive immune system, Regardless, anti-inflammatories (generally steroids) are the most effect treatment. Topical steroids are effective for minor forms of the disease, but, in more aggressive cases, system steroids are necessary to get the disease under control. A biopsy is necessary for a definitive diagnosis. There are some studies that show a weak correlation between Lichen planus and oral cancer, and it can be severe enough to cause loss of bone around the teeth and even tooth loss. If you think that you may have Lichen planus, seeing a periodontist for a biopsy is the first step to getting it under control. 

Tuesday, January 15, 2019

Gum recession

Although not really classified as a disease process, the second most common gum issue is recession of the gums, leading to exposure of tooth roots, sensitivity, decay, and esthetic issues. This isn't generally due to infection, although it can be. Causes of recession are traumatic tooth brushing, tooth clenching and grinding, orthodontic treatment, thin gum tissue, tooth wear, and there may also be a genetic or diet component as well. Of course prevention is best, and all people should use a soft tooth brush and use a circular rather than sawing motion with the brush. Pressing hard with an electric tooth brush is also an issue. Bite guards are the best way to deal with clenching and grinding, and teeth with thin gums should be grafted before orthodontic treatment. After the recession has occurred, there are a variety of procedures for recovering the roots and preventing future problems. These include repositioned flaps, grafts (from the patient, synthetic, or from human tissue banks), and orthodontic treatment to reposition teeth back within the bony housing. If grafts are necessary, we have a variety of techniques for best addressing the particular issue that your condition presents. While you may see one or another grafting technique promoted on dental websites, the truth of the matter is that no one procedure is best to treat all recession issues. Periodontists are trained in many techniques and have the best judgement and experience to recommend the optimum procedure for your particular condition. 

Friday, January 11, 2019

Periodontal Diseases

Today, I'm going to start a series about periodontal diseases, and we'll start with adult periodontitis, the most common form of gum disease. 
Adult periodontal disease is defined as a loss of attachment and support for the teeth as a result of inflammation caused by certain oral bacteria. These bacteria are normally found in the mouth, but, in some people, and under some conditions, they cause inflammation in the area surrounding the teeth that leads to bone loss and, eventually, tooth loss. This is a complex process that involves many different bacteria, but the caveat is that the bacteria themselves do not directly cause the bone loss. It is an over-response by the body's own immune system that causes the damage. This is why there is tremendous variability in the amount of dental plaque (100% bacteria by weight) that is necessary to cause problems. You may know people who seldom brush, floss, or have regular dental cleanings that don't have gum issues. They have more resistance to the inflammation caused by plaque. Other people do a good job of keeping their teeth clean, but still have bone loss. Of course, the best way to prevent gum disease is to keep your teeth as clean as possible and have regular dental cleaning, regardless of your susceptibility to gum disease. If you have gum problems, see a dentist or periodontist, so you can minimize the damage and get back to a healthy mouth that will benefit you throughout life. 

Tuesday, December 4, 2018

Don't waste it!

Time is short to use your 2018 benefits. If you have been putting off treatment and have benefits remaining, you don't have much time to maximize those benefits. Most offices will be closed for Christmas and New Years, so get scheduled ASAP before you are forced to push your treatment to next year. 

Monday, August 20, 2018

Make the commitment to yourself now!

Just like everything else in life, people procrastinate when it comes to their oral health, and the consequences can be worse than you might have imagined. There are situations in which we are forced to make hard decisions of whether or not to retain teeth that might be otherwise savable. In most cases, these terrible decisions involve oropharyngeal cancer. Approximately 52,000 people in the United States will be diagnosed with this horrible and sometimes disfiguring cancer this year. Of those, approximately 20% will die of that cancer. Radiation treatment is one of the primary means of treating cancers of the head and neck, and the side effects can be very debilitating. As  dentists, there are several consequences of radiation treatment that we deal with. In most cases, the salivary glands are a casualty of radiation, which leads to greatly reduced saliva flow, dry mouth (xerostomia) and subsequent root decay and periodontal (gum) disease. The other major side effect is perhaps the worst of all. Radiation causes the bone of the jaws to be far less resilient when it comes to repairing itself following any type of trauma. Trauma includes oral surgery such as root canal treatments, implant placement, periodontal surgery, and tooth extraction. Even the rubbing of a denture on the gum tissue can cause major problems that can lead too a disease process known as osteoradionecrosis. This causes bone loss that can spread to encompass most or all of the bone in the upper or lower jaw. In order to prevent this, we generally extract unhealthy teeth prior to the radiation treatment that would otherwise be savable, because after the radiation treatment, a tooth requiring removal could cause osteonecrosis and the horrible consequences associated with it. For people who have kept up with their oral care prior to their cancer diagnosis, this is pretty much a non-issue. For those who have decay and/or gum disease, it means the loss of the teeth involved and difficulty ever replacing those teeth. Any oncologist will tell you that the overall health of a patient entering cancer treatment has a major impact on the success of that treatment and the quality of life afterwards. Do yourself a favor and do what it takes to keep your body and your mouth in a healthy state. We can't predict what the future holds for us, but going into that future as healthy as possible can only make it better.