Category Archives: Periodontal Health & Treatment

Root Planing

Periodontal-Health-&-Treatm

Root planing is a non-surgical treatment that usually done together with deep dental scaling. It is done after the supragingival (or superficial) plaque and calculus were remove through gross scaling. The aim of this treatment is to removes the roughened cementum and surface dentin that is impregnated with calculus, microorganisms and their toxins leading to the creation of a clean smooth root surface. Usually this implies that some cementum and dentin are removed. Deep scaling and root planing are done under local anaesthesia and requires 25-45 minutes per quadrant. If the pockets are deeper, the procedure becomes more significantly more difficult and more time is needed.

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Cosmetic Gum Surgery

Introduction

Cosmetic gum surgery – It is a type of surgery used to reshape healthy gum tissue around the teeth to make them look better. If a person has tooth recession where the gum is pushed away from the tooth, a gingivoplasty surgery can be done. Basically to ‘bring’ back the gum to cover the expose root surface of a tooth:

Before cosmetic gum surgery (gingivoplasty surgery) – receding gum especially on patient’s left side
After cosmetic gum surgery (gingivoplasty surgery)

To read more on the gingivoplasty procedure click here.

On the other hand, if there is excessive gum covering the teeth, then the procedure is to remove some part of the gum covering the teeth (gingivectomy surgery) to show more of the tooth thus reduce gummy smile and improve smile line.

Before gingivectomy
After gingivectomy

To read more on the gingivectomy procedure click here.

After gum surgery, it is important that the periodontist or dental hygienist inform you how to clean the teeth and gum tissue with a toothbrush and an antimicrobial fluoride toothpaste, floss and antibacterial mouth rinse. Please consult your periodontal specialist or dentist for more information of how to care for your gum tissue and teeth after gum surgery.

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Scaling & Air Polishing

Why do we have to clean our teeth?

Tartar (calculus) are deposits that have built up on the teeth over time. Dental cleanings involve removing plaque (soft, sticky, bacteria infested film) and tartar (calculus) deposits that have built up on the teeth over time. Your teeth are continually bathed in saliva which contains calcium and other substances which help strengthen and protect the teeth. While this is a good thing, it also means that we tend to get a build-up of calcium deposits on the teeth. This chalky substance will eventually build up over time. Usually it is tooth coloured and can easily be mistaken as part of the teeth, but it also can vary from brown to black in colour.

If the calculus (or tartar, as dentists like to call it) is allowed to accumulate on the teeth it will unfortunately provide the right conditions for bacteria to thrive next to the gums. The purpose of the scaling and polishing is basically to leave the surfaces of the teeth clean and smooth so that bacteria are unable to stick to them and you have a better chance of keeping the teeth clean during your regular home care. Also it leaves your teeth feeling lovely and smooth and clean, which is nice when you run your tongue around them.

10 Reason why you need to have Dental Cleaning

 

How are dental cleanings done?

Dental surgeon or dental hygienist uses specialized instruments to gently remove these deposits without harming the teeth.

1) Ultrasonic instrument (Scaler)

Ultrasonic Scaling

Commonly used first is an ultrasonic instrument or scaler unit which uses tickling vibrations to knock larger pieces of tartar loose. It also sprays a cooling mist of water while it works to wash away debris and keep the area at a proper temperature. The device typically emits a humming or high pitched whistling sound. This may seem louder than it actually is because the sound may get amplified inside your head, just like when you put an electric toothbrush into your mouth.

The ultrasonic instrument tips are curved and rounded and are always kept in motion around the teeth. They are by no means sharp since their purpose is to knock tartar loose and not to cut into the teeth. It is best to inform the operator if the sensations are too strong or ticklish so that they can adjust the setting appropriately on the device or modify the pressure applied.

With larger deposits that have hardened on, it can take some time to remove these, just like trying to remove baked-on grime on a stove that has been left over a long time. So your cleaning may take longer than future cleanings. Imagine not cleaning a house for six months versus cleaning it every week. The six-month job is going to take longer than doing smaller weekly jobs.

2) Air polishing

After the dentist has done scaling using the ultrasonic scaler, he will proceed with polishing either using air polishing or polishing cup. Air polishing is an alternative more advance method  than the polishing cup and paste method. It requires a special ultrasonic unit (e.g. Air Flow from EMS) that allows use of this insert in the handpiece.

EMS Air polishing unit
EMS Air polishing unit

Air polishing uses medical-grade sodium bicarbonate and water in a jet of compressed air to “sandblast” the surface of the enamel leaving your teeth smooth and clean.

Indications for air polishing

  • Heavily smoking stain on the teeth
  • Staining due to coffee or tea
  • To remove fine tartar that are still attached to the teeth surface after scaling
Tobacco and coffee stain

Video: Air polishing method with EMS Air Flow®

Advantages of using air polishing

  • There is no physical contact with the tooth, therefore thermal injury is of no concern.
  • It is ideally suited for teeth separated by wide diastemata and considerable in shape and size.
  • Particularly good for cats where teeth are so small that standard cups can create gingival damage.
  • They are very efficient at removing stains from teeth.

Is scaling & air polishing going to be painful?

Most people find that cleanings are painless, and find the sensations described above – tickling vibrations, the cooling mist of water, and the feeling of pressure during “scraping” – do not cause discomfort. A lot of people even report that they enjoy cleanings and the lovely smooth feel of their teeth afterwards! There may be odd zingy sensations, but many people don’t mind as they only last a nanosecond.

Be sure to let your dentist/hygienist know if you find things are getting too uncomfortable for your liking. They can recommend various options to make the cleaning more enjoyable.

Painful cleaning experiences can be caused by a number of things: a rough dentist or hygienist, exposed dentine (not dangerous, but can make cleanings unpleasant), or sore gum tissues.

In case you may have had painful cleaning experiences in the past, switching to a gentle hygienist/dentist and perhaps a spot of nitrous oxide can often make all the difference. You could also choose to be numbed. If you find the scaling a bit uncomfortable because the gum tissues (rather than the teeth themselves) are sensitive, topical numbing gels can be used.

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Bleeding Gums During Pregnancy

Periodontal-Health-&-Treatm

 

Pregnancy Gingivitis

Topics

  • What is Gingivitis?
  • What is Pregnancy Gingivitis?
  • Causes of Gum Disease in Pregnancy
  • Symptoms of Pregnancy Gingivitis
  • Complications of Pregnancy Gingivitis
  • Treating Gingivitis in Pregnancy
  • Prevention


Some ladies may feel that their gums are uncomfortable than usual during pregnancy. Their gums are sore or tender, or if they bleed when brushing or flossing, they may have a condition called pregnancy gingivitis. Pregnancy gingivitis is a very common occurrence during pregnancy however; if it is not treated it can lead to complications with their pregnancy. If you are pregnant and notice any of the symptoms of pregnancy gingivitis it is important that you visit with your dentist in order to get appropriate treatment.

Pregnancy gingivitis is an hyperplastic reaction to microbial plaque. Elevated estrogen or progesterone levels resulting from hormonal shifts enhance tissue vascularity, which permits an exaggerated inflammatory reaction to plaque.

What is Gingivitis?

Gingivitis is more commonly referred to as gum disease, and it will affect over 90% of Americans at some point in their lives. Caused by the sticky plaque that accumulates on our teeth and gums, it can leave your gums swollen and tender, and even cause them to bleed. Gingivitis can also make brushing and flossing extremely painful. Gingivitis is one of the earliest stages of a more severe type of gum disease, called periodontal disease. Untreated gum diseases will progress into periodontal disease, which can cause irreversible damage to your gums and teeth. (More info on gingivitis)

What is Pregnancy Gingivitis?

Pregnancy gingivitis is simply gingivitis that occurs during pregnancy. More than 50% of all pregnant women experience some form of pregnancy gingivitis. Though gingivitis disease is annoying, it is usually harmless, unless it is left untreated. Pregnancy gingivitis is an hyperplastic reaction to microbial plaque. Elevated estrogen or progesterone levels resulting from hormonal shifts enhance tissue vascularity, which permits an exaggerated inflammatory reaction to plaque.  Pregnancy gingivitis produces fiery red, swollen and tender marginal gingiva and compressible and swollen interdental papilla. If pregnancy gingivitis progresses to periodontal disease, it can increase your risk of going into preterm labor.

Causes of Gum Disease in Pregnancy

There are a number of causes of gum disease in pregnancy. One such reason is increased blood flow. During pregnancy, your blood flow actually increases by between 30% and 50%. This is to ensure that your baby is provided with the appropriate nutrients to grow and develop. Unfortunately, this increased blood flow can also cause you gums to swell and become very tender. It may even cause your gums to bleed, leaving them at increased risk for gingivitis.

The rise in your hormones can also play a role in you developing pregnancy gingivitis. These higher levels of hormones leave your gums and teeth more sensitive to the bacteria that hide in plaque. This is one reason why gingivitis is so common in pregnancy.

Morning sickness may also play a small role in contributing to pregnancy gingivitis. Many women find that they can no longer stand the smell or taste of toothpaste, making it difficult to maintain good oral hygiene. Increased vomiting during pregnancy can also take its toll on your gums. Vomit contains stomach acid which can eat away at your gums and teeth, making your mouth very sensitive.

Symptoms of Pregnancy Gingivitis

There are a few symptoms of gum disease to keep an eye out for. If you notice any of these symptoms, it is important to seek treatment as soon as possible.

  • tender, swollen gums
  • red or purple-red gums
  • gums that look shiny
  • bleeding gums after brushing or flossing
  • persistent bad breath
  • a bad taste in the mouth that won’t go away
  • mouth sores

Complications of Pregnancy Gingivitis

Generally speaking, pregnancy gingivitis is nothing to worry about. However, if your gingivitis is left untreated it could cause potential health problems for both you and your baby.

Sometimes, gum disease can cause sores to form on your gums. These sores are often called pregnancy tumors. These tumors can grow up to three-quarters of an inch in size and may cause discomfort or even pain. If ruptured, pregnancy tumors can become infected. Most tumors can be easily removed though, before they cause any complications.

It is important to take pregnancy gingivitis seriously because, if untreated, it will lead to periodontal disease. Periodontal gum disease is an advanced form of gingivitis that attacks the bones and tissues supporting the teeth. This disease can cause permanent damage to your mouth, and can cause you to lose both your gums and teeth. Periodontal disease has also been linked to a higher risk of premature birth – in fact, women with periodontal disease are seven times more likely to give birth prematurely.

Treating Gingivitis in Pregnancy

There are no cures for gum disease although its damage can sometimes be reversed or halted. All pregnant women should receive at least two thorough dental cleanings during pregnancy. This should help to reduce your chances of developing pregnancy gingivitis or periodontal disease.

If you already have gingivitis, the best gum disease treatment is to have a complete cleaning at your dentist’s office. Your dentist will scale your teeth using a variety of instruments. This will remove excess plaque from your teeth and around your gum line. Serious gingivitis may also require root planning, a process during which the roots of your teeth are cleaned of plaque completely.

Prevention

As always, the best treatment for gingivitis is prevention. Maintaining a good oral hygiene routine will ensure that you have healthy gums and teeth for a long time to come. Try following these tips:

  • brush twice a day for at least five minutes
  • use a soft bristle brush – this will prevent you from irritating your gums
  • floss once a day or use an anti-bacterial mouthwash to get rid of plaque from between your teeth
  • avoid eating large amounts of refined sugar – this will cut down on plaque and tartar buildup
  • visit your dentist regularly

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Treatments of gum disease:

 

Dental Implants

BEST THING TO NATURAL TEETH

What is Dental Implant?

A dental implant is a small “anchor” made of titanium. It is inserted into the jawbone to take the place of your missing tooth root. After Osseointegration, or when the surrounding bone has attached to the implant, a replacement tooth is secured to the top of the implant. The new tooth looks, feels, and performs just like your natural teeth.

Dental implants can be used in a variety of situations, whether you need to replace a single missing tooth or many teeth. They can even be used to replace a full denture. As anchor points, implants can also securely attach a partial denture or bridge.

 

What are the benifits of dental implant?

Choosing implants offers you a number of significant advantages including:

More healthful and beautiful: When teeth are missing, the surrounding bone begins to shrink. This unhealthy bone loss can make your jawline recede. Dental implants can help prevent deterioration of the jawbone caused by loss of teeth, so your face retains its natural shape.

As an alternative to bridgework, dental implants eliminate the need to grind down healthy teeth when replacing one or more adjacent teeth.

More comfortable: Because dental implants are securely anchored, there is no slipping or movement as there is with dentures. This eliminates some of the key worries of dentures, including poor fit, gum irritation, and pain from exposed nerves.

More confident: With dental implants, you will never need to cover your mouth when laughing, smiling, or speaking. You can eat your favorite foods without pain or fear of embarrassment – and taste every bite. You will look better, feel better, and live more confidently.

Are you the candidate for dental implants?

If you’re healthy enough to have a tooth extracted, you’re probably healthy enough to have an implant – whether your missing teeth are the result of injury, disease, or decay. General good health and adequate bone in the jaw are the key requirements. Your doctor can tell you if implants are right for you.

What is involved in implant procedure?

The dental implant process involves several steps that take place over a time period that averages from four to nine months. The typical process will include:

Initial implant placement: This procedure is typically performed in your dentist’s office under either a local or a general anesthesia. Your doctor places the implant into your jaw. Over the next several months, bone will attach to the surface of the implant anchoring it into position. Depending on your particular case, an additional minor procedure creates an opening through which your artificial tooth will emerge.

Implant prosthetic attachment: During this phase, your dentist painlessly attaches a prosthetic “post” from Zimmer Dental to the implant. A simple impression will be taken and over the next few days an artificial tooth will be created for a functional natural restoration.

Implants can improve your appearance, confidence and freedom

Since dental implants look and feel like natural teeth, they naturally enhance your appearance. More importantly, the securely attached implant gives you the confidence of eating what you like, speaking easily and clearly, and freedom from embarrassment. And, by following a regular routine of careful oral hygiene and regular checkups, your implants can last for many years.

To find out if implants are a solution for you, ask your doctor to evaluate you today.

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