Posts for tag: gum disease
In 2016, voters in three states—California, Massachusetts and Nevada—joined Alaska, Colorado, Oregon, Washington and the District of Columbia in legalizing the use of recreational marijuana. These referenda moved the country closer to what may soon be a monumental political showdown between the states and the federal government, which still categorizes marijuana as a controlled substance.
But there’s another angle to this story often overshadowed by the political jousting: is increased marijuana use a good thing for your health and overall physical well-being?
When it comes to your dental health, the answer might be no. The Journal of Periodontology recently published a study that included frequent marijuana users showing increased signs of periodontal (gum) disease. This harmful bacterial infection triggered by plaque buildup can cause weakening of gum attachment to teeth and create the formation of large voids between teeth and gums called periodontal pockets. Left untreated, the disease can also cause supporting bone loss and eventually tooth loss.
The study looked at the dental treatment data of over 1,900 adults of which around one-quarter used marijuana once a month for at least a year. Marijuana users in the study on average had 24.5% of pocket sites around their teeth with depths of at least eight millimeters (an indication of advanced gum disease). In contrast, non-users averaged around 18.9% sites.
To be sure, there are several risk factors for gum disease like genetics, oral hygiene (or lack thereof), structural problems like poor tooth position or even systemic conditions elsewhere in the body. This published study only poses the possibility that marijuana use could be a risk factor for gum disease that should be taken seriously. It’s worth asking the question of whether using marijuana may not be good for your teeth and gums.
Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.
One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.
It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.
We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).
Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.
Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.
A loose permanent tooth is not a good thing—and not something you should put off having examined. That’s because a loose tooth could soon become a lost tooth.
How we treat it depends on its underlying cause, which could be one of two types. One is primary occlusal trauma, meaning the affected tooth has experienced accidental trauma or higher biting forces than it normally encounters. This usually happens because of teeth grinding habits.
It could also be secondary occlusal trauma. Unlike primary trauma where the supporting gums and bone may be reasonably healthy, secondary trauma occurs because these structures have been severely damaged by periodontal (gum) disease. As the gums begin to detach from a tooth and its underlying bone deteriorates, even normal biting forces can loosen it.
If gum disease is present, our first priority is to bring it under control. We do this primarily by removing all dental plaque (a thin film of bacteria and food particles that triggers the infection and sustains it) and calculus or tartar (calcified plaque). This can take several sessions and, in the case of deep infection, may require a surgical procedure.
On the other hand, if teeth grinding is the primary cause, we’ll focus on minimizing the habit and its effects. One way is to create a custom-fitted guard worn to prevent upper and lower teeth from making solid contact. You may also need to improve your management of stress—another factor in teeth grinding—through medication, therapy or biofeedback.
In either case, improved periodontal health will help the gums naturally regain their strong attachment with help, if necessary, from gum tissue or bone grafting surgery. But this healing process can take time, so we may need to secure a loose tooth in the interim by splinting it to neighboring stable teeth. This usually requires bonding rigid material or metal across the back of all involved teeth or in a channel cut along the teeth’s biting surfaces. In this way the more stable teeth support the loose one.
Splinting may be temporary as the mouth heals from disease or trauma and the teeth regain their stability. In some cases, though, it may be permanent. Either way, dealing promptly with a loose tooth can help ensure it’ll survive—so see your dentist as soon as possible.
If you would like more information on treating loose teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment for Loose Teeth.”
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”
If you suspect you have periodontal (gum) disease, it's important to get a correct diagnosis and begin treatment as soon as possible. The sooner you begin treatment the better the long-term outcome.
Gum disease is a bacterial infection that's most often triggered by plaque, a thin film of food particles on tooth surfaces. Plaque buildup most often occurs when a person doesn't practice effective oral hygiene: daily brushing and flossing and professional cleanings at least twice a year.
The most common type of gum disease, gingivitis, can begin within days of not brushing and flossing. It won't always show itself, but you can have symptoms like swollen, red or bleeding gums, as well as bad taste and breath. You could also develop painful abscesses, which are localized pockets of infection within the gums.
If we don't stop the disease it will eventually weaken the gum attachment to the teeth, bone loss will occur and form deep pockets of infection between the teeth and bone. There's only one way to stop it: remove the offending plaque from all tooth surfaces, particularly below the gum line.
We usually remove plaque and calculus (hardened plaque deposits) manually with special hand instruments called scalers. If the plaque and calculus have extended deeper, we may need to perform another procedure called root planing in which we shave or “plane” the plaque and calculus (tartar) from the root surfaces.
In many cases of early gum disease, your family dentist can perform plaque removal. If, however, your gum disease is more extensive, they may refer you to a periodontist, a specialist in the treatment and care of gums. Periodontists are trained and experienced in treating a full range of gum infections with advanced techniques, including gum surgery.
You can also see a periodontist on your own for treatment or for a second opinion — you don't necessarily need a referral order. If you have a systemic disease like diabetes it's highly advisable you see a periodontist first if you suspect gum disease.
If you think you might have gum disease, don't wait: the longer you do the more advanced and destructive the disease can become. Getting an early start on treatment is the best way to keep the treatment simple and keep gum disease from causing major harm to your teeth and gums.
If you would like more information on the diagnosis and treatment of gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When to See a Periodontist.”