What Is It?

Periodontitis is a term used to describe a group of conditions that involves inflammation of the gums and other structures that support the teeth. Periodontitis is caused by bacteria found in dental plaque and often, but not always, starts as gingivitis.

In trying to eliminate the bacterial infection, your body produces substances that destroy the structures that hold the teeth in the jaw, including the periodontal ligament and underlying bone. As this process continues, the teeth become loose. Pockets form between the teeth and gums, allowing more bacteria to accumulate. Left untreated, periodontitis can result in tooth loss.

Periodontitis usually is relatively painless. The onset of significant pain may signal the development of an abscess.

Older adults are more likely to have periodontitis.

People who smoke are four to seven times more likely than nonsmokers to get periodontitis. Smoking may impair the body's defense against bacteria.

Symptoms

Symptoms include:

• Reddened, swollen or bleeding gums
• Receding gums
• Loose Teeth
• Bad breath
• An unpleasant taste in the mouth

However, many people are unaware of these symptoms or do not believe they are signs of a serious problem.

Diagnosis

Your University Place dentist will examine your mouth, paying special attention to your gums and teeth. If you have periodontitis, a dental probeinserted between your tooth and your gums will penetrate deeper than it normally would.

Your dentist may also test for loose teeth. Teeth have a normal range of mobility, but in people with periodontitis, the teeth are looser due to the destruction of the fibers and bone supporting the teeth.

Your dentist may also order X-rays to help diagnose periodontitis. These can be compared with older X-rays to see if changes have occurred in your teeth and gums.

Expected Duration

Unlike gingivitis, periodontitis cannot be completely reversed. In some situations, the supporting fibers and bone that have been lost can be regenerated. In most cases, however, particularly in advanced stages of the disease, the effects are permanent. However, treatment and improved oral hygiene at any stage can improve the health of your gums and prevent further destruction.

Prevention

Daily brushing and flossing (morning and night) and regular visits for professional cleaning can help prevent periodontitis or allow you to have it treated during its earliest stages. If you smoke, quitting will reduce your risk significantly.

Treatment

Treatment depends on how severe your periodontitis is. Dentists classify the disease as mild, moderate or severe.

Mild periodontitis is usually treated first with a thorough cleaning called scaling and root planing. Scaling removes plaque or calculus that has accumulated on the crowns of your teeth (the parts that show) and slightly below the gum line. Root planing has two purposes: 1) to remove plaque or calculus from the roots of your teeth and 2) to smooth the roots of the teeth, making it more difficult for bacteria to cling to them. This, combined with good oral hygiene at home, often is enough for successful treatment.

Moderate periodontitis may require more than scaling and root planing. Typically, your dentist will scale and root-plane your teeth. If this does not take care of the problem, he or she may decide that you need surgical treatment. Surgery can involve reshaping the gums to fit the teeth (resective surgeries) or encouraging lost bone to regrow (regenerative surgeries). Your dentist will decide whether you will need surgery and what type you need.

Severe periodontitis likely will require surgical intervention and, in some instances, antibiotics. At this stage of disease, tooth loss is a distinct possibility.

No matter which treatment you undergo, you should start a strict regimen of brushing and flossing to help restore your teeth to health.

When To Call Your University Place Dentist

The best course of action is to get regular dental checkups. If you have persistent bleeding or swelling of your gums or notice loose teeth, call your dentist.

Prognosis

The outlook is good if the disease is recognized early and treated aggressively. Once bone loss occurs, the prognosis depends on the severity of the loss. Quitting smoking is very important for periodontal therapy to be successful. Lifelong maintenance will be required once the disease is controlled.

In order to achieve a sparkling smile, you’ll need to treat your teeth to more than just regular brushing. Healthy teeth start with healthy habits — from your brushing routine to the foods you should and shouldn’t eat.

"Your mouth is your body’s initial point of contact with the nutrients you consume," says Kimberly A. Harms, DDS, a spokesperson for the American Dental Association (ADA). "So naturally, what you put in your mouth impacts not only the health of your teeth and gums, but also your overall health." That includes beverages, the type and frequency of snacks, and even the gum you chew.

It’s important to go beyond brushing and change your daily habits to get the bright, healthy smile you want. Here's how:

• Avoid enamel damage. The layer of protective enamel on your teeth is your first defense against cavities, but certain foods and drinks strip it away, putting your smile at risk. Opting for sugar-filled sodas, sticky sweets (such as taffy), sweetened fruit drinks, and sugary snacks promotes tooth decay, Dr. Harms says. "When you eat sugary foods or sip sugary drinks for long periods of time, plaque bacteria use that sugar to produce acids that attack your enamel." Be sure to read food labels and choose foods that are lower in sugar.
• Eat nutrient-rich foods. Your teeth need nutrients to stay strong, white, and cavity-free. "For good dental health, it’s important to eat a variety of foods from each of the five major food groups," Harms says. This ensures that your teeth get the essential nutrients they need. Calcium, found in dairy products and leafy greens, is especially important for your teeth. Phosphorous, which can be found in proteins such as eggs, fish, poultry, meat, and dairy, is also essential. Both of these nutrients help protect and restore the enamel on your teeth, according to the ADA.
• Limit snacks. Too much snacking isn't only bad for your waistline; it's bad for your smile, too. "Foods eaten as part of a meal cause less harm to teeth than eating lots of snacks throughout the day do because more saliva is released during a meal," Harms says. "Saliva helps wash foods from the mouth and lessens the effects of acids, which can harm teeth and cause cavities." Some snacking is inevitable, so make sure to opt for something healthy such as cheese, veggies, nuts, or fruit, the ADA recommends.
• Don’t smoke or use tobacco. Smoking and using any kind of tobacco stains your teeth, but it also affects your whole mouth, the ADA says. It causes gum disease, which can lead to tooth loss as well as oral cancer. If you have oral surgery or a tooth extraction, smoking can slow your healing time. If you smoke or use other tobacco products, find a plan that works for you to quit. Ask your doctor or dentist for help or look for local or online quit programs.
• Limit teeth-staining culprits. Your favorite beverages might be dulling your smile. Coffee, tea, and red wine are some of the biggest culprits, Harms says. "They have intense color pigments called chromogens that attach to the enamel, which is the white, outer part of your tooth." For whiter teeth, cut back on these teeth-staining beverages. To help counteract existing stains, consider using fluoride toothpaste that also whitens teeth, or ask your dentist about whitening treatments to help reverse any damage.
• Drink plenty of water. It's healthy, it's free, it's widely available, and it's great for your oral health — so try to carry a water bottle with you everywhere and sip all day long. "Drinking water is also one of the best things you can do for your teeth, especially if it’s fluoridated," Harms says. Fluoride is considered "nature's cavity fighter," according to the ADA. It helps strengthen your teeth and ward off tooth decay. Water also helps keep your mouth moist and clean and washes away food particles that bacteria feed on.
• Chew sugar-free gum. It's always beneficial to brush between meals, but if you can't get to a sink, chew sugar-free gum. "Chewing sugarless gum increases the flow of saliva, which washes away food and other debris, neutralizes acids produced by bacteria in the mouth, and provides disease-fighting substances throughout the mouth," Harms says. "Increased saliva flow also carries with it more calcium and phosphate to help strengthen tooth enamel." Opt for gum with a seal from the ADA on the package to be sure it's sugar-free.
• See your dentist regularly. Be sure to get regular cleanings and checkups in order to spot dental problems before they get out of hand. Early diagnosis and treatment of dental issues is often simpler and more affordable, Harms says, and regular dental visits can help prevent many problems from developing. "Visiting your dentist is also important because some diseases or medical conditions have symptoms that can appear in the mouth," she says. Schedule regular checkups with your dentist so your smile is bright, white, and healthy, and to know you're doing all you can for your teeth.

If you are overdue for a dental cleaning, please contact our University Place Dentist today.

What is Gum Disease?

Gum disease is an inflammation of the gums that can progress to affect the bone that surrounds and supports your teeth. It is caused by the bacteria in plaque, a sticky, colorless film that constantly forms on your teeth. If not removed through daily brushing and flossing, plaque can build up and the bacteria infect not only your gums and teeth, but eventually the gum tissue and bone that support the teeth. This can cause them to become loose, fall out or have to be removed by a dentist.

There are three stages of gum disease:

• Gingivitis: this is the earliest stage of gum disease, an inflammation of the gums caused by plaque buildup at the gumline. If daily brushing and flossing do not remove the plaque, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. You may notice some bleeding during brushing and flossing. At this early stage in gum disease, damage can be improved, since the bone and connective tissue that hold the teeth in place are not yet affected.
• Periodontitis: at this stage, the supporting bone and fibers that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gumline, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.
• Advanced Periodontitis: in this final stage of gum disease, the fibers and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, if aggressive treatment can't save them, teeth may need to be removed.

How do I Know if I Have Gum Disease?

Gum disease can occur at any age, but it is most common among adults. If detected in its early stages, gum disease can be improved so see your dentist if you notice any of the following symptoms:

• Gums that are red, puffy or swollen, or tender
• Gums that bleed during brushing or flossing
• Teeth that look longer because your gums have receded
• Gums that have separated, or pulled away, from your teeth, creating a pocket
• Changes in the way your teeth fit together when you bite
• Pus coming from between your teeth and gums
• Constant bad breath or a bad taste in your mouth

How is Gum Disease Treated?

• The early stages of gum disease can often improve with proper brushing and flossing. Good oral health will help keep plaque from building up.
• A professional cleaning by your dentist or hygienist is the only way to remove plaque that has built up and hardened into tartar. Your dentist or hygienist will clean or "scale" your teeth to remove the tartar above and below the gumline. If your condition is more severe, a root planing procedure may be performed. Root planing helps to smooth irregularities on the roots of the teeth making it more difficult for plaque to deposit there.

By scheduling regular checkups, early stage gum disease can be treated before it leads to a much more serious condition. If your condition is more advanced, treatment in University Place dentist office will be required.

What are Cavities?

"Cavities" is another way of saying tooth decay. Tooth decay is heavily influenced by lifestyle, what we eat, how well we take care of our teeth, the presence of fluoride in our water and toothpaste. Heredity also plays a role in how susceptible your teeth may be to decay.

While cavities are generally more common among children, adults are also at risk. The types of cavities include:

• Coronal cavities — the most common type occurring in both children and adults, coronal cavities usually are located on chewing surfaces or between the teeth
• Root cavities — as we age, our gums recede, leaving parts of the tooth root exposed. Since there is no enamel covering tooth roots, these exposed areas easily decay
• Recurrent decay — decay can form around existing fillings and crowns. This is because these areas may have a tendency to accumulate plaque, which can ultimately lead to decay

Adults are especially at risk for cavities if they suffer from dry mouth, a condition due to a lack of saliva. Dry mouth may be caused by illness, medications, radiation therapy and chemotherapy, and may be either temporary (days to months) or permanent, depending on its cause.

Cavities are very serious. Left untreated, a cavity can destroy your tooth and kill the delicate nerves at its center, which may result in an abscess, an area of infection at the root tip. Once an abscess forms, it can only be treated with a root canal, surgery or by extracting the tooth.

How Do I Know if I Have a Cavity?

Only your dentist can tell for sure whether you have a cavity. That's because cavities develop below the tooth's surface, where you can't see them. When you eat foods that contain carbohydrates (sugars and starches), these carbohydrates are eaten by the bacteria in plaque, producing acids that eat into the tooth. Over time, the tooth enamel begins to break down beneath the surface while the surface remains intact. When enough of the sub-surface enamel is eaten away, the surface collapses, forming a cavity.

Cavities are most likely to develop in pits on the chewing surfaces of the back teeth, in between teeth, and near the gumline. But regardless of where they occur, the best way to spot them and treat them before they become serious is by visiting your dentist regularly for checkups.

How Can I Help Prevent Cavities?

• Brush at least twice a day and floss daily to remove plaque from between teeth and below the gumline
• Have regular dental checkups. Preventive care can help stop problems from occurring and keep minor problems from becoming major ones
• Eat a well-balanced diet that limits starchy or sugary foods. When you do eat these foods, try to eat them with your meal instead of as a snack to minimize the number of times that your teeth are exposed to acid
• Use dental products that contain fluoride, including toothpaste
• Make sure that your children's drinking water is fluoridated. If your water supply does not contain fluoride, your dentist or pediatrician may prescribe daily fluoride supplements

Please contact Light Dental Studios of University Place if you have any questions regarding dental cavities.

Dental implants have been used successfully for many years. Your implant should last for a very long time if you take the following points to heart.

Smoking

This is one of the greatest risks for implant-related complications. You should therefore try to quit smoking.

Oral Hygiene

Thoroughly cleaning and caring for the implant during all steps of the treatment is extremely important. Careful attention to your oral hygiene every day is important for the survival of your implant.

Maintenance

Visiting your dental practice for regular checkups (recalls) is just as important. You and your dental team have to decide how often these visits should take place, but they are usually at intervals of 3 to 6 months. At these visits, your implants, teeth, and gums are checked and professionally cleaned, including the areas you cannot reach at home. Professional cleaning of implants is more complex than cleaning teeth, which means that it takes longer and may require special instruments.

Mucositis and peri-implantitis can develop without any obvious symptoms. This is another reason why regular checkups with your dentist are so important. Mucositis and peri-implantitis do not usually cause pain, so patients often fail to notice the development of these diseases.

Jennifer Flach was a college junior when her wisdom teeth started making themselves known.

"My other teeth started moving around," she remembers. "The wisdom teeth were pushing out and undoing some of the orthodontic work I had done in high school."

At the same time, her brother — who's two years younger and was also in college — had no symptoms. But the family dentist suggested his wisdom teeth should come out too.

Jen and her brother had back-to-back wisdom tooth extractions and recovered together at home during spring break. "It was quite a week at my parents' house," she says.

Patrick Grother was 26 when his dentist mentioned that his wisdom teeth might need to be removed. His bottom left wisdom tooth had partially erupted into his mouth and a flap of gum still covered it. "The dentist said food would get trapped there and it could get infected," he says. Patrick then visited a periodontist, who said that the gum flap could be cut away but it would grow back.

"I put it off for awhile," Patrick said, but he eventually had the wisdom teeth on the left side of his mouth extracted.



A few people are born without wisdom teeth or have room in their mouths for them, but like Jen and her brother, many of us get our wisdom teeth taken out during our college years. And like Patrick, many of us are first alerted to the problem when our wisdom teeth don't emerge (erupt) into the mouth properly because there is not enough toom for them to fit.

"A part of the tooth may remain covered by a flap of gum, where food particles and bacteria can get trapped, causing a mild irritation, a low-grade infection called pericoronitis and swelling," says Dr. Donald Sadowsky, professor emeritus of clinical dentistry College of Dental Medicine and the Mailman School of Public Health. This usually happens with the lower wisdom teeth. Pericoronitis and the pain it causes is the most common reason people need their wisdom teeth taken out.

Pericoronitis is just one of the reasons that you may need to have a wisdom tooth or more than one removed.

In many people, the wisdom teeth never even partially enter the mouth. Often the teeth are tilted under the gum and blocked from coming in by bone or other teeth. Dentists call these impacted teeth; they may cause pain, but you may feel nothing at all for years. You may not even be aware that you have wisdom teeth until your dentist sees them on an X-ray.

Regular dental visits are important during your teens and early twenties because this is the time when teeth are most likely to decay. Regular visits allow your dentist to follow the progress of your wisdom teeth with X-rays.

Even if your wisdom teeth aren't causing any pain or other problems, they may cause problems at some point. The most common problems are decay, infection, and crowding or damage to other teeth. But more serious complications can occur, including the development of a cyst that can cause permanent damage to bone, teeth and nerves.

However, not all wisdom teeth need to be removed.

If removing wisdom teeth is necessary, it's easier in younger people because the tooth roots are not fully developed and the bone in which the teeth sit is less dense. Extracting your wisdom teeth before any complications develop also allows for shorter recovery time and less discomfort after the surgery.

Teeth for a Lifetime

Thanks to better at-home care and in-office dental treatments, more people than ever before are keeping their teeth throughout their lives. Although some diseases and conditions can make dental disease and tooth loss more likely, most of us have a good deal of control over whether we keep our teeth into old age.

The most important thing you can do to maintain good oral health is to brush and floss your teeth regularly.

Most mouth woes are caused by plaque, that sticky layer of microorganisms, food particles and other organic matter that forms on your teeth. Bacteria in plaque produce acids that cause cavities. Plaque also leads to periodontal (gum) disease, a potentially serious infection that can erode bone and destroy the tissues surrounding teeth.

The best defense is to remove plaque daily before it has a chance to build up and cause problems. Brushing removes plaque from the large surfaces of the teeth and, if done correctly, from just under the gums. Flossing removes plaque between teeth.

Brushing

Most of us learned to brush our teeth when we were children and have kept the same technique throughout our lives. Unfortunately, many of us learned the wrong way. Even if we learned the correct method, it's easy to become sloppy over the years. Brushing correctly isn't instinctive. Getting the bristles to remove plaque without damaging your gums is a little trickier than you might think.

There are different ways to brush teeth, and your dentist or dental hygienist can show you the method that he or she feels would be best for you. The modified Bass technique is among the most popular for adults and is very effective in removing plaque above and just below the gum line. Children, however, may find it difficult to move the toothbrush this way. A dentist or dental hygienist can explain to your child the best way to brush. Parents should supervise their children's oral hygiene until age 9 or 10.

Here are a few general pointers about brushing:

• Brush at least twice a day: Many oral health professionals recommend brushing just before going to bed. When you sleep, saliva decreases, leaving the teeth more vulnerable to bacterial acids. Teeth should also be brushed in the morning, either before or after breakfast, depending on your schedule. After breakfast is ideal so food particles are removed. But if you eat in your car, at work or skip breakfast entirely, make sure you brush in the morning to get rid of the plaque that built up overnight.
• Brush no more than three times a day: Brushing after lunch will give you a good mid-day cleaning. Remember, though, that brushing too often can cause gums to recede over time. Brush lightly —Brushing too hard can cause gums to recede. Plaque attaches to teeth like jam sticks to a wooden spoon. It can't be totally removed by rinsing, but just a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can't remove it, so brushing harder won't help. Try holding your toothbrush the same way you hold a pen. This encourages a lighter stroke.
• Brush for at least two minutes: Set a timer if you have to, but don't skimp on brushing time. Longer is fine, but two minutes is the minimum time needed to adequately clean all your teeth. Many people brush for the length of a song on the radio. That acts as a good reminder to brush each tooth thoroughly.
• Have a standard routine for brushing: Try to brush your teeth in the same order every day. Some oral health professionals feel that this helps patients remember to brush all areas of their mouths. If you do this routinely, it eventually will become second nature. For example, brush the outer sides of your teeth from left to right across the top then move to the inside and brush rights to left. Repeat the pattern for your lower teeth.
• Always use a toothbrush with "soft" or "extra soft" bristles: The harder the brush, the greater the risk of harming gum tissue.
• Change your toothbrush regularly: As soon as the bristles begin to splay, the toothbrush loses its ability to clean properly. Throw away your old toothbrush after three months or when the bristles flare, whichever comes first. If you find your bristles flaring much sooner than three months, you may be brushing too hard. Try easing up.
• Electric is fine, but not always necessary: Electric or power-assisted toothbrushes are a fine alternative to manual brushes. They are especially useful for people who are less than diligent about proper brushing technique or for people with physical limitations that make brushing difficult. As with manual brushes, choose soft bristles, brush for at least two minutes and don't press too hard or you'll damage your gums.
• Choose the right toothpaste for you: It can be overwhelming to face the huge number of toothpaste choices in the average supermarket. Remember, the best toothpaste for you may not be the best toothpaste for someone else.

Toothpastes don't merely clean teeth anymore. Different types have special ingredients for preventing decay, plaque control, tartar control, whitening, gum care or desensitizing teeth.

Most toothpastes on the market today contain fluoride, which has been proven to prevent, stop or even reverse the decay process. Tartar-control toothpastes are useful for people who tend to build up tartar quickly, while someone who gets tooth stains may want a whitening toothpaste. Whitening toothpastes will remove only surface stains, such as those caused by smoking, tea or coffee. To whiten teeth that are stained at a deeper level, talk with your dentist.

Your needs will likely change as you get older, so don't be surprised if your hygienist recommends a type of toothpaste you haven't used before. Look for the ADA seal of approval, which assures that the toothpaste has met the standards set by the American Dental Association. Once these conditions are met, choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint — these work alike, so let personal preference guide your decision.

Some people find that some toothpaste ingredients irritate their teeth, cheeks or lips. If your teeth have become more sensitive or your mouth is irritated after brushing, try changing toothpastes. If the problem continues, see your dentist.

Flossing

Many people never learned to floss as children. But flossing is critical to healthy gums and it's never too late to start. A common rule of thumb says that any difficult new habit becomes second nature after only three weeks. If you have difficulty figuring out what to do, ask your dentist or dental hygienist to give you a personal lesson.

Here are a few general pointers about flossing:

• Floss once a day: Although there is no research to recommend an optimum number of times to floss, most dentists recommend a thorough flossing at least once a day. If you tend to get food trapped between teeth, flossing more often can help remove it.
• Take your time: Flossing requires a certain amount of dexterity and thought. Don't rush.
• Choose your own time: Although most people find that just before bed is an ideal time, many oral health professionals recommend flossing any time that is most convenient to ensure that you will continue to floss regularly. Choose a time during the day when you can floss without haste.
• Don't skimp on the floss: Use as much as you need to clean both sides of every tooth with a fresh section of floss. In fact, you may need to floss one tooth several times (using fresh sections of floss) to remove all the food debris. Although there has been no research, some professionals think reusing sections of floss may redistribute bacteria pulled off one tooth onto another tooth.
• Choose the type that works best for you: There are many different types of floss: waxed and unwaxed, flavored and unflavored, ribbon and thread. Try different varieties before settling on one. People with teeth that are closely spaced will find that waxed floss slides more easily into the tight space. There are tougher shred-resistant varieties that work well for people with rough edges that tend to catch and rip floss.

If you have any further questions regarding keeping your teeth healthy, please contact our University Place dentist today!