 |
DENTAL BONE LOSS
aka, PERIODONTAL DISEASE (often mistaken as PERIDONTAL DISEASE), GUM DISEASE
If untreated, YOU WILL LOSE YOUR TEETH and end up in DENTURES . It is that simple. GUM DISEASE is VERY REAL, and VERY SERIOUS! Many people think “if it don’t hurt, don’t fix it”. Sometimes yes, but not in this case! If your dentist tells you you have gum disease, BELIEVE IT (the CONSEQUENCES of not, are SEVERE). Not only will you LOSE YOUR TEETH, but it can also cause BAD BREATH and HALITOSIS!
WHAT IS DENTAL BONE LOSS?
HOW DOES IT HAPPEN??
BUT IT’S REVERSIBLE, RIGHT?? NO. It is NOT reversible, but it is arrestable. Meaning, the bone will NEVER grow back, but you can prevent further loss. This is done by having DEEP cleanings (called root planning) at REGULAR intervals. The interval varies on a case by case basis, but is usually every 3-6 months. With a PROBE. Seriously! That is the instrument that is used to measure your gum pockets. Often times when you have a dental exam, you will hear your dentist calling out numbers like 3, 4, 4, etc. In general, 3 or below is good, 4 is marginal, and anything higher than a 4 is NOT GOOD. If you start hearing numbers in the 7+ range, you ARE AT A HIGH RISK FOR LOSING YOUR TEETH!! The higher the number, the MORE bone you have LOST! Most patients are probed at intial visits, and at least once a year after that, depending on their particular condition. Patients are not probed until about the age of 20.
IF IT DOESN’T HURT, IT’S OK, RIGHT? WRONG. Once a tooth loses a certain amount of bone, it is deemed PERIODONTALLY HOPELESS. Hopeless teeth need to be EXTRACTED. Patients often think that because the tooth doesn’t hurt, they don’t understand why it needs to be extracted. The reason is that because the tooth is IMPOSSIBLE to clean with the extensive bone loss, the BONE LOSS will CONTINUE. The problem with continued bone loss, is that it makes RESTORING the space VERY DIFFICULT, and maybe IMPOSSIBLE. Consider, if you pull the tooth out now, maybe there will be enough bone left to place an IMPLANT. If you wait 5 years and lose MORE bone, maybe in 5 years there won’t be ENOUGH bone anymore, and an implant CANNOT be placed. Or, consider a DENTURE. One placed now may fit very well, versus one placed in 5 years after 5 more years of lost bone, may MOVE AROUND and not be stable AT ALL!
WHAT MAKES DENTAL BONE LOSS WORSE?? SMOKING: Along with all the other problems it causes, it DEFINITELY will make your periodontal disease progress faster. And we’re talking 2.5-6 TIMES as fast! Some may not be scared of getting lung cancer, but are you scared of LOSING ALL OF YOUR TEETH? SMOKELESS TOBACCO: This can affect the GUMS and teeth in the area that it’s placed, but does not have the same GENERALIZED effect that smoking has. On the other hand, many people place it in different areas, so it can affect ALL TEETH. Also, BOTH SMOKING and use of SMOKELESS TOBACCO increase the risk for ORAL CANCER. A NOTE ON QUITTING... Your gums will LOOK worse initially, but WILL SHOW IMPROVEMENT after about 6 MONTHS.
But back to DENTAL BONE LOSS… UNCONTROLLED DIABETES: This can also make the periodontal disease progress faster. So get them BOTH under control, and they very well may help each other! POOR ORAL HYGIENE: If you leave the bugs on your teeth, they’re going to keep EATING. It’s that simple. OSTEOPOROSIS: This may contribute to periodontal disease, but its effect may also be linked to quality of home care. In other words, with good home care, it may have less of an effect than if home care is poor.
MEDICATIONS: DILANTIN, CALCIUM CHANNEL BLOCKERS, and CYCLOSPORIN may promote GINGIVAL OVERGROWTH. When this happens, often times the gums need to be SURGICALLY cut back.
AGE: The older you are, the more likely you are to exhibit some level of periodontal disease, however, there are elderly patients who do not.
The bottom line is, if you WANT to KEEP your teeth, you need to do EVERYTHING your dentist recommends. It is always interesting to see the patients who come in for regular cleanings, but always have bleeding and swollen gums because they use the WRONG END of the toothbrush, then get MAD at the dentist or hygienist because the PERIODONTAL DISEASE is progressing! …and you WILL succeed in KEEPING YOUR TEETH!!
It is recommended to brush and floss before going to bed because while you sleep, your saliva flow decreases, and saliva does help to decrease bacterial activity on the teeth and gums. TREATMENT: Once you start getting gum disease, it may not be possible for a toothbrush to completely clean all the gum pockets. This is why ROOT PLANING by your hygienist may be recommended. ROOT PLANING is cleaning the root surfaces of the teeth, which get exposed when a patient has lost bone supporting the teeth. The irregular root surfaces gather bacteria much more readily than the smooth surfaced enamel (outer layer), therefore often times the cleanings will take LONGER, and need to be done MORE frequently. While many people having cleanings every 6 months, those with periodontal disease may need to be cleaned every 3-4 months. OTHER TREATMENT AIDS: There are other aids available to help control periodontal disease as well. CHLOHEXIDINE (PERIDEX) mouthwash is sometimes recommended. The main drawback to this is that it tends to STAIN teeth when used frequently. Your dentist also may elect to place ANTIBIOTICS in your gum pockets, in order to try and firm up the gums. They are placed after the cleaning is done, and are biodegradable so they do not normally need to be removed. After placement, your dentist will likely advise you not to brush or floss BELOW THE GUM for 10-14 days. (After 14 days, the products lose their effectiveness). There are 3 products currently available. ATRIDOX: This is a DOXYCYCLINE product. All the products have shown some effectiveness in helping manage periodontal disease, however they all can be fairly expensive.
gum disease, gum pain, bone loss, bad breath, root planing, periodontal disease
PERIODONTAL SURGERY can be very beneficial, but unfortunately tends to be fairly painful post operatively. In general, it is not the first course of treatment, but may be needed if other treatments do not produce satisfactory improvements. Most periodontal patients should have scaling and root planing first, and the periodontal condition should be re-evaluated prior to surgery being indicated.
OSSEOUS SURGERY: This is done when patients have severe periodontal disease, and is done to decrease the pockets around the teeth. This allows patients to clean more effectively around the gums. On the flip side, often times more tooth will be exposed, so your teeth may look longer and you may get some root sensitivity. GINGIVAL GRAFTS: When you have gum recession or thin tissue, sometimes it is necessary to graft tissue over the particular area to support the teeth and prevent tooth loss. Often times the tissue is taken from the roof of your mouth, and grafted to the particular area it is needed, often the lower anterior region. IMPLANTS (also done by ORAL SURGEONS ): Think of drilling a screw into BONE! Then attaching a TOOTH to that screw. Simple. Excellent, excellent, excellent; but NOT ALL patients are good candidates!! Unfortunately… Implants are only as strong as the neighboring teeth. For example, if you have severe periodontal disease, implants may not be your best option. Also, you do need a sufficient amount of bone to support the implant. Sometimes additional surgeries need to be done prior to the implant being placed. CROWN LENGTHENING: Surgery done to expose more tooth. Say your tooth BREAKS OFF at the GUMLINE... HOW IS YOUR DENTIST SUPPOSED TO FIX THAT? Think of buying an ice cream cone at your favorite ice cream parlor. They hand you the cone wrapped in paper, right? After you eat the ice cream down to the cone, you have to UNWRAP the paper to eat more cone, right? CROWN LENTHENING surgery is like unwrapping the paper (gums) from the ICE CREAM CONE (tooth), to EXPOSE more TOOTH. After more tooth is exposed, THAT can be RESTORED.
DON’T LIKE THAT GUMMY SMILE?? Periodontal surgery can be done to fix that. The gums can be lifted to expose more teeth, and show less gums! It may sound painful and invasive, but the results may ASTONISH you!
dental bone loss, peridontal disease, gum infections
dental bone loss, peridontal disease, gum infections
dental bone loss, peridontal disease, gum infections
|
