Posts for: May, 2018
Since their development in the laboratory over five decades ago, lasers have found increasing use in our everyday lives. In the field of medicine, it’s not uncommon to find lasers in the offices of dermatologists, ophthalmologists and surgeons, to name just a few. Now, some dentists are finding that lasers can offer an alternative means of treating gum disease — and one that may have advantages in certain situations.
You probably know that a laser produces a special kind of light — in fact, its name is an acronym for “Light Amplification by Stimulated Emission of Radiation.” Essentially, a medical laser uses electrical energy to produce an intense and narrow beam of concentrated light. This light can be directed to a particular area, often via a fiber-optic channel. The laser’s precision allows a doctor or technician to focus the light energy exactly where it’s needed — to remove diseased tissue, seal off blood vessels, and sterilize a wound, for example.
For several years, periodontists — dentists who specialize in treating diseases of the gums — have been researching the use of lasers for treating certain types of gum disease. In standard clinical practice, hand-held instruments and ultrasonic cleaning tools are used at regular time intervals (3 – 6 months) to remove the sticky bacterial biofilm, as well as calculus (tartar), that forms in between teeth and gums. If that still isn't effective, gum surgery may be required to access the affected area, remove diseased tissue, and reduce pocket depth (the space below the gum line that gets larger as bone loss occurs) to prevent reinfection.
Recently, however, several new procedures have been developed that use lasers to accomplish some or all of these goals. One type of therapy uses a special laser that emits pulses of light with a specific wavelength (color) of 1064 nanometers. This light passes through healthy cells like a sunbeam through a window — but when it encounters darkly-pigmented bacteria, it vaporizes them instantly!
One of the potential advantages of laser treatment is its precision: focused directly on the area where trouble occurs, it targets diseased tissue but leaves healthy tissue alone. Another is that laser treatment is less invasive: It requires less tissue removal, and may cause less discomfort and tissue shrinkage (gum recession) than conventional periodontal surgery. And because it produces small amounts of heat, it can seal blood vessels and help control bleeding.
While lasers have long shown promise for treating gum disease, until recently it wasn’t clear if they offered any advantages over traditional methods. Now, several studies have shown that certain laser treatments can be just as effective as traditional gum surgery in many cases — with the potential benefit of being less invasive. In the future, the use of lasers for periodontal procedures is likely to increase.
It’s important to remember that no single treatment — not even a laser — can “zap” gum disease in one fell swoop. Controlling periodontal disease requires effective at-home oral hygiene combined with regular professional care. If you have questions about periodontal disease, please call our office to schedule a consultation.
Many people learn they have periodontal (gum) disease after noticing gum swelling, soreness or bleeding. But what you can see or feel may be only the tip of the iceberg — the damage may extend much deeper.
Gum disease is caused mainly by dental plaque, a thin film of bacteria and food particles built up on teeth due to ineffective brushing and flossing. Infection of the visible gums is only the beginning — left untreated, it can advance well below the gum line and even infect supporting bone.
One critical concern in this regard is the areas where the roots of a tooth separate from each other, known as furcations. Here an infection known as a furcation invasion can cause the bone to weaken and dissolve.
This usually occurs in stages (or classes) we can detect through manual probing and/or with x-rays. In the earliest stage, Class I, we might only notice a slight pocket in the gums with no significant bone loss. In Class II, though, the pocket between the roots has become a horizontal opening of two or more millimeters, indicating definite bone loss with increased pocket depth getting “under” the crown of the tooth. Class III, the last and most serious stage, describes an opening we can probe under the crown all the way to the other side of the tooth; the bone loss now extends “through and through” the furcation.
The basic goal of gum disease treatment is to remove plaque and calculus (tartar) from all tooth and gum surfaces. But removing plaque below the gum line, especially “into” the furcations, can be challenging. We will need instruments called scalers to clean root surfaces, assisted sometimes by ultrasonic equipment to vibrate plaque loose. With furcations we may also need to employ surgery to aid gum or bone tissue regeneration or to make the area easier to access for future cleaning.
Of course, the best way to protect against furcation invasions is to prevent gum disease in the first place. Be sure to brush and floss daily and visit us for thorough dental cleanings and checkups at least every six months.
And don’t delay contacting us if you see any signs of teeth or gum problems. The sooner we can identify gum disease, the more likely we’ll be able to prevent it from doing serious damage to your gums, bone and teeth.
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?”
Chronic stress is like a tea kettle on the boil—all that “steam” has to go somewhere. We often do this through behaviors like biting our nails, binging on comfort food—or grinding our teeth. That latter habit, however, could have a detrimental effect on teeth, including excessive enamel wear or even fractures.
Also known as bruxism, teeth grinding is the forceful and often involuntary contacting of teeth that often generates abnormally high chewing forces. While not considered a relatively big problem with young children, it can be if you’re an adult. While there could be other causes, chronic stress is often a prime factor for adults with bruxism.
While teeth grinding can occur during the day when you’re awake, it often occurs at night during sleep and may be associated with other sleep disorders like snoring. Although you might not be consciously aware of a grinding episode as it happens, you may notice its effects the next morning, including sore jaws or headaches. Over time, your dentist may begin noticing its effects on your teeth.
So, how can you lessen teeth grinding? For starters, if you’re a tobacco user, quit the habit. Many studies indicate tobacco users report twice the incidence of teeth grinding as non-users. Excessive caffeine, alcohol or drug use can also contribute.
People have also found it helpful to address chronic stress through a number of relaxation techniques like meditation, more relaxing bedtime preparation, bio-feedback or therapy to “de-stress.” Although there’s not a lot of empirical evidence for these techniques’ effectiveness, there’s much anecdotal data from people who’ve found stress relief from them.
There’s also a dental treatment using an occlusal guard that, while not stopping bruxism, can help prevent dental damage. Usually worn during sleep, the custom-made guard fits over the teeth of one jaw, usually the upper. Its high impact plastic prevents the teeth from making solid contact, thus reducing the biting force. You may also be able to reduce bruxism effects through dental work and orthodontics,
You and your dentist can explore the options to find the right treatment strategy for you. By taking action now, you may avoid much more extensive—and expensive—problems with your teeth down the road.
If you would like more information on teeth grinding and what to do about it, 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 “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”