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By Phares Family Dentistry
September 19, 2021
Category: Oral Health
Tags: gum disease  
PeriodontalProbingCanTellUsaLotAbouttheSeverityofaGumInfection

The red and puffy gums that sometimes accompany the onset of periodontal (gum) disease don't always catch your attention. You may not even get any symptoms at all, in fact, until the disease has become well advanced.

That's why regular dental visits are so important for gum health: For while you may not notice anything abnormal about your gums, we have a simple procedure known as periodontal probing that can help diagnose the condition of your gums.

Gum disease is a common bacterial infection that affects millions of people worldwide. It most often begins with plaque, a filmy, bacterial buildup on teeth. These bacteria feed and multiply on the remnant food particles in the film, increasing the chances for an infection.

As it grows—as well as the inflammation the body initiates to fight it—the infection weakens the gum attachment to teeth. This can cause the miniscule gap between gums and teeth at the gum line to widen, forming a void called a periodontal pocket. The deeper and wider the pocket, the more advanced the gum infection.

We may be able to verify the presence of a periodontal pocket by using a long, thin probing instrument with millimeter gradations. We gently insert the probe at various locations around a tooth as far as it will comfortably go. We then record the depth by reading the gradation measures lined up with the top of the gums, as well as observing how snug or loose the probe feels within the gum space.

One to three millimeters signifies a healthy attachment between the tooth and gums—anything more than that usually indicates gum disease. Measurements of 5mm indicates a problem, the higher the number, the more advanced is the periodontal disease.

We use these probe readings and other factors to guide our treatment approach in individual cases of gum disease. With a less-advanced infection we may only need to remove plaque and calculus adhering to the crown and just below the gum line. More advanced gum disease infecting the root area may require surgical access through the gums.

All in all, keeping up with regular dental visits can increase the chances of early diagnosis, when the disease is still in its initial stages. And daily oral hygiene to remove harmful plaque may help you avoid gum disease altogether.

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 “Understanding Periodontal Pockets.”

By Phares Family Dentistry
September 09, 2021
Category: Dental Procedures
RemovingaToothCouldHelpCorrectThisParticularBiteProblem

Dentists extract millions of teeth each year, mostly because of disease. But sometimes a healthy tooth is removed to gain a more favorable, long-term dental health outcome.

An example of this is extracting teeth for the sake of orthodontic treatment. This is often beneficial when treating bite problems caused by crowding, a condition in which not enough space on the jaw exists to accommodate all of the teeth coming in. When this happens, the limited space can force teeth out of their proper alignment.

Crowding also complicates correcting the bite problem with braces: As with the eruption phase, there's no available room for orthodontic movement. One solution that may arise after a detailed examination is to open up space on the jaw by removing some of the teeth.

Planning this kind of tooth extrication requires careful forethought with the end in mind—ultimately, the dental providers involved want the resulting appearance after braces to look as natural as possible. For that reason, dentists usually choose teeth for extraction that are outside of the "smile zone" (the teeth visible while smiling) like premolars and molars.

Additionally, dentists are concerned about bone loss after extracting the teeth. Bone often diminishes around empty tooth sockets, especially if those sockets were damaged during extraction. This loss in bone can weaken the jaw structure and cause significant problems while moving teeth with braces.

To avoid this, dentists take great care during tooth removal not to damage the socket. Additionally, they may place a bone graft within the socket immediately after removing the tooth, especially if the space will remain vacant for a significant period of time. A bone graft serves as a scaffold upon which new bone cells can form and accumulate.

After the extractions, the orthodontist may then proceed with correcting the bite. Patients may also need some form of prosthetic teeth to fill in the spaces while wearing braces. Often prosthetic teeth can be incorporated with the braces for a more natural look. After braces, any remaining gaps may require further restoration, either with dentures, bridges or, later in adulthood, dental implants.

Complex bite problems like crowding pose unique challenges in correcting them. But using techniques like tooth extraction can help achieve a successful and satisfactory outcome.

If you would like more information on treatments for bite problems, 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 “Tooth Removal for Orthodontic Reasons.”

By Phares Family Dentistry
August 30, 2021
Category: Dental Procedures
Tags: celebrity smiles  
JimmyFallonsDaughterLosesaToothonNationalTelevision

Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they're still giving us something to watch via virtual interviews. In the process, we're given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon's daughter Winnie interrupted with breaking news: She had just lost a tooth.

It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it's not an uncommon experience. Nevertheless, it's still good to be prepared if your six-year-old is on the verge of losing that first tooth.

Primary teeth may be smaller than their successors, but they're not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That's why it's optimal for baby teeth to remain intact until they're ready to come out.

When that time comes, the tooth's roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness, though, doesn't automatically signal a baby tooth's imminent end. But come out it will, so be patient.

Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.

Here's some advice from your dentist: Don't. Trying to pull a tooth whose root hasn't sufficiently dissolved could damage your child's gum tissues and increase the risk of infection. It could also cause needless pain.

Left alone, the tooth will normally fall out on its own. If you think, though, that it's truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it's ready, it should pop out. If it doesn't, leave it be for another day or two before trying again.

Your child losing a tooth is an exciting moment, even if it isn't being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.

If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”

By Phares Family Dentistry
August 20, 2021
Category: Oral Health
Tags: oral health  
DontIgnoreChronicMouthBreathing-ItCouldDisruptJawDevelopment

Although the air we breathe has one destination—the lungs—it can arrive there via two possible routes: through the nose or the mouth. In terms of survival, it matters little through which path air travels—just so it travels one of them!

In terms of health, though, breathing through the nose is more beneficial than through the mouth, and is our default breathing pattern. The nasal passages filter minute noxious particles and allergens. Air passing through these passages also produces nitric oxide, a gaseous substance that relaxes blood vessels and improves blood flow.

On the other hand, chronic mouth breathing during childhood can impact oral health. While breathing through the nose, the tongue rests against the roof of the mouth and thus becomes a mold around which the upper jaw and teeth develop. But mouth breathing places the tongue on the lower teeth, which deprives the upper jaw of support and can lead to an abnormal bite.

So why would people breathe through their mouth more than their nose? Simply put, it's more comfortable to do so. Because breathing is so critical for life, the body takes the path of least resistance to get air to the lungs. If obstructions caused by allergic reactions or swollen tonsils or adenoids are blocking the nasal pathway, the action moves to the mouth.

But chronic mouth breathing can often be treated, especially if addressed in early childhood. This may require the services of an ear, nose and throat specialist (ENT) and possible surgical intervention to correct anatomical obstructions. It's also prudent to have an orthodontist evaluate the bite and institute corrective interventions if it appears a child's jaw development is off-track.

Even after correcting obstructions, though, it may still be difficult for a child to overcome mouth breathing because the body has become habituated to breathing that way. They may need orofacial myofunctional therapy (OMT), which retrains the muscles in the face and mouth to breathe through the nose.

Chronic mouth breathing isn't something to be ignored. Early intervention could prevent future oral and dental problems and help the person regain the overall health benefits for nose breathing.

If you would like more information on overcoming chronic mouth breathing, 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 “The Trouble With Mouth Breathing.”

By Phares Family Dentistry
August 10, 2021
Category: Dental Procedures
Tags: gum recession  
GumRecessionDoesntHavetobePermanent

The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.

Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.

Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.

But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.

The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.

There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.

In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting.  The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.

Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.

If you would like more information on treating gum recession, 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 “Periodontal Plastic Surgery.”





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