Periodontal disease: what it is and how to avoid it

Periodontal disease is an infection of the tissues that support your teeth.

There is a very slight gap (called a sulcus) between the tooth and the gum.

Periodontal diseases attack this gap and cause a breakdown in the attachment of the tooth and its supporting tissues.

When the tissues are damaged, the sulcus develops into a pocket and, as the disease gets more severe, the pocket usually gets deeper.

The two major stages of periodontal disease are gingivitis and periodontitis.

Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to periodontitis, which is a more serious, destructive form of periodontal disease.

There are several factors that have been shown to increase the risk of developing periodontal disease:
– Systemic diseases such as diabetes
– Some types of medication
– Crooked teeth
– Bridges that no longer fit properly
– Fillings that have become defective
– Smoking
– Pregnancy

And there are a number of warning signs that can suggest a possible problem:
– Gums that bleed easily
– Red, swollen, tender gums
– Gums that have pulled away from the teeth
– Persistent bad breath or taste
– Permanent teeth that are loose or separating
– Any change in the way your teeth fit together when you bite
– Any change in the fit of partial dentures

However, it’s also possible to have periodontal disease with no warning signs.

It’s therefore important to have regular dental checkups and periodontal examinations.

If you have developed periodontal disease, the treatment will depend on how far it has progressed.

You can take steps to prevent periodontal disease from becoming more serious or recurring.

Good dental hygiene practices such as brushing twice a day, cleaning between your teeth, eating a healthy diet and having regular visits to the dentist will make a huge difference.

How removable partial dentures can help you

Removable partial dentures usually involve replacement teeth attached to plastic bases, connected by metal framework.

They attach to your natural teeth with metal clasps or �precision attachments’. Precision attachments generally look better than metal clasps and are nearly invisible.

Crowns may be required on your natural teeth to improve the fit of a removable partial denture.

When you first get a partial denture, it may feel awkward or bulky. But you will gradually get used to wearing it.

It will also take a bit of practice to get used to inserting and removing the denture. It should fit into place easily and you should never force it.

Your dentist may suggest that you wear your partial denture all the time at first. While it will be uncomfortable for a while, it will help you identify if any parts of the denture need adjustment.

After making adjustments, your dentist will probably recommend that you take the denture out of your mouth before going to bed and replace it in the morning.

With a denture, eating should become a more pleasant experience compared to having missing teeth.

But, initially, you’ll need to eat soft foods cut into small pieces. And avoid foods that are extremely sticky or hard.

Some people with missing teeth find it hard to speak clearly so wearing a partial denture may help. However, you’ll probably need to practice certain words at first to get completely comfortable.

While it can take a little geting used to initially, a partial denture can help you enjoy your food with less worries.

What to do if your tooth cracks

While our teeth are normally very strong, they can crack for a number of reasons.

Reasons could include tooth decay, trauma/injury, grinding of the teeth or a stress fracture.

Sometimes, our jaw may be stronger than our teeth and the teeth can fracture when we bite heavily on food.

We can protect our teeth in some circumstances – for example it may be advisable to wear a mouthguard during sports.

Taking proper care of the teeth and regular visits to the dentist will help keep your teeth in good shape.

If a tooth cracks, it may become painful if the nerve is exposed and the area can become tender.

If this happens, rinse your mouth with warm water to clean the area and apply a cold compress to reduce swelling. Then call your dentist immediately.

Treatment will depend on where the tooth has fractured, how close it is to the nerve and the overall condition of the tooth.

A cracked tooth may be repaired with silver alloy, gold, porcelain or plastic. Or it may require a crown or overlay or bonding, which applies porcelain or enamel to the fractured tooth.

If you contact your dentist quickly, they will be able to take the most approriate action to preserve the tooth as much as possible.

Your saliva and why it’s so important

You probably don’t give too much thought to the saliva in your mouth, but if you think of it like a bloodstream you’ll realize how important it is.

Like blood, saliva helps build and maintain the health of the soft and hard tissues.

It removes waste products from the mouth and offers first-line protection against microbial invasion that might lead to disease.

Saliva is derived from blood and therefore can also be used to detect disease.

Saliva enhances enamel protection by providing high levels of calcium and phosphate ions. It contains the minerals that maintain the integrity of the enamel surface and helps protect against caries.

When salivary flow is reduced, oral health deteriorates – much in the same way body tissues suffer if blood circulation is disrupted.

Patients with dry mouths (xerostomia) experience difficulty chewing, speaking and swallowing. A major cause of dry mouth is medication – almost eighty percent of the most commonly prescribed medications lead to dry mouth.

Chewing gum after a snack or meal stimulates salivary flow, clearing food from the mouth and neutralizing plaque acid.

Your saliva is important to your oral health both for preventing disease and in helping to diagnose problems.

How dentistry has developed over the last 300 years

When you visit a modern dental surgery, it’s hard to imagine the challenges of dental treatment without all the latest technology.

Yet specialists have been taking care of people’s teeth for thousands of years.

Here are some of the key developments over the last 300 years.

1723: French surgeon Pierre Fauchard – credited as being the father of modern dentistry – publishes the first book to describe a comprehensive system for the practice of dentistry.

1760: John Baker, the earliest medically-trained dentist to practice in America, immigrates from England and sets up practice.

1790: John Greenwood adapts his mother’s foot treadle spinning wheel to rotate a drill.

1790: Josiah Flagg, a prominent American dentist, constructs the first chair made specifically for dental patients.

1832: James Snell invents the first reclining dental chair.

1841: Alabama enacts the first dental practice act, regulating dentistry in the United States.

1844: Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice.

1880s: The collapsible metal tube revolutionizes toothpaste manufacturing and marketing.

1890: Willoughby Miller notes the microbial basis of dental decay in a book which started a world-wide movement to promote regular toothbrushing and flossing.

1896: New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S.

1938: The nylon toothbrush, the first made with synthetic bristles, appears on the market.

1945: The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.

1950s: The first fluoride toothpastes are marketed.

1960: The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced in the United States. A cordless, rechargeable model follows in 1961.

The early years of dentistry and teeth

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes “tooth worms” as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first “dentist”, dies. An inscription on his tomb includes the title “the greatest of those who deal with teeth, and of physicians.”

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of “silver paste,” a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade � sharp knives and razors � were useful for surgery. Following the edicts, barbers assume the monks’ surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

Why your routine dental cleaning is not routine

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appoinment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a “dental prophylaxis,” or “prophy” and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

How smoking affects your teeth

While the general effects of smoking on your health are well-known, it can also have significant effects on your oral health.

Here are some of the ways smoking can harm your oral health and hygiene:

– Oral Cancer
– Periodontal (gum) disease
– Delayed healing after a tooth extraction or other oral surgery
– Bad breath
– Stained teeth and tongue
– Diminished sense of taste and smell

Research suggests that smoking may be responsible for almost 75% of adult gum disease.

Tobacco products damage your gum tissue by affecting the attachment of bone and soft tissue to your teeth. One effect is receding gums which expose the tooth roots and increase your risk of tooth decay or to sensitivity to hot and cold in these unprotected areas.

Cigar smoking is equally a major risk and even smokeless tobacco products contain a variety of toxins associated with cancer. Smokeless tobacco can also irritate your gum tissue.

Giving up smoking will provide a significant boost to your oral health as well as giving you the chance to live longer.

How the food you eat can cause tooth decay

When you put food in your mouth, it immediately meets the bacteria that live there.

Plaque, for example, is a sticky film of bacteria.

These bacteria love the sugars found in many foods. So, when you don’t clean your teeth after eating, the bacteria and the sugar can combine to produce acids which can destroy the enamel – the hard surface of the tooth.

In time, this can lead to tooth decay. The more often you eat and the longer foods are in your mouth, the more damage occurs.

Many foods that are nutritious and important in our diet contain sugars – such as fruits, milk, bread, cereals and even vegetables.

So the key is not to try and avoid sugar but to think before you eat.

When you eat is also important because each time you eat food that contains sugars, the teeth are attacked by acids for 20 minutes or more.

This means that foods that are eaten as part of a meal cause less harm. More saliva is released during a meal, helping to wash foods from the mouth and reduce the effects of acids.

Here are some tips to follow when choosing your meals and snacks.
– Eat a variety of foods from different food groups
– Limit the number of snacks that you eat
– If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt, or a piece of fruit

It’s also important to brush your teeth twice a day and to clean between your teeth daily with floss or interdental cleaners.

And of course regular visits to your dentist will help prevent problems from occurring and catch those that do occur while they are easier to treat.

How to make visiting the dentist easy for kids

Your child should have their first trip to the dentist by the time they are 18 months old and it’s good to make the process as easy as possible for them from the start.

Dental staff are used to dealing with young children and they will know how to make them feel comfortable.

Sometimes, children under three may be treated on the parent’s lap. In this case, the parent sits in the dental chair facing the dentist, and the child is on their lap.

The dentist will tell the child what he or she is going to do in terms they can understand. They will usually have fun dental toys they can use to help.

They will start with an oral examination checking the teeth present and looking at the development of the jaw, gums and soft tissues.

Naturally, as in any new situation, some children are initially unsettled but this is usually short-lived as they get used to it.

Parents can help by ensuring they are calm and relaxed as any anxiety will transfer to the child.

With older children, the parents may stay in the background though sometimes children behave better when the parent is not in the room!

Work with your children and your dentist to find the best way of ensuring they get the treatment they need with minimum worries for everyone.