Julie, age 51, wanted a second opinion on a new denture. Julie said she had sever gum disease. She decided to have her remaining 26 teeth removed before seeing me. On examining her pre-surgical X-ray I found her to have had a lot of bone support on 2/3rds of her teeth and could have had a few of her worse teeth removed and kept most of her teeth if she was willing to have gum therapy and do some additional home care. Having teeth removed is a final solution to gum disease, but not everyone is a successful denture wearer, they are now a dental cripple. Some patients are fed up with tooth problems and the cost and just want them all out, which may be a good solution for them. Carefully weigh the options (614) 775-9300 or (740)427-2929


Eva wanted a permanent, pleasant and painless solution to her dark and crooked teeth. A complete examination of tooth structure and gum tissue found Eva to be healthy. Dental Solutions: Option 1. Braces or Invisalyn to straighten her teeth, following up with tooth bleaching. Bleaching is not permanent, and a straightening did not seem pleasant to Eva. Option 2. Lumineers, porcelain veneers that can be created without shots or pain, very little or no drilling and the custom light color is permanent and the porcelain is very strong and durable. Eva decided that Lumineers would be the permanent, pleasant, painless solution for her. (614) 775-9300 or (740)427-2929


Healthy Gums:
Healthy gums have a coral pink color, hug the teeth tightly and there is no bleeding or puss found during a dental gum evaluation

Gum Disease - Periodontal Disease

What are common signs and symptoms of periodontal disease?
Periodontal disease is often silent, meaning symptoms- particularly pain- may not appear until an advanced stage of the disease. However, you should still be on the lookout for the signs and symptoms, which include:

  • Red, swollen or tender gums or other pain in your mouth
  • Bleeding while brushing, flossing, or when eating certain foods
  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer
  • Loose or separating teeth
  • Pus between your gums and teeth
  • Sores in your mouth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

What can I do at home to prevent gum or periodontal disease?
The best way to prevent periodontal disease is to take good care of your teeth and gums at home. This includes brushing your teeth after every meal and before bedtime, Hydro-flossing at least once each day, using toothpicks, interdental cleaners and floss. Seeing your dentist or periodontist for regular exams two to four times a year. Spending a few minutes a day on preventative measures may save you the time and money of treating periodontal disease!

Treatment for gum or periodontal disease

Non-Surgical Treatments:
Periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis.

Most dentists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

Periodontal Surgery:
If you're diagnosed with periodontal disease, your dentist may recommend periodontal surgery. Periodontal surgery is necessary when it is determined that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:

  • Pocket Reduction Procedures
  • Regenerative Procedures
  • Crown Lengthening
  • Soft Tissue Grafts

What are the consequences of missing teeth?
There are actually several negative consequences of missing some or all of your teeth. First, missing teeth will affect the esthetics of your face. Not only will your smile be affected by the gaps from missing teeth, but if you’re missing too many teeth, the skin around your mouth won’t be supported properly and will start to sag, making your appear older than you are. Additionally, missing teeth will make it more difficult to chew your food properly and may even affect the way you speak. Finally, missing even one tooth may have emotional consequences; many people feel less confident about their smile when they are missing teeth. If you are currently missing any of your teeth, consider replacing them, every tooth has a role to play in the proper function and esthetics of your mouth and smile.

FAQs (Frequently Asked Questions)

Are you taking new patients?
YES. Because our patients love us they often refer their friends and family because they want them to receive the same level of care. We are proud of the confidence our patients have placed
in us.

What happens at my first visit?
In order to treat each and every patient, as an individual with unique dental needs it is vital to completely assess their current oral health. We perform an oral cancer screening, we look at muscles and joints that open and close the mouth. We will look at your teeth, and your gums and bone that hold the teeth. We then take photos and necessary digital x-rays. With this information we make an accurate diagnosis. Hopefully the diagnosis is health, but if there is disease, infection and inflammation these findings will determine the treatment that is right for you. I have heard there is a connection between gum disease and heart disease. Is this true? The connection between gum disease and heart disease is a very hot topic in the field of periodontics right now! Several research studies have indicated that heart disease and gum disease may be linked, and researchers suspect that inflammation may be the basis behind this relationship. If you are at risk for heart disease, it is a good idea to mention this to your dentist, since gum disease may increase this risk.

Is there a link between periodontal disease and diabetes?
Research has suggested that there is a link between periodontal disease and diabetes. People with diabetes are more likely to have periodontal problems, possibly because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered one of the major complications of diabetes. Interestingly, the relationship between the two conditions goes both ways; just as diabetes can increase a person’s chance of developing periodontal disease, research suggests that efficient and effective periodontal hygiene may positively affect blood sugar levels.

What causes gum recession?
This condition is defined as a loss of gingival tissue over the jaw bone which directly causes root exposure. The problem is also commonly referred to as gingival recession. Receding gums are extremely common among men and woman aged 40 plus; however, the problem may have it's origin in the teenage years. Over-aggressive brushing is probably the greatest cause of receding gums. The enamel at the gum line is corroded by the harsh motions and movements cause by the brush pressure. Bacteria accumulation as a result of bad oral hygiene has the potential of leading to break-down of bone as well as enamel. Common recession symptoms are severe discomfort, pain, inflammation and irritation in the gum areas, tooth root exposure, tooth sensitivity and caries below gum line. Prevention should be your number one priority. Tooth grinding or clenching also called bruxism can also cause gum recession.

BRUXISM (Clenching/Grinding of Teeth)
Symptoms include tooth wear, fractures of the teeth and fillings, grinding noise, facial muscle fatigue or pain, headaches, locking, cracking, and clicking of the jaws, tooth mobility, gum recession and sensitive teeth. Tooth wear due to grinding “wears the teeth out”, wears teeth flat, makes the teeth weaker and more prone to teeth chipping and teeth fracturing. This same action wears and weakens dentistry
making it more likely to fracture or chip.

Grinding noise from teeth rubbing forcefully against each other is usually not heard by patient, noticed by a sleeping partner. You may even hear some people grind their teeth during the day, again the patient cannot hear this sound. Muscle Fatigue, muscle pain and headaches, locking, cracking and clicking of jaw joints; all can be contributed to Bruxism. These are also covered under the umbrella of “TMJ” or “TMD”

We can make you aware of the habit and discuss the causes of bruxism. A removable intraoral appliance or orthotic can be made for you commonly called a night guard or bruxism splint. The night guard protects the teeth from the forces of clenching and grinding the teeth together, in many cases patients grind less wearing the night guard. The patient still want to grind they can slide around on the orthotic distributing the force among more teeth and the patient can wear out the plastic rather than their teeth.

The latest thoughts on bruxism:
Patients grind their teeth, while doing so tongue position improves and this opens their airway. At night many patients do not maintain sufficient air way for good oxygenation. Grinding the teeth makes the muscles tense, improves tongue posture and position and in the process opens the airway and the patients oxygen improves. Muscles relax airway narrows, oxygen goes down. Body realizes lower oxygen, grinds teeth and oxygen goes up. Cycle repeats, the faster the cycle the more grinding. See Sleep Apnea Page I have big gums and short teeth, so when I smile you can almost only see my gums. I don’t smile very often anymore because I am so self conscious of my gums.

Is there a way to improve my smile?
Yes, there may be a way to enhance your smile. It’s a good idea to discuss your options first. We can explain the best way to create the smile you want, as well as answer any questions that you
may have. For example, one procedure that can remove excess gum tissue is called crown lengthening. After the excess gum tissue is removed, the gum line is then reshaped in order to
create the right proportion between gum tissue and tooth surface.

Dental Hygiene Services:

  • Dental and Periodontal Exams—A full mouth assessment is performed prior to any treatment. These exams include checking for oral cancer, periodontal health and other diseases of the oral
  • Polishing—Professional polishing removes biofilm, plaque and stain from the teeth.
  • Scaling—The removal of hard deposits (calculus) above and below the gum line. Calculus cannot be removed with a toothbrush or floss and must be professionally removed.
  • Root Planing—The removal of rough spots on the root of the tooth where the germs gather and helps remove the bacteria that contributes to gum disease. scaling and root planing (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins.
  • DIAGNOdent—This technology inspects your teeth by using a simple laser diode. The laser measures the density of the tooth structure by giving a number reading from 0-99. A reading of
    21-99 indicates a definite area of decay and requires removal of the cavity and placement of a mercury-free filling.
  • Natural Treatments - There's a wonderful range of natural treatments and remedies available to treat the problem inexpensively not to mention effectively. These need to be used in conjunction with periodic gum evaluation to make sure your gums are in a state of health.

Sage solutions are wonderful for tightening gums gently while also effectively relieving pain and discomfort often associated with receding gums. Brew your own solution by adding a couple of sage leaves to boiling water, strain and thoroughly rinse your mouth 2 times a day.

Tea tree oil is a wonderful ingredient for prevention of bacteria accumulation. Mix a couple of drops tree oil with warm water and rinse your mouth no more than 2 times a day. Baking Soda, Baking Soda with Peroxide - Search Keyes Technique - labor intensive butcan do wonders for the diligent patient.

Great links to save

Tooth and Gum Tonic
Perioprotect -  we are a perioprotect providing office


Occlusion status affects how adults rate the attractiveness, personality and even the intelligence of other adults, according to a study published in the November 2011 edition of the American Journal of Orthodontics and Dentofacial Orthopedics.

A researcher in Michigan and a private practitioner in North Carolina combined to survey 889 people (46 percent male, 54 percent female, ranging in age from 18 to 90 years), asking them to evaluate photos that had been manipulated to show either normal occlusion or one of six malocclusions (open bite, deepbite, underbite, overjet, crowding and spacing).

"The ratings of attractiveness, intelligence, conscientiousness, agreeableness and extraversion differed significantly depending on the occlusion status depicted," their report states.

People with normal occlusion were rated as most attractive, intelligent, agreeable and extraverted, while those with underbite were rated least attractive, intelligent and extraverted. Females with malocclusion were rated more favorably than males. Younger and more educated respondents were more critical in their evaluations than older, less educated respondents.

Conducting the study were Drs. Jase A. Olsen, a private practitioner in Southern Pines, N.C., and Marita Rohr Inglehart, associate professor, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan.

"Judgments that are negatively influenced by the effects of malocclusion might leave those without a normal occlusion at a social disadvantage and professionally handicapped," the study notes.\

The study also quotes earlier research showing that "attractive" people were perceived to be more intelligent and socially competent, to have a more positive personality, to have better social interactions and to receive more favorable professional ratings.

In addition, the study quotes from the National Health and Nutrition Examination III from 1988-91, which showed that 57 percent to 59 percent of adults had some degree of malocclusion.

Although that study is two decades old, it still provides the most current prevalence data for malocclusion among U.S. adults.

The American Journal of Orthodontics and Dentofacial Orthopedics is the official publication of the American Association of Orthodontists.

Am J Orthod Dentofacial Orthop 2011; 140:669-79; www.ajodo.org


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October 2014