Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, 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 “Root Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”

If you have periodontal (gum) disease, you probably already know you’re in danger of eventual tooth and bone loss if the infection isn’t brought under control. But if you also have diabetes, the effects from gum disease could extend well beyond your mouth.

Gum disease is a bacterial infection caused by plaque, a film of food remnant that builds up on tooth surfaces mainly due to poor oral hygiene. As the infection grows, your body’s immune system responds by flooding your gum tissues with antibodies to fight it, resulting in inflammation. As the inflammation persists, though, it damages the gum and underlying bone tissue, which in turn leads to gum and bone loss from the teeth.

Diabetes also causes an inflammatory response within the body. The disease develops either as a result of the body’s decreased ability to produce insulin to balance the glucose (sugar) levels in the bloodstream (Type 1) or the body develops a resistance to insulin’s effects (Type 2). As a result diabetics experience abnormally high blood glucose levels, a condition called hyperglycemia. This triggers chronic inflammation that can lead to inhibited wound healing, increased risk of heart, kidney or eye disease, coma or death.

Gum disease can worsen diabetic inflammation, and vice versa. The effects of the oral infection add to the body’s already overloaded response to diabetes. In turn, the immune system is already compromised due to diabetes, which can then increase the severity of the gum disease.

Research and experience, though, have found that pursuing treatment and disease management for either condition has a positive effect on managing the other. Treating gum disease through plaque removal, antibiotic therapy, surgery (if needed) and renewed oral hygiene will diminish the oral infection and reduce the body’s immune response. Caring for diabetes through medication, diet, exercise and lifestyle changes like quitting smoking will in turn contribute to a quicker healing process for infected gum tissues.

Treating gum disease when you have diabetes calls for a coordinated approach on both fronts. By caring for both conditions you’ll have a more positive effect on your overall health.

If you would like more information on the relationship between diabetes and gum disease, please contact us to schedule an appointment for a consultation.

Here’s a sobering statistic: you have a 50/50 chance over your lifetime for developing periodontal (gum) disease. And it’s much more serious than irritated gums: if not treated aggressively you could experience bone loss, which can not only lead to tooth loss but actually increases your risk of heart attack and stroke.

Initially, you may not notice any symptoms unless you know what to look for: mainly red and puffy gums that frequently bleed during brushing and flossing. As the infection advances into the underlying support structures that hold teeth in place you may also notice receding gums (moving away from your teeth causing them to look longer), pus around the gums or lingering bad breath or taste. And one or more loose teeth are a definite sign the supporting structures have weakened severely.

So, how does gum disease happen? It starts with bacteria. Your mouth contains millions of these and other microorganisms, most of which are friendly and even beneficial. Unfortunately, a fraction of them can infect and harm tissues like the gums and underlying bone. Your mouth’s defenses can normally handle them if their numbers remain low. But a bacterial population explosion can quickly overwhelm those defenses.

Bacteria are like any other life form: they need a secure environment and food. Disease-causing bacteria establish the former by utilizing proteins and other components of saliva to form a sticky biofilm on teeth known as plaque. Within the safe haven of dental plaque bacteria quickly multiply and form a complex and concentrated ecosystem feeding on remnant food particles, especially sugar and other carbohydrates.

The key to gum disease prevention (as well as treatment) is to deprive bacteria of their home and food source by removing plaque and its more hardened form calculus (tartar). You can manage plaque buildup by brushing and flossing daily, seeing your dentist regularly for cleanings to remove any remaining hard-to-reach plaque and calculus, and eating a nutritious diet with fewer sweets or other carbohydrate-rich snacks.

You can further lower your disease risk by avoiding smoking and other tobacco products and moderating your consumption of alcohol. And be sure to see your dentist as soon as possible if you notice any signs of infection with your gums. Taking these steps can help you avoid gum disease’s destructiveness and help preserve a healthy and attractive smile.

If you would like more information on gum disease, please contact us or schedule an appointment for a consultation.

Teeth-replacing dental implants not only look life-like, they’re made to last. For one thing, the metals and dental materials used in them are impervious to bacterial infection.

But that doesn’t mean implants are impervious to failure. Implants depend on the bone and other natural mouth structures for support. If the bone becomes weakened due to disease, the implant could become unstable and ultimately fail.

Peri-implantitis, the condition that can lead to this kind of failure, is a major concern for implant longevity. It’s a type of periodontal (gum) disease triggered by plaque, a thin film of food particles that can build up quickly in the absence of adequate brushing and flossing. The gum tissues around the implant become infected and inflamed.

If the infection isn’t properly treated with renewed oral hygiene and clinical plaque removal, it could spread below the gum line and begin to damage the underlying gum tissues and bone. This could destroy the all-important connection between the titanium implant post and the bone. The implant could eventually loosen and become completely detached from the bone.

The key is early intervention before the bone becomes damaged. Besides plaque removal we may also need to apply antibiotics in some form to control the growth of disease-causing bacteria. If the disease has fairly advanced we may also need to consider surgical repair to strengthen the attachment between implant and bone.

You can help to avoid peri-implantitis altogether by practicing consistent daily brushing and flossing around all your teeth including the implant, and seeing your dentist at least twice a year for cleanings and checkups. And by all means see your dentist if you notice any signs of gum swelling, redness or bleeding. Staying on top of your gum health will help not only the natural tissues and remaining teeth in your mouth, it will help preserve your implants for decades to come.

If you would like more information on maintaining your dental implants, please contact us or schedule an appointment for a consultation.

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.