Dr. Bob's Blog

Posts for: August, 2017

OvercomingGumRecessionwillRestoreDentalHealthandyourSmile

Your gums not only help hold your teeth securely in place, they also help protect them. They're also part of your smile — when healthy and proportionally sized, they provide a beautiful frame for your teeth.

But if they become weakened by periodontal (gum) disease, they can detach and begin to shrink back or recede from the teeth. Not only will your smile be less attractive, but you could eventually lose teeth and some of the underlying bone.

Treating gum recession begins with treating the gum disease that caused it. The primary goal is to remove the source of the disease, a thin film of food particles and bacteria called dental plaque, from all tooth and gum surfaces. This may take several sessions, but eventually the infected gums should begin showing signs of health.

If the recession has been severe, however, we may have to assist their healing by grafting donor tissue to the recession site. Not only does this provide cover for exposed tooth surfaces, it also provides a “scaffold” for new tissue growth to build upon.

There are two basic surgical approaches to gum tissue grafting. One is called free gingival grafting in which we first completely remove a thin layer of surface skin from the mouth palate or a similar site with tissue similar to the gums. We then attach the removed skin to the recession site where it and the donor site will usually heal in a predictable manner.

The other approach is called connective tissue grafting and is often necessary when there's extensive root exposure. The tissue is usually taken from below the surface of the patient's own palate and then attached to the recession site where it's covered by the surrounding adjacent tissue. Called a pedicle or flap, this covering of tissue provides a blood supply that will continue to nourish the graft.

Both of these techniques, but especially the latter, require extensive training and micro-surgical experience. The end result is nothing less than stunning — the tissues further rejuvenate and re-attach to the teeth. The teeth regain their protection and health — and you'll regain your beautiful smile.

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.”


By Dr. Malenius
August 14, 2017
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”


By Dr. Malenius
August 06, 2017
Category: Oral Health
Tags: oral hygiene   flossing  
RegularFlossingnotYourThingTryanOralIrrigator

One of the keys to a healthy mouth is daily oral hygiene. These tasks have one objective: remove plaque, a thin film of bacteria and leftover food particles, from tooth surfaces. Plaque fosters bacterial growth that can cause diseases like tooth decay or periodontal (gum) disease.

Brushing does an effective job removing plaque from the broad surfaces of teeth. But because plaque can also grow between teeth where your brush can’t reach, you also need to floss.

Unfortunately, flossing is a lot of people’s least favorite hygiene task. It can be time-consuming and requires a little more dexterity than brushing. As a result, it’s common for people to brush but not floss — and potentially miss plaque that could trigger dental disease.

There is an easier alternative to traditional string flossing: an oral irrigator. These countertop appliances deliver a stream of pulsating water at high pressure through a handheld device that looks similar to a power toothbrush. The user directs the water stream through the nozzle tip (which comes in various sizes) between the teeth. The water vibrates plaque loose and then rinses it away.

Besides people with limited dexterity, water flossers are also ideal for individuals wearing braces or other orthodontic hardware. Because of the metal hardware on and around teeth, flossing can be an arduous task. An oral irrigator makes it easier to floss and reduce plaque buildup, a perennial problem for orthodontic patients. In fact, one study of orthodontic patients found that using an irrigator with a tip especially designed for braces removed five times as much plaque as patients using only a manual toothbrush.

Of course, anyone can use an oral irrigator as an alternative to traditional flossing. Your dentist and staff can advise you on what to look for in equipment and provide instruction on how to use it. If traditional flossing isn’t your thing, consider an oral irrigator to get rid of plaque and keep your teeth and gums healthy and attractive.

If you would like more information on oral irrigation to remove daily plaque, 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 “Cleaning between Your Teeth: How Water Flossing can help.”