When a patient is facing or has endured tooth loss, the end of the conversation is not the appointment to remove the tooth. The end of the conversation needs to be to discuss how to replace a missing tooth. Often having a tooth extracted is a less expensive treatment in the short term, however there are several long term effects of a missing tooth. Firstly, the tooth that used to oppose the missing tooth now has nothing to chew against, so eating function is compromised. Secondly, that tooth also now has nothing to keep it in place and may start to grow out of the bone and gum tissue, a condition called super eruption. Super eruption can then lead to cleansing issues by exposing more of the root surfaces, which can lead to periodontal or “gum” disease around the tooth. And lastly, when a tooth is missing, there is nothing to hold the bone in place and that will start to create bone loss in the area of the missing tooth which can affect the surrounding teeth.

With all of these negative effects of tooth loss, it is extremely important to have the discussion with your dental provider about what to do when you’re faced with losing a tooth. Although there are options that many people are more familiar with, for example a fixed prosthetic called a bridge, or a removable prosthetic called a partial denture, these both have their limitations in that they also affect the surrounding teeth. Bridges are created by cutting down the teeth on either side of the missing tooth and bonding crowns to those teeth with a fake tooth adhered between them and supported by them. This takes away perfectly healthy tooth structure just to help replace a missing tooth. Partial dentures require clasps to hold them in place. These clasps can create pockets of gum tissue around the teeth the hold on to, they can harbor bacteria, and they also put unnecessary stress and force on the surrounding teeth. While these have been the go-to restorations of the past, dentistry is moving forward, always trying to perfect our methods and offer patients better, healthier options. This is why we now recommend dental implants as a solution to missing teeth.

A one-tooth solution for a one-tooth problem.

What is a dental implant? An implant is essentially a titanium or titanium  post, which is placed in the bone where the missing tooth was.

Titanium is used because it is lightweight, strong and biocompatible. It osseointegrates, or fuses to the bone, which prevents bone loss and helps stabilize the bone and improve density. Titanium is the most widely used metal in dental and other types of bone implants (such as orthopedic implants), but above all, dental implants have the highest success rate.

After the titanium screw is placed, a healing period must occur to allow for osseointegration to occur, typically anywhere from 3-6 months. After the healing period has taken place, a fake tooth, or crown, is placed atop the implant. This fake tooth is the only portion of the implant that the patient can see. It restores chewing function, improves esthetics and allows for better cleansability of the area by keeping food particles out of the open space. Add to that the success rate of dental implants is approximately 95%, implants are clearly the number one choice of dentists when it comes to replacing a missing tooth.

If implants are the best option, why don’t more patients have them?

Many patients hear the word “implant” and instantly think it will be too expensive. This used to be the case. With insurance companies not helping with the bill, many patients faced the cost of implants completely out of pocket. However, most insurance companies are now offering their customers a discounted rate on implants and at times even paying a portion of the discounted fee. As dentistry progresses, so must the insurance companies who carry coverage of dental procedures for the vast majority of the population.

Another thing to consider is that once an implant is placed, it is typical that it will last a lifetime. Bridges are usually replaced after approximately 20 years, due to breakdown and their propensity to get cavities, and partial dentures must be replaced once their fit becomes compromised after bone loss occurs in the area of the missing tooth (not to mention the effect they have on surrounding teeth, which will then require restoration). While these options may seem more cost-effective at first, they can cost exponentially more in the long run.

For more information on implants, cost of implants, or to find out if you’re a candidate, schedule a consultation with your dental experts at JB Dental to discuss all the options available to you to help replace your missing teeth.

Paige Tscherpel, RDH, BSDH

Sources Consulted Include:

https://dentalimplants.com

http://myoms.org/procedures/dental-implant-surgery

There are two main infections of the gum tissue that a patient can experience. The first is gingivitis. Gingivitis is characterized by reddened, swollen, sometimes painful gum tissue, that bleeds when measured or cleaned. Gingivitis is reversible. This is a key factor of distinction regarding this type of infection.

The second major type of gingival infection is called periodontal disease. Also known as “gum disease” or “Periodontitis”, periodontal disease is defined as “inflammation of the supporting tissues surrounding the teeth”. To make matters simple, periodontal disease includes not only all the symptoms of gingivitis, but also adds in the destruction of the supporting ligament and bone of the teeth. While periodontal disease can be treated and stabilized to prevent further bone and attachment loss, the loss experienced can never be replaced. Plainly, periodontal disease is treatable yet the damage is irreversible.

So why do some people have gingivitis, and some people have periodontal disease?

It all comes down to how your body deals with bacteria. In much the same way that some people catch a million colds, yet others get the sniffles once a decade, some people react harshly to bacteria and others fight it well. Everyone knows somebody who barely brushes their teeth and yet they’ve never had a cavity in their life. Similarly, it’s hard to predict when your body will start fighting you instead of the bacteria.

Eventually the bacteria in plaque and calculus (tartar) build up to a point where your body can no longer handle the toxins they produce. This phase is called gingivitis. Once your body crosses that threshold, it will literally start producing an immune response that destroys the bone and structures that support your teeth. This phase is called periodontal disease. Untreated, periodontal disease can lead to tooth loss. The pathogens associated with periodontal disease are also linked to diabetes, cardiovascular disease and preterm/low birth weight babies in affected mothers.

Approximately 47.2% of US adults have some form of periodontal disease, and as we look at adults over the age of 65, that percentage climbs to 70.1%. These are not small numbers. The American Academy of Periodontology recommends a yearly periodontal exam to screen for disease, which your hygienist should carry out during your routine cleanings and exams. There are warning signs you can be looking for as well, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or eating hard food
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• 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

Of course, these symptoms are indicative of moderate-to-severe periodontal disease. Early periodontitis and gingivitis can be completely symptom-free, which means that you may have no idea the disease process has begun in your mouth or the risk it is posing to your overall health.

To assess your risk and ensure your gum health, call today to schedule your routine exam and cleaning. Be sure to bring any concerns you may have to the attention of your dentist or dental hygienist.

S. Paige Tscherpel, RDH, BSDH

Consulted Sources Include:
https://www.perio.org/consumer/types-gum-disease.html
http://www.hindawi.com/journals/ad/2014/596824/
http://www.ncbi.nlm.nih.gov/books/NBK2496/
https://www.perio.org/consumer/cdc-study.htm

As a dental hygienist for the last 7 years, I’ve heard plenty of reasons about why people don’t take care of their teeth. Most patients are well-meaning, but life gets in the way. I’m a mom and wife, with a career to attend to and plenty of laundry and grocery shopping to do as well. Trust me, I understand the lack of time that goes along with a busy life. Dental providers are people too, we know the stress of day to day routines, and not even we have perfect homecare.

There is one excuse that has to be dispelled though, as it’s a common one that takes all responsibility and opportunity away from the patient. We hear it so often as dental providers that we are quick to dismiss  it without often explaining why it doesn’t have to apply.

“I have cavities/gum disease because my mom/dad had them/it.”

Actually, yes, you do….and no, you don’t.

And here’s why.

I’m blond because my grandparents were blond, and I have green eyes because my mother has green eyes.

My grandparents on both sides have heart disease, but I do not.

My parents are both afflicted by cavities and gum disease, but I am not.

Your genetics predisposes you, it does not condemn you.

My teeth look like my mom’s, but they are not undergoing the same problems because of how I care for them. Our genetic predisposition means that we have a compilation of our family DNA, and we are more susceptible to certain diseases and afflictions because of how our bodies react to certain bacterias and environments. We have been given the DNA and bacteria we grow up with by our parents, which we cannot help. What we can help is how we care for our bodies, which determines how they thrive or break down.

In short, if I don’t want heart disease, I probably shouldn’t eat a pound of bacon every day, because my body is more susceptible to heart disease.

And likewise, if I don’t want cavities and gum disease, I need to make sure I remove harmful bacteria regularly from my mouth, because my mouth is more susceptible to cavities and gum disease.

Tooth decay is 60% affected by genetic risk factors. The other 40% is the environment you expose your teeth to. Periodontal (gum) disease is 40-80% affected by genetic risk factors. The remaining 20-60% is the environment you leave your gum tissue in. These numbers prove that yes, your genetics play a role, but no, they are not the only factor. You have an opportunity every day to drink the soda or to choose water, to eat the candy or the apple, to floss or let the bacteria buildup on your teeth. YOU are in control, this means something wonderful…you CAN keep your teeth for life. You are not at the mercy of your DNA, you just have to learn your risk factors and manage them.

Your dentist and dental hygienist are your ultimate partners in this journey. Tell us your family’s dental history, be explicit with your own medical history and we will tell you what your risks are and what you can do to combat them. We want success for you and we are here to assist you in every way possible.

S. Paige Tscherpel, RDH, BSDH

Consulted sources include:
http://www.cnn.com/2014/07/03/health/tooth-decay-causes/
http://www.rdhmag.com/articles/print/volume-20/issue-1/feature/genetics-periodontal-disease.html

Pregnancy brings a whole host of changes to your body, but among the backaches, morning sickness and stretch marks, there’s also an effect to your gum health during those 40 weeks.

The most common oral symptom pregnant women report is pregnancy-related gingivitis. Hormone levels sky rocket during pregnancy, especially that of the hormone progesterone. The increase in progesterone can make it easier for gingivitis-causing bacteria to grow, and it can also make the gum tissue more sensitive to plaque related inflammation by creating a heightened response to bacterial toxins found in plaque.

This exaggerated response to bacteria can create reddened, swollen gums with the tendency to bleed and at times can be painful. Most often these symptoms seem to increase in the second trimester. Since the second trimester is usually the most comfortable time during pregnancy for most women, routine oral examinations and cleanings are highly recommended at this time to ensure any oral infections are addressed and treated. Pregnancy gingivitis left untreated can develop into a more serious condition, known as periodontal disease. Periodontal disease not only begins destruction of the bone that supports your teeth, it also has the potential to cause preterm labor and low birth weight babies. Women with periodontal disease are 4 to 7 times more likely to deliver underweight babies before 37 weeks gestation.

There are several things you can do during pregnancy to ensure a healthy mouth, even if you are among the unlucky 50+% of women who suffers from mild to severe morning sickness.

Diligent home-care is a must during pregnancy. A soft bristled or electric toothbrush, used twice a day and aimed at the gumline will help to reduce the plaque buildup that creates inflammation. Daily flossing to remove plaque between the teeth is also crucial.

Warm salt water rinses will help to pull inflammation out of the oral tissue. Use approximately 8oz of warm water and 1 tsp of table salt. Rinse for 30 seconds each day. (This is not recommended if you are currently dealing with high blood pressure or pre-eclampsia.)

Go in for your routine check-up and cleaning. Make your provider aware of your pregnancy and explain any symptoms you may be having. Allow them the time to explain any treatments or homecare technique changes that you may need to make.

Delivery of your sweet bundle of joy should bring relief to women who experience pregnancy-related gingivitis. If you decide to breastfeed, you may continue to experience some of the symptoms, as you will still have fluctuating hormone levels. As always, please let your dentist or dental hygienist know if you are experiencing any continued swelling, bleeding or discomfort.

S. Paige Tscherpel, RDH, BSDH

Consulted sources include:
http://www.m.webmd.com/oral-health/pregnancy-gingivitis-tumors
http://americanpregnancy.org/pregnancy-health/swollen-gums-during-pregnancy/
http://www.babycenter.com/_bleeding-gums-during-pregnancy_217.bc

“Oil pulling”. We’ve all heard of it in one capacity or another. In a society that is constantly evolving to a more natural state of dealing with health-related issues, we are used to new remedies and rituals popping up all over the news and social media. Usually these are touted as “miracle cures” and given a certain amount of respect because they are considered “natural”. People are quick to try out these new claims, wanting any solution that doesn’t involve medical or dental intervention, but it is something that bears having an in-depth discussion before you start raiding your pantry.

First, what is oil pulling? Oil pulling is an ancient Ayurvedic remedy for oral detoxification. The routine consists of swishing a spoonful of oil around your mouth for 20 minutes, twice a day. The claim is that the oil then “pulls” the toxins away from the body, preventing a wide host of maladies, including gum disease, migraines and bronchitis. Sounds pretty great, doesn’t it? But let’s take a closer look.

Is oil pulling effective? Here’s the science behind it. Plaque is a biofilm that creates a barrier around self to prevent its own destruction. In the dental field, we know that the best means of removal is through physical disruption, i.e. brushing and flossing. The claim that oil can break through this barrier is scientifically unproven. You can think of it similar to running water over your dirty dishes, versus getting out the scrubber and cleaning them. Which is going to give you a better outcome?

Next, let’s look at the mechanics of the oil itself. Oil is a liquid in warm temperatures (inside the oral cavity). Liquids of all kinds, including mouthwash, have only been proven effective to a depth of 2mm. Most gum disease and gingivitis patients have pockets higher than that, thus the oil is not effective at the base of the pocket, leaving millions of bacteria behind.

And lastly, as a hygienist, I can honestly tell you that it is hard enough to get patients to spend 2 minutes a day caring for their mouths, let alone 40. As a preventive oral healthcare provider, I would never recommend oil pulling as a replacement to diligent brushing and flossing. If oil pulling sounds intriguing to you, please understand it should only be used as adjunctive therapy, never as a replacement.

S. Paige Tscherpel, RDH, BSDH

Consulted sources include:

http://blog.goodmouth.com/2014/03/20/oil-pulling-what-is-it-and-is-it-good-for-your-teeth/

http://www.ada.org/en/science-research/science-in-the-news/the-practice-of-oil-pulling

Oil Pulling Your Leg