Posts for: January, 2017
When you visit us for your regular checkup we're examining more than your teeth and gums. We're also checking to see if you're having problems with soft tissues in and around your mouth.
Besides canker sores, rashes or other types of abnormalities, our exam may uncover strange looking lesions known as lichen planus on the inside of the mouth. These purple-tinted bumps or rash-like discolorations are named for their similarity in appearance to lichen fungi found on trees or rocks. Although these mouth sores may look odd, they're fairly rare and usually do not cause concern.
Most people don't even know they have lichen planus until it's discovered during a dental exam. If there are any symptoms, it's usually a feeling of roughness, tenderness or itching. They may increase your sensitivity to spicy or acidic foods, but rarely cause extreme pain. If they're located around the gums, you may also notice a little soreness after brushing or eating.
To confirm it is lichen planus, we need to perform a biopsy. During this procedure, we remove a tiny amount of the affected tissue and have it examined microscopically. We do this not only to determine the correct diagnosis, but also to rule out more serious problems like pre-cancerous lesions or oral cancer.
Thankfully, though, this worst case scenario is quite rare, and although the condition can't be cured, there are some things you can do to keep any discomfort to a minimum. If the lesions are irritating, we recommend using a soft toothbrush with gentle brushing action. You may also want to limit or avoid spicy or acidic foods like citrus, tomatoes, hot peppers and caffeinated drinks. Managing stress can also help. For some extreme conditions, we can prescribe a topical steroid to help relieve discomfort.
If you notice any of the above symptoms, be sure to contact us or point it out at your next appointment. Once we know what we're dealing with, we can take steps to treat you.
If you would like more information on different types of mouth sores, 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 “Lichen Planus.”
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 allÂ 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.” Â 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.
You've seen the ads for obtaining a new tooth in one day with a dental implant. Those aren't exaggerated claims — you can leave the dental office the same day with a new tooth that looks and functions like the old one.
But the dramatic marketing aside, there is a bit more to the story. Same day tooth replacement isn't appropriate in every situation. And even when it is, there are risks for failure.
We can minimize those risks, however, by focusing on certain goals during the three distinct phases in the process: removing the natural tooth; placing the metal implant into the jawbone; and affixing the visible, crown.
It's crucial during tooth extraction that we avoid damaging the socket bone that will ultimately support the implant's titanium post. If the socket walls break down it could set up future gum recession or cause us to abort the implant procedure altogether that day.
When placing the implant, we want to focus on achieving a strong hold. Due to its special affinity with titanium, bone cells gradually grow and adhere to the post to firmly anchor the implant in time. But since we're immediately loading a crown rather than allowing the bone to fully integrate first, we need to ensure the implant has a secure hold from the get-go. We can only achieve this with precise placement based on careful examination and planning, as well as adequate bone.
Even so, the implant still needs to integrate with the bone for a lasting hold, and that takes time. Even with normal biting forces the implant risks damage during this integration period. That's why we place a temporary crown a little shorter than the surrounding teeth. Those adjacent teeth will take the brunt of the biting force and not the implant.
Once the bone has fully integrated, we'll replace the temporary crown with a permanent one the proper height proportional to the other teeth. Even with the temporary crown, though, you'll still have a life-like tooth the day we removed the older one.
The key to success is planning — first determining if you meet the criteria for a same-day implant and then mapping out and carefully executing each succeeding step. Doing this will ensure your same-day implant is a success from day one.
If you would like more information on same-day tooth replacement, 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 “Same-Day Tooth Replacement with Dental Implants.”