Posts for: March, 2020
While braces are a tried and true method for achieving a more attractive smile, they may also give rise to problems with dental disease. This is because their hardware — the brackets and bands that serve as tracks for the tensioning wires — make it more difficult to access the tooth and gum surfaces to clean away plaque. This thin film of food remnant may then become a haven for bacteria that cause gum disease or tooth decay.
One of the more common conditions to occur while wearing braces is gingivitis. This is an initial inflammation of the gum tissues caused by bacterial plaque that hasn’t been removed by brushing or flossing. As the inflammation grows unchecked, the infection could advance deeper into the tissues to become a more serious form of gum disease that threatens the survival of affected teeth.
Difficult as it may be for those wearing braces, the best way to avoid gingivitis is through more thorough oral hygiene practices. Fortunately, there are many hygiene products that can help you get around many of the access difficulties posed by braces. Smaller toothbrushes known as interproximal brushes and floss threaders, small aids that thread dental floss under braces wires, can access the spaces between teeth more readily than conventional brushes or floss. Water flossers (which use water under pressure to remove plaque between teeth) and motorized toothbrushes can further increase efficiency. We can also reduce bacterial growth in the mouth if need be with prescription-strength antibacterial mouthrinses.
If, however, gingivitis or gum overgrowth (another common occurrence during orthodontic treatment) continues to be a problem, we may need to take other actions including surgery. In extreme cases, the braces may need to be removed to adequately treat the gums and allow them time to heal before proceeding with orthodontics.
Extra care with daily hygiene and regular dental checkups and cleanings in addition to your orthodontic visits will help keep gum problems at bay while you’re wearing braces. Taking this extra care will stop or minimize the effect of disease as you continue on to the ultimate goal of your orthodontic treatment — a more beautiful smile.
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating gum disease, 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 “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”
Hollywood superstar Jennifer Lawrence is a highly paid actress, Oscar winner, successful producer and…merry prankster. She's the latter, at least with co-star Liam Hemsworth: It seems Lawrence deliberately ate tuna fish, garlic or other malodorous foods right before their kissing scenes while filming The Hunger Games.
It was all in good fun, of course—and her punked co-star seemed to take it in good humor. In most situations, though, our mouth breath isn't something we take lightly. It can definitely be an unpleasant experience being on the receiving end of halitosis (bad breath). And when we're worried about our own breath, it can cause us to be timid and self-conscious around others.
So, here's what you can do if you're concerned about bad breath (unless you're trying to prank your co-star!).
Brush and floss daily. Bad breath often stems from leftover food particles that form a film on teeth called dental plaque. Add in bacteria, which thrive in plaque, and you have the makings for smelly breath. Thorough brushing and flossing can clear away plaque and the potential breath smell. You should also clean your dentures daily if you wear them to avoid similar breath issues.
Scrape your tongue. Some people can build up a bacterial coating on the back surface of the tongue. This coating may then emit volatile sulfur compounds (VSCs) that give breath that distinct rotten egg smell. You can remove this coating by brushing the tongue surface with your toothbrush or using a tongue scraper (we can show you how).
See your dentist. Some cases of chronic bad breath could be related to oral problems like tooth decay, gum disease or broken dental work. Treating these could help curb your bad breath, as can removing the third molars (wisdom teeth) that are prone to trapped food debris. It's also possible for bad breath to be a symptom of a systemic condition like diabetes that may require medical treatment.
Quit smoking. Tobacco can leave your breath smelly all on its own. But a smoking habit could also dry your mouth, creating the optimum conditions for bacteria to multiply. Besides increasing your disease risk, this can also contribute to chronic bad breath. Better breath is just one of the many benefits of quitting the habit.
We didn't mention mouthrinses, mints or other popular ways to freshen breath. While these can help out in a pinch, they may cover up the real causes of halitosis. Following the above suggestions, especially dental visits to uncover and treat dental problems, could solve your breath problem for good.
If you would like more information about ways to treat bad breath, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”