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Posts for category: Oral Health

By Dr. Brian Gniadek
February 15, 2019
Category: Oral Health
Tags: gum disease  
YourRegularDentalVisitsMightChangeifYouvehadGumDisease

Periodontal (gum) disease is as common as it is destructive. Almost half of all adults 30 and older have some form—and those numbers increase to nearly three-quarters by age 65.

Fortunately, we have effective ways to treat this bacterial infection, especially if we catch it early. By thoroughly removing all plaque, the disease-causing, bacterial biofilm that accumulates on tooth surfaces, we can stop the infection and help the gums return to normal.

Unfortunately, though, you're at a greater risk for a repeat infection if you've already had gum disease. To lower your chances of future occurrences, we'll need to take your regular dental exams and cleanings to another level.

Although everyone benefits from routine dental care, if you've had gum disease you may see these and other changes in your normal dental visits.

More frequent visits. For most people, the frequency norm between dental cleanings and exams is about six months. But we may recommend more visits for you as a former gum disease patient: depending on the advancement of your disease, we might see you every three months once you've completed your initial treatment, and if your treatment required a periodontist, we may alternate maintenance appointments every three months.

Other treatments and medications. To control any increases in disease-causing bacteria, dentists may prescribe on-going medications or anti-bacterial applications. If you're on medication, we'll use your regular dental visits to monitor how well they're doing and modify your prescriptions as needed.

Long-term planning. Both dentist and patient must keep an eye out for the ongoing threat of another gum infection. It's helpful then to develop a plan for maintaining periodontal health and then revisiting and updating that plan as necessary. It may also be beneficial to perform certain procedures on the teeth and gums to make it easier to keep them clean in the future.

While everyone should take their oral health seriously, there's even greater reason to increase your vigilance if you've already had gum disease. With a little extra care, you can greatly reduce your chances of another bout with this destructive and aggressive disease.

If you would like more information on preventing recurring 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 “Periodontal Cleanings.”

By Dr. Brian Gniadek
January 06, 2019
Category: Oral Health
Tags: dental records  
3ReasonsWhyYourNewDentistNeedsYourTreatmentRecords

Like other healthcare providers, your dentist keeps records of your ongoing care. These include not only their written notes but also x-ray imaging, frequency of visits and cleanings, and any medical information that could affect your care. What’s more, they have a legal obligation to maintain these records.

Your dental records help guide decisions about your care. In that regard, you should consider something else—you may need to change providers: your dentist retires or you move; your dentist isn’t in your new insurance network; or, unfortunately, you have an “irreconcilable” difference with your provider.

If that happens, it’s very important your dental records find their way to your new provider. Here are 3 reasons why.

Your individual dental history. Each person’s dental situation and needs are unique. Your past records help clue in your new dentist about your past history and current needs, which will help guide how they treat you.

Time and money. Your dental records contain x-rays or other diagnostic information about your oral condition, including preparations for any upcoming dental work. If you change dentists before completing that treatment, your new dentist may have to start over with new diagnostic tests if they don’t have this previous data. It could cost you more money and make you wait longer for a needed procedure.

Coordinating dental care with your general health. Your mouth isn’t isolated from the rest of your body, and some dental treatment measures could affect other health conditions (and vice-versa). If your new dentist knows other health issues you may have from your previous records, it can help ensure you’re getting dental treatment appropriate to your overall health.

For the most streamlined transition between providers, it’s important your dental records follow you. You’re entitled to having those records transferred, and, if you’re uncomfortable asking yourself, your new provider can obtain them for you. Just be sure to ask.

If you would like more information on your rights regarding your dental care records, 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 “Why Your Dental Records Should Follow You.”

By Dr. Brian Gniadek
December 27, 2018
Category: Oral Health
Tags: loose teeth  
ThePerilsofaLoosePermanentTooth-andWhattodoAboutit

A loose baby tooth is normal and expected; a loose permanent tooth is quite another matter: it’s an advanced sign of disease that could lead to losing the tooth.

The reasons for its looseness may vary. You may have experienced “primary occlusal trauma,” in which the teeth have experienced a prolonged excessive biting force beyond their tolerance. This can be caused by habitual grinding or clenching the teeth.

You may have also experienced “secondary occlusal trauma”: although the biting forces are within normal ranges, the teeth still can’t handle the stress due to degraded bone support and gum tissue detachment. Clenching habits combined with weakened bone and gums will only accelerate and worsen the damage.

The most frequent cause in adults for loose teeth is secondary trauma from periodontal (gum) disease. Bacterial plaque built up on teeth from poor oral hygiene causes a chronic infection that eventually weakens gum attachment to the teeth. A loose tooth is a late sign of this damage.

Treatment for disease-based loose teeth has a twofold approach. First, we thoroughly clean the tooth, root and gum surfaces of all plaque and calculus (hardened plaque deposits) to reduce the infection and inflammation and restore tissue health. This is often accompanied by antibiotic treatments to reduce bacteria below the gum tissue.

For the loose teeth themselves, we may need to modify the forces against them while the gums and bone heal. One way to lessen the biting force on a tooth is to reshape its and the opposing tooth’s biting surfaces. For extensive looseness we can also splint the affected tooth or teeth with other teeth. Temporarily, we can apply splinting material to the outside of both the loose and stable teeth or cut a small channel into them and apply bonding material to join them. A permanent option is to crown both the affected teeth and nearby stable teeth and fuse the crowns together.

These and other stabilizing techniques, like occlusal night guards to reduce the effects of teeth grinding or orthodontic treatment, will help secure the teeth. Coupled with disease treatment and renewed dental care and hygiene practices, you may be able to keep that loose tooth from being lost.

If you would like more information on treating loose teeth, 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 “Treatment for Loose Teeth.”

By Dr. Brian Gniadek
November 27, 2018
Category: Oral Health
Tags: gum disease  
PeriodontalProbingIncreasesAccuracyinDiagnosingGumDisease

If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.

That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.

Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.

During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.

Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.

If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.

Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.

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 article “Understanding Periodontal Pockets.”

AdvancedEquipmentandSafePracticesEnsureX-RaySafetyforChildren

When it comes to our children’s safety, there isn’t much nowadays that isn’t under scrutiny. Whether food, clothing, toys and more, we ask the same question: can it be harmful to children?

That also includes tried and true healthcare practices. One in particular, the routine x-ray, has been an integral part of dental care for nearly a century. As a means for detecting tooth decay much earlier than by sight, it has without a doubt helped save billions of teeth.

But is it safe for children? The reason to ask is because x-rays are an invisible form of electromagnetic radiation that can penetrate human tissue. As with other forms of radiation, elevated or frequent exposure to x-rays could damage tissue and increase the future risk of cancer.

But while there is potential for harm, dentists take great care to never expose patients, especially children, to that level or frequency of radiation. They incorporate a number of safeguards based on a principle followed by all healthcare professionals in regard to x-rays called ALARA, an acronym for “as low as reasonably achievable.” This means dentists and physicians use as low an exposure of x-ray energy as is needed to achieve a reasonable beneficial outcome. In dentistry, that’s identifying and treating tooth decay.

X-ray equipment advances are a good example of ALARA in action. Digital imaging, which has largely replaced film, requires less x-ray radiation for the same results than its older counterpart. Camera equipment has also become more efficient, with modern units containing lower settings for children to ensure the proper amount of exposure.

Dentists are also careful how often they take x-ray images with their patients, only doing so when absolutely necessary. As a result, dental patients by and large experience lower dosages of x-ray radiation in a year than they receive from natural radiation background sources found every day in the environment.

Dentists are committed to using x-ray technology in as safe and beneficial a way as possible. Still, if you have concerns please feel free to discuss it further with your dental provider. Both of you have the same goal—that your children have both healthy mouths and healthy bodies for the rest of their lives.

If you would like more information on x-ray safety for children, 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 “X-Ray Safety for Children.”