What is Gum Recession and Why is it a Concern?

Gum recession is when the gums and bone support pull away from the tooth.  This exposes the porous root surface.

Potential Causes of Recession:
Gum disease

Clenching or grinding

Poorly aligned teeth and/or crowding
Aggressive brushing

Signs of Recession:

Hot/Cold sensitivity
Brushing sensitivity
Teeth appearing "longer" than they used to
Notching present at the gum line
Decay present at the root surface

Gum recession is fairly common and occurs gradually.  Typically the first symptom is sensitivity or a "longer" appearance in the tooth.  Identifying what is causing the recession is key to finding a solution.

Cause and Potential Solutions

Gum Disease → Regular dental visits, daily brushing and flossing
Clenching/Grinding→ Night guard, bio- feedback
Poor Alignment/crowding→ Braces.
Aggressive brushing→ Switch to an extra soft tooth brush or electric tooth brush, brush with your non dominant hand.

It's important to stop recession from progressing further.  If recession continues, root surface cavities, loosening of teeth or tooth loss can occur.  

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What's the Difference Between Gingivitis and Periodontal (Gum) Disease?

Gingivitis:  Plaque bacteria isn't being brushed or flossed away.  This bacteria sitting around the gums causes swelling and bleeding.  The bacteria is breaking down the gum tissue.  You may notice bleeding when brushing or flossing.  This is your first sign that there is a problem.  Healthy gums do not bleed. Begin removing bacteria by brushing and flossing daily.  You should see improvement in the terms of swelling, malodor and bleeding reduction.

If bacteria isn't removed daily, it will successfully break down the gum tissue and then move into the bone and being breaking down bone.  Once the bone is involved it is now called periodontal disease.

Periodontal Disease:  Bacteria allowed to sit on your gums have now moved from the gums to the bone and is breaking down bone.  Essentially, you are losing part of your jaw bone.  Symptoms of periodontal disease include: bleeding, malodor, swelling and mild soreness in the gum tissue.  This is very similar to gingivitis.  That is why it is so important to maintain regular dental visits.  We measure bone support each visit and provide you with feedback and suggestions.  Periodontal disease is irreversible and maintaining bone levels where they are is important to keeping disease at bay.  If left untreated, teeth will loosen and eventually teeth will be lost.

Gingivitis

Periodontal Disease



Advance Periodontal Disease

The Difference Between a White and Silver Filling.

Composite: The dentist only removes the decay.  Essentially a 'hole' surrounded by healthy tooth remains.  That 'hole' is then filled with white composite that is bonded or glued to the sides of the 'hole.' This strengthens the tooth, looks like the tooth and feels smooth.

Amalgam or silver fillings: Since no bonding or 'glue' is used with a sliver filling, the dentist has to remove the decay and then shape the tooth in such a way that the silver filling will lock itself into place.  This means that healthy tooth has to be removed to prepare the tooth for a silver filling.

We like to keep as much of the natural, healthy tooth as we can.  Therefore a composite is likely recommended.

Image: The black lines indicate the amount of tooth removed to prepare the tooth for a filling.  The gray indicates the cavity or decay.

Electronic Cigarettes and Your Mouth

"I don't smoke cigarettes anymore; I switched to e-cigs. How does that impact my mouth?"

They Contain Toxins

Specifically, a harmful one and one unique to e-cigs, is diethylene glycol.  Diethylene glycol is used in anti-freeze, lead and chromium.  When inhaling an aerosol the first contact (the mouth) is the hottest and most potent.  This changes the make up of your cells, in a negative way.

Additionally, significant amounts of metal toxins leak from the coils in an e-cigarette.  Unsafe levels of nickel, lead, chromium and manganese are in the mouth and then inhaled.  Chronic inhalation of these metals can cause lung, liver, immune and cardiovascular and brain damage as well as cancers.

Nicotine's Role

E-cigarette contain liquid nicotine.  Nicotine in any form is a vasoconstrictor, meaning it cuts off the blood flow to the teeth and gums.  It chokes the tissue and causes death to the gum tissue.  Nicotine also cuts of salivary flow.  Saliva plays an important role in washing and protecting the teeth. Without it you become more at risk for decay, bad breath and gingivitis.  Nicotine is a stimulant and can also cause or intensify grinding or clenching.  This can result in jaw pain, wear, cracking and breaking of teeth.

Nicotine can also hide the symptoms of gum disease.  At the dental office, our first 'clue' to a gum problem is bleeding.  Since nicotine restricts blood flow, a smoker or vaper's, tissue won't bleed as easily until the disease is more advanced.

So what should you do to protect your oral health, if you use e-cigarettes?

• Obviously, quitting is recommend not only for your dental health, but for the health of your body.
• Drink water.  Due to using nicotine use, dry mouth is a concern.  Drinking plenty of water throughout the day will help lubricate the mouth, reducing decay and bad breath.
• Switch to no nicotine e-liquid.  Eliminating nicotine will reduce dental diseases
• Better Oral Hygiene.  Smokers and Vapers have to work harder than most because they are higher risk for dental diseases.  While some can get away with flossing a few times a week, smokers and vapers cannot.
• Visit the Dentist.  Be sure to maintain regular visits to the dentist and get regular x-rays.  This will help reduce decay and gum disease and/or catch it at an early and treatable stage. 

How to Care for Your Infant's Teeth

That sweet, gummy, baby smile is enough to melt your heart!  But how and when does a parent start practicing oral hygiene at home?

For starters, even before teeth come in, gently clean your baby's gums.  I find it best to do this during bath time.  Wrap a wet washcloth around your finger and gently glide along baby's gums.

Once teeth appear, you can continue to use the washcloth during bath time.  If it's not bath night, there are several baby tooth brushes that you can use.  This is my favorite to use until molars come in.

Once that happens a tooth brush, like the one below, works best (and saves your finger from a bite!)

Avoid using large amounts of toothpaste with fluoride in it.  A tiny smear of toothpaste is plenty.  It's not the end of the world if a bit of toothpaste is swallowed, but keep the tube out of reach.  If you are worried, there are fluoride free toothpastes available.  Incorporating the right amount of fluoride in your baby's teeth and developing adult teeth is important.

Flossing of course is recommended as soon as multiple teeth come in, easier said than done.  Check to see how tight your baby's teeth are.  Does floss easily slip into a large space between the teeth or does the floss 'snap' into place?  If that floss 'snaps' into place, your kiddo is more at risk for decay, making flossing all the more important.  That tight space traps bacteria and the tongue and saliva have a harder time cleaning out that area. I find it easiest to use flossers, with my child's head in my lap to clean out bacteria and food between the teeth.

8 Tips to Calm a Sensitive Gag Reflex

The gag reflex is there to prevent us from a foreign object obstructing our airway.  This reflex is triggered by an object touching the roof of mouth, back of tongue and/or tonsils.  While no one is entirely sure why someone's gag reflex is more sensitive than others, there are some tips on how to deal with a sensitive reflex.

1. Use a numbing spray or gel in your mouth
2. Squeeze your thumb.  Reflexology state that applying pressure in your hand by squeezing your thumb can help ease a gag reflex (see photo)
3. Desensitize your tongue, by brushing your tongue every day
4. Apply table salt to the center of your tongue
5. Hum
6. Wiggle your toes; raise your leg.  This will keep your mind on something else
7. Listen to music
8. Focus on breathing through your nose.

How a Crown is Prepared

Part 2 of our crown series is how a crown is actually done.  A crown is custom fit for each tooth.  Dr. Scott will reduce each side of the tooth, to allow for the new crown to fit in your mouth.  Without that reduction from every side of the tooth, that crown would be the only tooth your teeth hit when they come together.

After the tooth is reduced, a crown is placed over the top.  The color and type of crown is done to fit and blend perfectly with the neighboring teeth.

Having a crown does not mean you now have a fake tooth.  It is your natural tooth underneath.  You will still feel hot and cold.  You can chew normally; you will be able to floss normally.  It is still your tooth.

A crown does not mean you have to have a root canal.  However, the reverse is true:  if a tooth has a root canal, a crown is now recommended.  A root canalled tooth is hallow and thus fragile to breaking.  A crown strengthens a fragile tooth.  But just because a tooth has a crown does not mean it will need a root canal.

Why Do I Need a Crown?

Having a crown done is a very common practice in a dental office.  If it's your first you may have some questions.

The following are the most common reasons to crown a tooth:

• Cracked Tooth.  If a tooth is cracked, in order to keep that tooth together and keep that crack from spreading, a crown is placed over the top of the tooth.  The crack is still present but the tooth will no longer flex with chewing and temperature changes.  Keeping that crack right where it is, away from the nerve.
• If the Tooth has a Root Canal.  When you have a root canal, the nerve is removed and the tooth is now 'hallowed out'.  A hallow tooth is more at risk for cracking and breaking.  Since you no longer have a nerve in the tooth you can't feel if this is happening.  A crown, covering that tooth, protects it from breaking.
• Discolored or Misshapen Teeth.  For stains that won't whiten away or teeth that are a funny shape, a crown can make teeth more uniform in color and shape.
• A Lot of Decay.  A tooth with a lot of decay cannot support a filling.  You need a certain portion of natural tooth to support, not only a filling, but to withstand chewing forces.  If there isn't much healthy tooth left then your only option is to crown it, to avoid an extraction.
• Broken Tooth.  Same as a tooth with a lot of decay; if a large portion of the tooth is gone, it can't be filled.  Crowning is the only option to ensure longevity of that tooth.
• Wear.  Depending on how severe the wear is, in order to build it back up to where it was a crown is needed.

When doing a crown we can contour the tooth to fit ideally in your mouth.  We take into account what area is broken/decayed/worn to fit in with the surrounding teeth.  This can repair food catches, idealize contour of the tooth and reduce sensitivity to name a few.  Crowns are custom made to only fit that one tooth and provide you with a more predictable, attractive result.  Before crowns, a damaged tooth would have been pulled, now a crown allows you to keep a damaged tooth for a long time, often the rest of your life.  

A crown is nothing to be ashamed of.  In fact, you may not ever even notice them; they look and feel like a natural tooth.