Diplomates, American Board of Periodontology
Certified in Periodontology and Dental Implant Surgery
Brush or Floss-Which Should You Do First??
Following a recent article from the Associated Press, there
have been reports in the media that there is little evidence that
flossing is required for good dental health. We would like to give you our
perspective on bacterial plaque removal and periodontal health.
You are not healthy
unless you are periodontally healthy
We know that bacterial plaque causes periodontal
bone and tissue loss that can be disfiguring, cause loss of function, and affect
your overall health. As stated by the
researcher from the Associated Press article, removal of bacterial plaque on a
regular basis is essential. Flossing is
only one method of removing bacteria from between your teeth but certainly not
the only method.
CDC reports nearly
half of adults over the age of 30 have periodontal disease
We know that according to the Centers for
Disease Control’s most recent data, nearly 50% of adults over the age of 30
suffer from ongoing periodontitis and this disease is still the major cause of
tooth loss in the US. For patients over
the age of 60 the incidence of periodontitis climbs to nearly 70%.
Flossing manages the
risk of developing periodontal disease and controls progression of the disease
We know that in some patients there is a genetic
susceptibility to this chronic disease while others may be resistant. This is not unlike other chronic diseases of
aging such as heart disease, cancer, diabetes.
For example while we understand that a high fat diet and lack of
exercise are primary risk factors, there are some patients that are genetically
resistant to heart disease. We all know
patients who, despite smoking, live a long, cancer-free life. There are obese patients who despite having
the primary risk factors do not develop diabetes. Periodontal diseases are similar in that
there is a segment of the population that are resistant to developing
periodontitis despite having a high risk factors present such as unremoved
bacterial plaque. Risk factors are an
indication that you are likely to develop disease- not that you will have the
disease. You see, just like eating
right, exercise and other healthy lifestyle behaviors, flossing manages your
risk for developing and, after treatment, controlling your periodontitis.
periodontal evaluation is recommended for adults over 30 years of age
The American Academy of Periodontology
recommends that all dentists (not just periodontists) conduct a comprehensive
periodontal evaluation at least on a yearly basis for all adults over 30. Your dentist may refer you to a
periodontist. A periodontist is a
specialist in treating periodontal diseases and conditions with three years of
additional training after dental school. Periodontists have advanced training
in managing your periodontitis, regenerating lost bone and tissue from
recession, and performing dental implant surgery. You do not have to lose your teeth to this
devastating, chronic disease. Periodontists see patients referred by dentists,
physicians or see patients without referral who are concerned about their
TAKE CONTROL OF YOUR PERIODONTAL HEALTH AND CALL US TODAY
FOR A COMPREHENSIVE PERIODONTAL EVALUATION. You can reach our office to schedule an
appointment at: (714) 441-0436.
Bleeding gums are not healthy gums, so if you notice bleeding when you brush or floss, you should schedule an appointment with your dentist or periodontist to evaluate the reason. Here are a few tips to keep your gums healthy.
Improve Your Dental Hygiene
Bleeding gums are a primary symptom of gingivitis, which can occur when plaque is allowed to build up on the gum line. Plaque is made up of bacteria that cause the gum tissue to become red and inflamed. If not removed regularly, plaque can also harden into tartar which is irritating to the gums and creates a rough place for additional plaque bacteria to collect. The best way to reduce the amount of plaque on your teeth and to avoid potentially bleeding gums is to brush and floss regularly and efficiently.
Use the Proper Toothbrush
Many people make the mistake of believing that a toothbrush with hard bristles will be the best tool for cleaning their teeth, but this simply isn’t true. Harder bristles are abrasive which irritates the gums and causes recession of the gums and erosion of hard tooth structure. Instead, search for a toothbrush that has soft bristles and brush in a circular motion rather than back and forth.
Review Your Medications
Some medications can increase the chance of bleeding gums, such as aspirin. Aspirin is a blood thinner, so it is known to increase bleeding. Prescription medications may also cause bleeding gums, so if you suspect that a drug prescribed to you by your physician is the cause, contact your doctor to discuss your concerns.
Visit Your Dentist and Dental Hygienist
Visit your dentist regularly so that small issues don’t progress to bigger ones. He will examine your gums and teeth to ensure that you haven’t developed a more serious condition, and treatment options will be discussed.
See your Periodontist
Following four years of dental school, a periodontist completes a three year advanced residency program before becoming certified. A periodontist specializes in the prevention, diagnosis and treatment of periodontal (gum) disease. Your periodontist will provide a comprehensive periodontal evaluation and recommend treatment (see previous Blog: What Is a Periodontal Examination and What Should I Expect?)
During your dental appointment, you may have heard your
dentist or hygienist mention periodontal pockets, but do you really know what
Periodontal Pockets Defined
In a healthy mouth, the space between the gum and the tooth
(which is measured from the top of the gum, down to where the gum attaches to
the tooth) should only be 1-3 mm deep. Unfortunately, gum disease can create deeper spaces around the teeth,
and these are known as periodontal pockets.
Left untreated, tooth loss can occur.
The Formation of Periodontal
Plaque and tartar build up along the gumline. The bacteria in plaque causes gum inflammation
which breaks down the soft tissue that supports the tooth. As periodontal (gum) disease progresses, the
bacteria also breaks down the supporting bone tissue. This inflammation and bone loss causes a
pocket to form between the teeth and the gums, and the deeper space becomes the
perfect location for more plaque and tartar to hide out.
Periodontal Pockets and
While the main cause of periodontal disease is bacteria, a
patient’s susceptibility to this infection may be responsible for the level of
severity of bone loss. Evidence is
growing, that a person’s response to inflammation may be genetically
pre-determined. So as a result, there
are patients that may be more susceptible to a number of chronic diseases such
as arthritis, diabetes and periodontal diseases based on their individual
genetics. Our office offers genetic
testing as part of your personalized health care.
Treating Periodontal Pockets
The dentist or hygienist uses a periodontal probe to measure
and record the depth of the spaces around each tooth. If periodontal pockets are detected, the
first stage in treatment is often a non-surgical approach called root
Our specialty practice uses advanced ultrasonics to remove
established bacteria and inflamed tissue in a non-surgical approach to root
planing. This initial therapy will
decrease the inflammatory aspect of periodontitis but will not regenerate lost
tissue and bone. Other approaches using
lasers and locally applied antibiotics have been used but these other
adjunctive treatments have not been found to be more effective than thorough
root planning. It is important that
patients understand the most effective treatments for their condition that are also
minimally invasive. Ultrasonic root
planning allows for soft tissue healing with some reattachment to healthier
tooth root surfaces. In cases of more
severe bone loss, regeneration of soft tissue and bone may be possible with
some of the new technologies we employ.
Following the root planning procedure, our doctors will re-evaluate your
response and make further recommendations as needed.
Once periodontal treatment has been completed, it is
important to follow up with routine periodontal maintenance appointments. The periodontist will recommend how
frequently the maintenance appointment should occur.
Have you ever told you that you have inflamed gums (gingivitis) or gum disease, but you feel that your condition persists even though you continue to have regular cleanings? If left untreated, gingivitis can progress to periodontitis, a more severe form of gum disease. Most adults are not aware that they have periodontitis, since there is usually very little or no pain associated with it.
The Difference between Gingivitis and Periodontitis
Gingivitis is a common and mild form of gum disease that causes irritation, bleeding, redness and swelling (inflammation) of your gums. You should know that healthy gums should never bleed. Bleeding is a sign of inflammation and a signal that your gums are not healthy.
Periodontitis is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth. As the inflammation present in gingivitis becomes more severe, its progression to periodontitis can cause loss of bone around teeth and gum recession. Periodontitis is the leading cause of tooth loss in adults The inflammation and infection associated with periodontitis has also been associated with persistent bad breath and growing evidence has linked periodontitis to other chronic inflammatory diseases such as heart disease, diabetes, rheumatoid arthritis, chronic respiratory infections and other serious health problems. We now know that some individuals are genetically susceptible to periodontitis as well as some of these other chronic inflammatory diseases.
If you are concerned that your gingivitis has progressed to periodontitis, Dr. Clem and Dr. Yen will be able to better evaluate your current condition and guide you with which options are available to restore your periodontal and overall health.
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