Wine Country Perio & Implantology

Periodontal disease affects over 90% of Americans each year and the reality is that you will experience some form of it over the course of your life. The only question is to what degree. The main culprit of the disease is dental bacterial plaque, the biofilm that results when bacteria concentrate at the gum line in everyone’s mouth.

Think of your mouth as an ecosystem with your own oral tissues living alongside millions of bacteria. However, without thorough brushing, flossing, and routine dental cleanings, this balance can tip towards the first stage of periodontal disease—gingivitis or inflammation of the gingiva (gums). Without proper treatment, gingivitis can evolve into periodontitis, that can result in teeth becoming loose and possibly lost. Learn more in this comprehensive article “Understanding Gum Disease.”

As any dentist or medical professional will tell you, Benjamin Franklin gave great advice that is still true today when he said, “an ounce of prevention is worth a pound of cure.” The first tell tale sign of periodontal disease is bleeding gums when brushing your teeth or flossing. Unfortunately, most people ignore this sign because they think that they’re brushing or flossing too hard. Bleeding gums reveal you have gum disease as healthy gum tissue doesn’t normally bleed. And it only takes gentle brushing and flossing the right way to remove dental bacterial plaque, not hard scrubbing. If left untreated, your condition may develop into periodontal disease: disruption and loss of attachment of the gums and bone support which “unzip” from the teeth creating pockets of infection. Learn more by reading “Warning Signs of Periodontal (Gum) Disease.”

It seems that evidence mounts daily identifying a link between your oral health and the health of the rest of your body. In this blog article we will explore the specific connection between your gum health and Arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease affecting about 1.5 million Americans that causes chronic inflammation of the joints and other areas of the body. The result is often debilitating pain, reduced flexibility and, in some cases, erosion of the surrounding bone.

Periodontal disease refers to advanced bacterial infection of the gums. It generally follows gingivitis that is left untreated for an extended period of time. If allowed to continue without professional treatment, severe gum disease can lead to dramatic recession of the gums, tooth loss and damage to the bones of the jaw.

The Inflammation Connection

The exact nature of the link between these two diseases is still being researched. Scientists originally pointed to bacteria as the leading factor; however, more recent research shows that inflammation is might likely responsible for the association. What is clear at this point, is that the connection does exist and treatment for periodontal disease is strongly recommended for patients with RA.

Preventing Periodontal Disease and Its Affects on RA

Due to the connection between diseases, proper oral hygiene has become a key component in treatment plans for arthritis sufferers. It is believed that reducing inflammation in the gums can help decrease their joint pain and fatigue related to RA. Unfortunately, oral health habits can be exceedingly difficult for arthritic joints in their hands. The American Dental Association has offered these recommendations for their hygiene routines:

• Try an electric toothbrush. A quality electric brush with a large handle allows for a better grip and can clean teeth and gums effectively, without as much hand motion.
• Consider floss holders. If traditional flossing methods are difficult, RA patients are encouraged to try angled floss holders. These plastic devices are affordable and easy-to-find.
• Protect yourself with mouthwash. An RA patient generally needs extra oral protection than a healthy patient. A fluoridated mouthwash, used 2-3 times per day, can help keep bacteria at bay.
• Avoid smoking. Besides putting themselves at risk of host of other medical conditions, smokers are much more likely to develop gum disease.

If you are patient suffering from Rheumatoid arthritis, please don’t hesitate to call us with any questions or for advice regarding your oral health routines.

We’ve all heard of Gingivitis, most likely on flashy television commercials proclaiming prevention and cures, or by receiving a warning from your dentist, but do you really know what Gingivitis is and how to prevent and treat it?

Gingivitis is a form of periodontal (gum) disease. It causes inflammation and infection in the tissues of your teeth and gums, as well as in the periodontal ligaments (which attach your teeth to bone) and the tooth sockets, which means bad news for your gums and teeth.

It’s the long-term effects of plaque deposits on your teeth that cause Gingivitis, which is why it’s so important to brush and floss daily. Plaque, a mixture of bacteria, mucus, and food debris, cultivates on the surface of your teeth, causing tooth decay. If plaque is not removed it turns into tartar (also called calculus) that gets trapped at the base of your teeth, causing swollen, tender, and infected gums. Left untreated, Gingivitis causes your gums to recede, spoiling that pretty smile of yours.

Brushing and flossing daily helps remove plaque before it turns into tartar, which, if left to its own devices, is more difficult to remove and can create a shield locking in bacteria. At this point, only your dentist can remove it, which is why it’s so important to maintain bi-yearly dental cleanings.

If left untreated, Gingivitis can turn into Periodontitis, (the progressive loss of the soft tissue and bone that support your teeth) which can lead to loosening teeth and subsequent tooth loss. By simply brushing and flossing daily, and seeing your dentist every six months, you can save yourself thousands of dollars in possible dental implant and denture costs, not to mention ensure the quality of your pearly whites.

Certain factors that increase your risk for Gingivitis:

Dental Factors

• Bad oral health habits
• Misaligned teeth
• Ill-fitted dental restorations

Health Factors

• Poor nutrition
• Genetics
• Diabetes
• Substance abuse
• Certain viral and fungal infections
• Older age – more common after age 35
• Certain medications such as antidepressants, heart medications, and others (talk to your Periodontist about whether or not your medications put you at risk)
• Smoking – we all know smoking is bad for your health, but did you know that over time it breaks down your gums and your jawbone?
• Decreased immunity from illnesses such as HIV/AIDS, leukemia, and other conditions
• Gender – women are more susceptible than men due to hormonal changes caused by monthly menstrual cycle, oral contraceptives, and pregnancy

Risks of Gingivitis

• Diabetes (both type 1 and 2)
• Heart disease
• Women with periodontitis have an increased risk of birthing premature babies, or babies with low birth weight versus women with healthy gums.
• Increased risk of heart attack, stroke and lung disease

Symptoms

• Painful, tender, and swollen gums
• Bleeding gums, especially when flossing and/or brushing
• Bright red to purple-pink gums (as opposed to healthy pink)
• Shiny gums
• Mouth sores
• Receding gums
• Puffy, soft gums
• Bad breath

If you are experiencing any of these symptoms, make an appointment with your dentist as soon as possible, and follow up with regular cleanings. The moral of the story is: all you need to prevent Gingivitis is good dental hygiene – brushing at least twice a day and flossing at least once a day. Warm salt water and antibacterial rinses can also be used to help reduce gum swelling.

Dr. Steigerwald routinely replaces missing teeth with dental implants here in our office.  Dental implants are artificial tooth “roots” made of titanium, used to anchor dental prostheses, including crowns, and implant supported bridges and dentures. One of the largest factors in successful dental implant placement is adequate, healthy bone density to anchor the post.

Unfortunately, not all patients have the proper bone in their jaw to support a dental implant. Some patients suffer from Osteonecrosis, a disease caused by reduced blood flow to bones. When there is not enough blood flow, bone can start to die and break down. This makes dental implants for these patients particularly susceptible to becoming loose or failing. Osteonecrosis can be a side effect of chemotherapy.

Scientists from the UCLA School of Dentistry have discovered that nanodiamonds could be used for stronger dental treatments. Nanodiamonds are much smaller than those traditionally used in jewelry.

Currently, standard bone repair operations include inserting a sponge surgically to administer proteins that promote bone growth.  This new study, led by Dr. Dean Ho, may have uncovered an easier way to deliver these proteins. Nanodiamonds, which are invisible to the human eye, bind rapidly to the materials needed for bone growth. This process can be done through injection or an oral rinse, rather than surgery.

“This discovery serves as a foundation for the future of nanotechnology in dentistry, orthopedics and other domains in medicine,” said No-Hee Park, dean of the School of Dentistry. “Dr. Ho and his team have demonstrated the enormous potential of the nanodiamonds toward improving patient care. He is a pioneer in his field.”

Results from the study will most likely pave the way for more study. Either way, stay tuned to find out how diamonds are playing a role in oral health care.

Read the full article from UCLA’s newsroom here: http://newsroom.ucla.edu/portal/ucla/nanodiamond-encrusted-teeth-248066.aspx

Dear Doctor,

My daughter is 15 years old and is just finishing wearing braces. She is missing two of her upper front teeth which never developed. The orthodontist made space to have them replaced, but now we’re told she has to wait 2 to 3 more years before she can have implants. She desperately wants her teeth replaced. Why can’t implants be done now?

Dear Alicia,

This is an important question and the current wisdom is not to have implants placed until jaw and facial growth are complete. Although it varies from person to person, growth of the jaws in most cases is not complete until late teens. Of course, we are faced with the dilemma of waiting for the optimal time to place implants so that they will succeed on the one hand, and respecting the psychological needs of a teenager missing front teeth on the other end.

Well, you may say, that still doesn’t answer the question. The rest of the answer has to do with the difference in the way in which teeth and implants attach to bone in which they are embedded.

To continue reading this article, visit:  http://www.deardoctor.com/library/50033/?&issue=issue7&startid=44

Are you someone who is anxious or fearful about dental treatment and even worries about it all the time? In Part One of this series, Comfortable Dentistry in the 21st Century “Overcoming Fear and Anxiety” we discussed how you can learn to overcome and cope with these negative emotions and become comfortable with modern dentistry so that you really do have the opportunity to have a “Lifetime of Dental Health.”

While it might take some faith in the beginning to realize that this is possible, Dear Doctor describes exactly how to develop a relationship with the right dentist promoting:

-Open discussion of your fears and experiences in a calm and safe environment;

-The listening relationship that you need to feel safe and in which you have the time you need to go at your own pace;

-Ultimately allowing you to develop the sense of control you need to reduce automatic anxiety responses.

Part Two bridges the gap to the next step in making your dental visits even more comfortable with the help of oral sedation or anti-anxiety medication. These oral sedatives or “anxiolytics” (dissolve anxiety) are administered by mouth (orally) to help transition you from anxiety to comfortable dental procedures.

To continue reading this blog visit: http://www.deardoctor.com/library/30141/?&issue=issue5&startid=60

In this article, we go a step further a look at how the basics of nutrition, coupled with diet and exercise, affect life-long general and oral health.

The surgeon General of the United Stats has stated emphatically that “you can’t be healthy without oral health.” And, as our last article explained, you can’t have good oral health without good nutrition.

In this issue, we’ll expand on the idea that good nutrition is the key to overall health, both general and oral. In other words, what’s good for the whole body is good for your teeth, gums and other oral tissues. We need good nutrition and dietary practice throughout life, for the formation, development and continued health of our oral tissues and structures, as well as those in the rest of the body.

You may have heard the term “edentulous”, a term that describes someone that has no teeth. Incredibly, more than 35 million Americans do not have any teeth. Despite advances in dentistry, this number is expected to grow in the next two decades along with an aging baby boomer generation. Tooth loss commonly results from decay and gum disease.

Up until now, the only option for edentulous patients has been dentures. Their history is a long one. Scientists have found evidence of early dentures, dating back to 700 BC in present-day northern Italy, made of human and animal teeth. Over the years, the materials changed, but the inconvenience of ill-fitting dentures did not.

While dentures are extremely common, most patients find them uncomfortable and awkward. They can make daily tasks most of us take for granted, like talking and eating, difficult.
Presently, dental implants are rapidly becoming the standard of care. The biggest difference in the patient’s experience is that dental implants look and function just like their natural teeth. Most dental implant patients even report not being able to feel a difference! They do not slip or move inside the mouth as dentures are prone to do. Dental implants will generally last longer, as well. This is an important point to consider when comparing costs. While implants are more expensive, they usually last a lifetime. Dentures, on the other hand, can wear down and require replacement.

For patients looking for a more affordable replacement option, with the increased stability of implants, they may want to consider implant-supported dentures. Unlike traditional dentures, which rely on suction, implant-supported dentures are secured by dental implants. Regardless of which route an edentulous patient takes, it is clear that benefits of implants far outweigh those of dentures and will pave the way for a new era in tooth replacement.

If you are interested in exploring dental implants as a replacement for your own dentures, give our office a call to reserve a consultation today!

The mouth harbors a diverse and plentiful and microbial community due to its hospitable environment. It is warm, nutrient-rich and maintains an ideal pH balance. This highly diverse microflora inhabits the various surfaces of the normal mouth- gums, teeth, tongue, cheeks. What many people don’t realize is that most of the bacteria are beneficial organisms and live in harmony with each other and the human body.

The “Bad Guys” of Dental Bacteria

Interestingly, a new born baby’s mouth does not contain bacteria, but becomes colonized rapidly in the early stages of life. Nobody knows for sure how many different bacteria species there are. Estimates in the oral cavity alone vary between 500 to 650 different species. Only a few specific species are believed to cause dental caries, including Steptococcus mutans, considered the most important bacteria involved with tooth decay. However, the type of bacteria varies according to the progress of tooth destruction.

This harmful bacteria collect around the teeth and gums forming a sticky, creamy-colored mass called plaque. Some areas of the mouth collect plaque more commonly due to less salivary flow, such as grooves in molars and between teeth. The oral cavity actually contains the only known part of the human body that does not have a regulated system of shedding surfaces: the teeth. This allows plaque to adhere to the surface of teeth for long periods of time. At first, plaque is soft enough to come off easily with a toothbrush. However, it starts to harden within 48 hours. After about 10 days, the plaque becomes dental calculus, called tarter, and is now difficult to remove.

Villians Love Carbohydrates

Sugars from candy, soft drinks, and fruit juice can play a significant role in tooth decay. When sucrose (table sugar), the most common of sugars, coats the surface of the mouth, some intraoral bacteria interact with it. The result is lactic acid, which decreases the pH in the mouth. This demineralization allows for greater bacterial invasion deep into the tooth.

Cariogenicity, or the extent to which tooth decay is likely, depends heavily on how long the sugar remains in the mouth. Surprisingly, it is not the amount of sugar ingested but the frequency of sugar ingestion that is the most important factor in tooth decay.

Bacteria’s Kyrpotite

Oral hygiene is key to battling the bacteria “bad guys”. Brushing your teeth twice a day will reduce dental plaque and food particles collecting around your teeth. Additionally, it is imperative to floss daily to wipe all your enamel surfaces free of plaque to discourage bacterial growth. Good general oral-health habits can usually prevent enough bacterial growth to keep tooth decay from starting.