Periodontics – Gum Disease
At Dr. Arteaga Family & Cosmetic Dentistry, we pride ourselves on preventative oral health. Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost. This is generally caused by bacterial plaque if gum disease is left untreated, bacterial plaque will harden and turn into tartar.
When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth.”) In periodontitis, gums pull away from the teeth and form spaces (called “pockets”) that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
Signs of gum disease include:
- Red, inflamed gums
- Bleeding while brushing or flossing
- Receding gums
- Loose or separating teeth
- Presence pus between the gum and tooth
- Chronic halitosis
- Remember that gum disease is reversible if caught while in the early stages.
Dr. Arteaga will scale the tooth to remove plaque and calculus, and plane the tooth roots to smoothing them. We may also prescribe antibiotics to clear up any infection or inflammation. Advanced cases may require surgery to trim the gums to remove the hardened plaque build-up, and re-contour the damaged bone.
A dental implant is a titanium “root” device used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth.
Virtually all dental implants placed today are root-form endosseous implants, i.e., they appear similar to an actual tooth root and are placed within the bone. The bone of the jaw accepts and osseointegrates with the titanium post. Osseointegration refers to the fusion of the implant surface with the surrounding bone. This is what makes the implant resemble the look and feel of a natural tooth. Since dental implants fuse with bone and lack the periodontal ligament, however, they will feel slightly different than natural teeth during chewing.
Generally this procedure is performed in the dental office under light local anesthesia. Once the implant is inserted, it will heal relatively quickly over a couple months. Once the incision site has fully healed, the crown is fitted and permanently attached.
Dental implants are stable, permanent, and do not rely on the neighboring teeth for support. They are ideal for tooth replacement procedures because they function like natural tooth roots.
Implants are perfect for patients who are unable to wear dentures. Dental implants are made from various types of bone-like ceramic materials that are compatible with body tissue, and resemble real teeth.
Complete and Partial Dentures
Dentures (also known as false teeth) are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch.
Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.
Dentures can take approximately five dental visits. First, Dr. Arteaga will take impressions of the gums and a wax bite – these are necessary to determine the vertical dimensions and proper jaw position. Dr. Arteaga may then make a trial denture or “try-in” to ensure of the correct shape and color as well as proper fit. Minor adjustments are usually needed when the denture is placed.
Root Canal Treatment
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.
“Root canal” is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s nerve lies within the root canal.
Root canal therapy involves first removing the decayed or dead pulp, and then cleaning out the canal. Dr. Arteaga may re-shape the canal and insert medication to rid bacteria, if necessary. Once Dr. Arteaga has determined that all infection has been cleared, the canal will be filled with gutta percha (a rubber-like material). The tooth then will be permanently sealed with porcelain or a permanent crown. Root canal therapy may take between one to three sessions, depending upon the condition of the patient’s tooth.
A dental bridge is a false tooth or teeth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth or teeth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.
In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but will last as many ten years or more.
There are several different types of dental bridges:
- The traditional bridge – a false tooth which is centered between two attached porcelain crowns
- Resin bonded bridge – also known as a “Maryland” bridge, false teeth are then fused together to metal bands and bonded to the back of the teeth on either side of the gap. This type of bridge is advantageous when missing teeth are in the front of the mouth.
- Cantilever – this type of bridge is created to adhere only to one tooth – on either side of the absent tooth.
A dental crown is a tooth-shaped “cap” that is placed over a tooth – covering the tooth to restore its shape and size, strength, and/or to improve its appearance. The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.
A dental crown may be needed in the following situations:
- To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
- To restore an already broken tooth or a tooth that has been severely worn down
- To cover and support a tooth with a large filling when there isn’t a lot of tooth left
- To hold a dental bridge in place
- To cover misshapened or severely discolored teeth
- To cover a dental implant
Dr. Arteaga usually requires two dental visits to install crowns. First, Dr. Arteaga will need to prepare to the tooth or implant for the upcoming crown. Dr. Arteaga will then grind and shape the tooth so that the crown can be properly fitted. Then, an impression will be made of the tooth and its surrounding gums, which is then sent to a laboratory for the crown can be fabricated. The dentist fits a temporary crown over the tooth, until the permanent crown is ready. During the second visit, Dr. Arteaga will remove the temporary crown and cement the finished permanent crown into place.
Generally, crowns last approximately five to eight years, and with good oral hygiene most crowns will last longer. Certain habits such as fingernail biting, chewing of ice, and grinding of teeth can do damage to the crown, and should be completely avoided.
Removal of Wisdom Teeth
Wisdom Teeth are a frequent source of problems for many people. The biggest reason for problems is that there isn’t enough room for them to erupt into the arch normally. They may also want to come in sideways. This causes them to become impacted, which means that they are impeded from normal eruption.
When they don’t erupt normally, our advice is to have them removed at your earliest convenience. Some people put this off, thinking that if their wisdom teeth aren’t bothering them, that they should leave them alone. The reason this is unwise is that complications from wisdom tooth surgery greatly increase the older you get. If you wait until they bother you, the extractions will be very difficult with serious risks of complications. If, however, they can be removed in the late teens or early twenties, complications are much milder and less likely to occur.
Also, when they do start to bother you, wisdom teeth can be a source of serious, even life-threatening infections that can swell to close off your breathing or can spread to your brain. Why take those chances when wisdom tooth removal at a young age is such a routine procedure?
Although the surgical removal of impacted and unerupted teeth may be stressful, Dr. Arteaga will help with pain relieving techniques. The choice of anesthesia can include local anesthesia, IV sedation or general anesthetics. Hospitalization may be required as determined by dental necessity i.e.: the severity of the surgical procedure and/or the medical and physical status of the patient.
Dr. Arteaga is always available to help you determine the condition in which your wisdom teeth are, and the proper treatment if deemed necessary. Dr. Arteaga Family & Cosmetic Dentistry has superior anesthesia management to insure their patients comfort.
If you should be experiencing difficulties with your wisdom teeth or have questions about the condition of your wisdom teeth, have your general dentist or orthodontist refer you or you may call Dr. Arteaga, to arrange a consultation appointment.
When teeth are lost, the “alveolar” bone that previously housed them begins to dissolve away in a process called “resorption.” Depending on the rate of resorption, the remaining bone may be insufficient to replace the missing tooth with an implant. If the missing tooth is to be replaced with a fixed bridge, the prosthetic tooth (“pontic”) may look artificially large if the bone and gum tissue (“gingiva”) have resorbed significantly.
One solution to this dilemma is to “graft” new bone onto the site. This process is sometimes referred to as “site development”, which refers to the fact that proper bony and gingival contours need to be re-established before ideal tooth replacement can be done. There are several ways of doing this. First, the bone resorption can be minimized by packing the tooth socket with powdered bone graft material at the time of tooth removal.
Bone grafting is prescribed to prevent the loss of tooth supporting (“alveolar”) bone following tooth removal, and to re-establish the height (limited) and width of alveolar bone that has already been lost. This is especially important if a patient’s restorative treatment plan includes fixed bridgework, or dental implants.
Stomatognathic disease or mouth disease refers to the diseases of the mouth and jaw.
The mouth is an important organ with many different functions. It is also prone to a variety of medical and dental disorders. The American Dental Association uses the term “oral and maxillofacial pathology”, and describes it as “the specialty of dentistryand pathology which deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes and effects of these diseases
The inside of your mouth is typically lined with a special type of skin (mucosa) that is smooth and coral pink in color. Alterations in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs of the beginning of a pathologic process or cancerous growth:
- Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
- A sore that fails to heal and bleeds easily
- A lump or thickening on the skin lining the inside of the mouth
- Chronic sore throat or hoarseness
- Difficulty in chewing or swallowing
- The above changes can be detected on the lips, cheeks, palate and gum tissue around the teeth, tongue, face and/or neck.
Remember that pain does not always occur with pathology, and curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason can also be at risk for oral cancer.
Dr. Arteaga recommends performing an oral cancer self-examination monthly and remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores. Contact Dr. Arteaga Family & Cosmetic Dentistry to schedule a consultation.