By Infinite Smiles Family Dentistry
June 22, 2017
Category: Dental Procedures
Tags: gum disease  
GumInfectionAroundToothRootsCallsforImmediateAction

Many people learn they have periodontal (gum) disease after noticing gum swelling, soreness or bleeding. But what you can see or feel may be only the tip of the iceberg — the damage may extend much deeper.

Gum disease is caused mainly by dental plaque, a thin film of bacteria and food particles built up on teeth due to ineffective brushing and flossing. Infection of the visible gums is only the beginning — left untreated, it can advance well below the gum line and even infect supporting bone.

One critical concern in this regard is the areas where the roots of a tooth separate from each other, known as furcations. Here an infection known as a furcation invasion can cause the bone to weaken and dissolve.

This usually occurs in stages (or classes) we can detect through manual probing and/or with x-rays. In the earliest stage, Class I, we might only notice a slight pocket in the gums with no significant bone loss. In Class II, though, the pocket between the roots has become a horizontal opening of two or more millimeters, indicating definite bone loss with increased pocket depth getting “under” the crown of the tooth. Class III, the last and most serious stage, describes an opening we can probe under the crown all the way to the other side of the tooth; the bone loss now extends “through and through” the furcation.

The basic goal of gum disease treatment is to remove plaque and calculus (tartar) from all tooth and gum surfaces. But removing plaque below the gum line, especially “into” the furcations, can be challenging. We will need instruments called scalers to clean root surfaces, assisted sometimes by ultrasonic equipment to vibrate plaque loose. With furcations we may also need to employ surgery to aid gum or bone tissue regeneration or to make the area easier to access for future cleaning.

Of course, the best way to protect against furcation invasions is to prevent gum disease in the first place. Be sure to brush and floss daily and visit us for thorough dental cleanings and checkups at least every six months.

And don’t delay contacting us if you see any signs of teeth or gum problems. The sooner we can identify gum disease, the more likely we’ll be able to prevent it from doing serious damage to your gums, bone and teeth.

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 magazine article “What are Furcations?

By Infinite Smiles Family Dentistry
June 14, 2017
Category: Dental Procedures
Tags: missing teeth  
TeenswithMissingTeethmayneedaTemporaryFixUntilTheyreOlder

Dental implants are widely considered by both dentists and patients as the premier choice for replacing missing teeth. Unfortunately, implants aren’t the appropriate choice for teenagers with missing teeth.

That’s because their jaws won’t fully finish most of their growth and development until early adulthood. An implant placed too early could become misaligned as the jaw matures. The best approach for a teenager is a temporary restoration until they’re old enough for an implant.

There are a couple of good options. One is a removable partial denture (RPD), prosthetic (false) teeth set in an acrylic base that mimics gum tissue at the locations of the missing teeth. RPDs, which stay in place by way of metal clips that fit over other teeth, are easy to wear and maintain.

On the downside, an RPD can break if you bite into something too hard. They can lose their fit and may need to be replaced with a new one. And, some teens aren’t quite keen on wearing a “denture.”

Another option is a bonded or Maryland bridge, a kind of fixed bridge. We bond dental material to the back of a prosthetic tooth with portions of the material extending out from either side of it.  We then bond these extending tabs to the back of the teeth on either side of the prosthetic tooth to hold it in place. Unlike traditional bridges, we can eventually remove it without any permanent alterations to the teeth it’s attached to.

Before we undertake a bonded bridge, though, we must make sure the gums and bone of the surrounding teeth are free from periodontal (gum) disease and are healthy and strong enough to support the bridge. We also need to be sure the patient doesn’t have a deep bite or a teeth grinding habit, which could cause the teeth to make contact with the tabs and break them.

The patient also needs the maturity to responsibly perform diligent oral hygiene: this type of bridge has a tendency to build up disease-causing plaque, so brushing twice and flossing once every day is critical. Not doing so increases the risk of tooth decay or periodontal (gum) disease, which could complicate a future implant.

We can discuss these options after a thorough dental examination of your teenager. Either way, we’ll be able to restore your teen’s smile until we can undertake a more permanent restoration.

If you would like more information on tooth replacement options for teenagers, please contact us or schedule an appointment for a consultation.

By Infinite Smiles Family Dentistry
June 06, 2017
Category: Dental Procedures
Tags: fillings  
EvenwithMercuryDentalAmalgamisaSafeChoiceforToothFilling

One of the top concerns in public health today is exposure to the metallic element mercury within the environment. At abnormal levels, mercury can have a toxic effect on our nervous systems and cause other health problems.

These concerns over mercury have also increased attention on one material in dentistry that has included the metal in its makeup for over a century — dental amalgam for filling teeth. Amalgam is a metal alloy that can include, in addition to mercury, silver, tin, and copper. When first mixed dental amalgam is a moldable material used for fillings in prepared teeth. It then hardens into a durable restoration that can withstand biting forces.

While the use of amalgam has declined with the introduction of life-like colored fillings, it's still used for teeth like molars subject to high biting forces. With what we now know about the ill effects of mercury (which can make up to half of an amalgam mixture) is it safe to continue its use?

The American Dental Association has performed extensive research into amalgam safety. They've found that mercury is stabilized by the other metals in the amalgam. This prevents "free" molecules of mercury, the real source of harm to health, from escaping into the blood stream in the form of vapor. Although trace amounts of mercury vapor from the amalgam are released as a person chews, those levels are well below the threshold that could cause harm.

From a patient standpoint, the biggest drawback to dental amalgam isn't safety — it's the appearance of teeth it's used on. Silver fillings aren't considered attractive. And now there are viable filling alternatives that not only look like natural teeth but can withstand biting forces almost as well as amalgam. These materials include composite resins, mixtures of glass or quartz within resin, or glass and resin ionomers. Each of these has advantages and disadvantages depending on how and where they're applied.

After a thorough dental examination, we'll be able to advise you on what filling material will work best to produce the best result. And if we do suggest dental amalgam you can rest assured it will be a safe choice.

If you would like more information on the safety of dental amalgam, 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 “Silver Fillings — Safe or Unsafe?

By Infinite Smiles Family Dentistry
May 29, 2017
Category: Oral Health
Tags: oral cancer  
NewSalivaTestmayHelpIdentifyOralCancerEarlier

A half million people are diagnosed every year with oral cancer. While other cancers are more prevalent, oral cancer is among the most dangerous with only a fifty percent five-year survival rate.

A major reason for this low rate is because this fast growing cancer is difficult to detect early — diagnosis comes far too often after the disease has already well advanced. In an effort to detect cancer earlier many dentists visually screen for oral abnormalities during checkups, especially patients over fifty, tobacco or heavy alcohol users, patients with a family history of cancer or a medical history of exposure to the sexually transmitted human papilloma virus, HPV-16.

If they detect an abnormality, the dentist often refers the patient to an oral surgeon or other specialist for a possible biopsy. In this procedure the surgeon removes a sample of the abnormal tissue, which is then examined microscopically for cancer cells. A biopsy remains the most effective way to diagnose oral cancer.

Because of the disease's aggressive nature, many dentists lean to the side of caution when referring patients for biopsy. As a result 90% of oral biopsies reveal no cancer. Reducing the number of biopsy referrals is highly desirable, especially for the patient undergoing the procedure. Tissue samples tend to be large to ensure complete detection of any cancer cells. Depending on the size and location of the sample, there may be a risk for loss of function or disfigurement.

A new screening tool using a sample of a patient's saliva could help reduce the number of biopsy referrals. Besides DNA, saliva also contains dormant genes called biomarkers that activate in response to the presence of a specific disease. This particular saliva test identifies those biomarkers for oral cancer if they're present.

A sample with a low score of biomarkers indicates no cancer present (with a statistical confidence of 99%). A medium or high score indicates cancer may be present, but only a biopsy can determine for sure. Using this test, dentists might be able to reduce the number of biopsy referrals and instead be able to employ watchful waiting in certain cases. Because of its simplicity and non-invasiveness, saliva screening could help identify oral cancer earlier.

If you would like more information on early detection and treatment for oral cancer, please contact us or schedule an appointment for a consultation.

By Infinite Smiles Family Dentistry
May 28, 2017
Category: Oral Health
DentalCareisDifficultbutnotImpossibleforaSpecialNeedsChild

A child with a chronic illness or condition often requires a lot of focus on care for their special needs. Other aspects of their health can often take a back seat — too often including dental care.

Proper dental care can be a challenge for special needs children if they have diminished physical, intellectual or behavioral capacities. Children with autism or attention deficit disorders may not be able or willing to perform tasks like brushing and flossing. Other conditions could make them intolerant to toothpaste in the mouth, or create an inability to keep their mouths open or to spit.

Some chronic conditions also seem predisposed to dental defects. For example, enamel hypoplasia, a lack of sufficient tooth enamel, is common with Down, Treacher-Collins or Turner Syndromes, and can greatly increase the risk of tooth decay.

But even though difficult, effective dental care isn't impossible. It begins with your dental provider.

Pediatric dentists are often excellent in this regard: they often have the training and experience to treat children with chronic conditions. Whoever you choose must be able to partner with you in caring for your child's dental needs.

Daily hygiene is also a critical factor. Your goal should be the same as with any child — to teach them to brush and floss for themselves. Depending on their condition, however, you may need to assist them for a longer term, perhaps permanently. But it is imperative — daily hygiene is their best defense against oral diseases.

You should also consider their medication and how it may impact their dental health. Antidepressants, antihistamines or drugs that assist with breathing function can cause mouth dryness. This, as well as drugs with sugar or acid compounds, can increase risk for dental disease. If they must take these types of medications, try to give them at mealtime to reduce their effect in the mouth.

Above all, pursue the same professional dental care as you would for any other child. Keep up regular dental visits beginning around their first birthday for cleanings and preventive measures like topical fluoride or sealants. By taking these measures you'll help ensure their dental health won't suffer.

If you would like more information on dental care for special needs 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 “Managing Tooth Decay in Children with Chronic Diseases.”





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