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By Bohle Family Dentistry
July 13, 2018
Category: Oral Health
Tags: gum disease   oral health  
WellHelpYouMaintainYourOralHealthAfterGumDisease

It’s been a long road back to oral health for you after periodontal (gum) disease. But after several plaque removal sessions and perhaps even surgical procedures to address deep infection, your gums have regained their healthy pink appearance.

But now you must face a hard reality: because you’ve had gum disease you’ll need to be extra vigilant with your oral hygiene to avoid another round with this destructive disease. But don’t worry—you won’t have to fight your prevention battle alone. We’ll continue to provide you care that reduces your risk of re-infection. We call that care periodontal maintenance (PM).

The heart of PM care involves regular dental visits for monitoring, cleanings and treatment when necessary. While most patients may visit their dentist at least twice a year, as a previous gum disease patient we may advise more frequent visits, especially if you’ve just finished periodontal treatment. Depending on the extent of your disease, we may begin with a visit every other week or once every two to three months. If your mouth continues to be disease-free we may suggest increasing the time between visits.

During your visit we’ll carefully examine your mouth, as well as screen you for any signs of potential oral cancer. We’re looking for both signs of re-infection or new issues with your teeth and gums. We’ll also assess the effectiveness of your oral hygiene efforts and advise you on ways you can improve.

If we find any signs of disease, we’ll then formulate a treatment plan to effectively deal with it. With frequent visits we have a better chance of discovering re-infection early—and the earlier the better to minimize any further damage. We may also need to take steps to make future PM care easier. This could include gum surgery to alter the tissues around certain teeth for easier access for examination and cleaning.

Our main focus with PM care is to look ahead: what can we do now to prevent a future bout of gum disease or at least lessen its effect? With continued monitoring and care we can drastically reduce your risk for further damage from this destructive disease.

If you would like more information on post-gum disease maintenance, 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 “Periodontal Cleanings.”

By Dr. Charles Bohle & Bohle Family Dentistry
January 06, 2016
Category: Oral Health
Tags: gum disease   diabetes  
DiabeticswithGumDiseaseBenefitfromCoordinatingTreatmentforBoth

If you have periodontal (gum) disease, you probably already know you’re in danger of eventual tooth and bone loss if the infection isn’t brought under control. But if you also have diabetes, the effects from gum disease could extend well beyond your mouth.

Gum disease is a bacterial infection caused by plaque, a film of food remnant that builds up on tooth surfaces mainly due to poor oral hygiene. As the infection grows, your body’s immune system responds by flooding your gum tissues with antibodies to fight it, resulting in inflammation. As the inflammation persists, though, it damages the gum and underlying bone tissue, which in turn leads to gum and bone loss from the teeth.

Diabetes also causes an inflammatory response within the body. The disease develops either as a result of the body’s decreased ability to produce insulin to balance the glucose (sugar) levels in the bloodstream (Type 1) or the body develops a resistance to insulin’s effects (Type 2). As a result diabetics experience abnormally high blood glucose levels, a condition called hyperglycemia. This triggers chronic inflammation that can lead to inhibited wound healing, increased risk of heart, kidney or eye disease, coma or death.

Gum disease can worsen diabetic inflammation, and vice versa. The effects of the oral infection add to the body’s already overloaded response to diabetes. In turn, the immune system is already compromised due to diabetes, which can then increase the severity of the gum disease.

Research and experience, though, have found that pursuing treatment and disease management for either condition has a positive effect on managing the other. Treating gum disease through plaque removal, antibiotic therapy, surgery (if needed) and renewed oral hygiene will diminish the oral infection and reduce the body’s immune response. Caring for diabetes through medication, diet, exercise and lifestyle changes like quitting smoking will in turn contribute to a quicker healing process for infected gum tissues.

Treating gum disease when you have diabetes calls for a coordinated approach on both fronts. By caring for both conditions you’ll have a more positive effect on your overall health.

If you would like more information on the relationship between diabetes and gum disease, please contact us to schedule an appointment for a consultation.

By Bohle Family Dentistry
September 22, 2015
Category: Dental Procedures
IsLaserTreatmentaGoodOptionforControllingGumDisease

Although techniques for treating periodontal (gum) disease can vary, they all boil down to one objective: remove the bacterial plaque and calculus (hardened plaque deposits) that cause the infection. The initial treatment usually involves two techniques known as scaling and root planing.

Scaling uses hand instruments, ultrasonic equipment or a combination of both to manually remove plaque and calculus from the tooth and root surfaces. Root planing takes it a step further by minutely “shaving” infected material from the root surfaces. While more invasive techniques (including surgery) may be needed, scaling and root planing are the first line of treatment for any recent diagnosis of gum disease.

In recent years, an adaptation to these treatments has emerged using the Nd: YAG laser. The laser uses a particular crystal that’s adaptable for many different types of surgery. In the case of gum disease, it’s been found as effective as traditional methods for removing the infected linings of periodontal pockets. Voids created by detaching gum tissues as bone loss occurs, enlarge the small natural gap between the teeth and gums, which fill with pus and other infected matter. Removing the diseased lining from these pockets reduces bacteria below the gum line and speeds healing.

Periodontal laser therapy may have one advantage over traditional treatments: less tissue damage and swelling, and hence reduced post-treatment discomfort. While some research seems to confirm this, more controlled studies are needed to render a verdict on this claim.

Regardless of whether you undergo traditional scaling and root planing or a laser alternative, the aim is the same — to bring the disease under control by removing plaque and calculus and reestablishing good daily oral hygiene practices. Stopping gum disease as soon as possible will help ensure you’ll have healthy teeth and gums for a long time.

If you would like more information on treatments for periodontal (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 “Lasers versus Traditional Cleanings for Treating Gum Disease.”

By Dr. Charles Bohle, Bohle Family Dentistry
February 05, 2014
Category: Oral Health
GumInflammationCouldHaveanEffectonYourHeartHealth

Your body’s organ systems are interlinked — what happens in one system may affect another. An example of this is the interrelationship between periodontal (gum) disease and cardiovascular disease (CVD).

Medicine has discovered a common link between these two different conditions — inflammation. A result of the body’s defense mechanisms, chronic inflammation is damaging to both your mouth and your heart. Inflammation can destroy the gum’s soft tissue and underlying bone and lead to tooth loss. In the cardiovascular system, inflammation can begin and accelerate the buildup of plaque within arterial blood vessels (atherosclerosis). This inhibits the flow of oxygenated blood to both the heart and brain, which sets the stage for a heart attack or stroke.

Gum disease begins with poor oral hygiene. When brushing and flossing aren’t performed on a regular basis, or not performed adequately, it allows a thin layer of bacterial plaque called biofilm to build up on the teeth. The bacteria cause infection in the soft tissues of the gum that triggers the chronic inflammation. Because it’s often unaccompanied by other signs of infection like fever, a patient may not even be aware of it. There’s evidence now that inflammation caused by moderate to severe gum disease can contribute to a similar response in blood vessels.

We can treat the gum disease and reduce or eliminate the inflammation. This first requires the removal of all plaque and calculus (harder deposits) on the teeth, down to the root level. It may require surgery to access these areas and to help regenerate some of the lost tissue and bone that support the teeth. It’s also important to institute proper oral hygiene — effective daily brushing and flossing, semi-annual office cleanings and checkups.

In a similar way, you should address signs of inflammation in your cardiovascular system, including blood pressure management and the control of LDL (bad) cholesterol. Because both gum disease and CVD share many of the same risk factors, you can positively impact both your oral and general health by eating more nutritional foods, engaging in regular exercise and quitting tobacco products.

Treating any symptom of inflammation is important to improving your total health. By bringing gum disease and its accompanying inflammation under control, you may in turn help your heart and blood vessels.

If you would like more information on the relationship between heart and gum diseases, 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 “The Link Between Heart & Gum Diseases.”

By Dr. Charles Bohle, Bohle Family Dentistry
September 05, 2013
Category: Oral Health
KeepYourGumsinthePink

Being “in the pink” is a good thing; it means you're healthy. Being “in the red” is not so good; it means your health is questionable (financially, anyway). Though they weren't coined for dentistry per se, these colorful expressions are helpful reminders when it comes to taking care of your gums: Pink is their natural, healthy color; that's what you want to see every time you look in the mirror. Red is generally a warning that something's amiss.

If your gums, or “gingiva,” appear slightly swollen and reddened at the margins and/or they bleed when lightly prodded by brushing or flossing, it's likely that you have gingivitis. This is an immune response to the buildup of bacterial plaque (biofilm) at your gum line. It is also an early red flag for periodontal disease (peri – around, odont – tooth), a degenerative process that affects not only the gums, but the periodontal ligament that attaches each tooth in its bony socket, and the underlying supporting bone.

Attentive home dental hygiene practices prevent most plaque buildup from occurring. Brushing correctly at the gum line is a good start. But even a deftly handled brush can't reach everywhere, so it's important to use dental floss or specially designed mini-brushes to get in between teeth and other hard-to-reach areas. Our office can instruct you on optimal home care techniques. We also encourage you to visit at regular intervals for professional cleanings so you are assured of addressing anything home care might miss.

In the absence of good oral hygiene, dental plaque can build and become increasingly difficult to remove as it calcifies, becoming tartar. It becomes a breeding ground for disease-causing microbes that normally wouldn't have the chance to gain a foothold. When caught early, gingivitis can be treated before any harm is done. Sometimes a thorough professional cleaning is sufficient. If the problem is ignored, however, the disease will most certainly progress to destruction of the surrounding, supporting tissues — the periodontal ligament and the underlying bone. If this happens, tooth loss could eventually result.

That said, there can be other causes for bleeding gums. These include:

  • Brushing too rigorously or using a toothbrush with bristles that are too firm
  • Side effect of a medication
  • In women, elevated hormone levels (e.g., birth control pills or pregnancy)
  • A systemic (bodily) disease

Whatever the reason, red is not normal when it comes to your gums. The sooner you discover the underlying reason(s) for inflammation or bleeding and take appropriate action, you and your smile will be back in the pink and you'll have no reason to be blue!

If you would like more information about preventing or treating bleeding gums, 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 “Bleeding Gums.”