Posts for: March, 2020
After months of wearing braces it's time for the big reveal: your new and improved smile! Your once crooked teeth are now straight and uniform.
But a look in the mirror at your straighter teeth might still reveal something out of place: small chalky-white spots dotting the enamel. These are most likely white spot lesions (WSLs), points on the enamel that have incurred mineral loss. It happens because mouth acid shielded by your braces contacted the teeth at those points for too long.
Most mouth acid is the waste product of bacteria that thrive in dental plaque, a thin film of food particles that can build up on tooth surfaces. High levels of acid are a definite sign that plaque hasn't been removed effectively through brushing and flossing.
But normal hygiene can be difficult while wearing braces: it's not easy to maneuver around brackets and wires to reach every area of tooth surface. Specialized tooth brushes can help, as well as floss threaders that help maneuver floss more easily through the wires. A water irrigator that uses pulsating water to remove plaque between teeth is another option.
However, if in spite of stepped-up hygiene efforts WSLs still develop, we can treat them when we've removed your braces. One way is to help re-mineralize the affected tooth surfaces through over-the-counter or prescription fluoride pastes or gels. It's also possible re-mineralization will occur naturally without external help.
While your teeth are sound, their appearance might be diminished by WSLs. We can improve this by injecting a liquid tooth-colored resin below the enamel surface. After hardening with a curing light, the spot will appear less opaque and more like a normal translucent tooth surface. In extreme cases we may need to consider porcelain veneers to cosmetically improve the tooth appearance.
In the meantime while wearing braces, practice thorough dental hygiene and keep up your regular cleaning visits with your general dentist. If you do notice any unusual white spots around your braces, be sure to see your dentist or orthodontist as soon as possible.
If you would like more information on dental care during orthodontic treatment, 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 “White Spots on Teeth during Orthodontic Treatment.”
While lasers still seem like science fiction, they’ve been used commercially (and medically) for decades. But there’s still room for growth in practical applications with this developing technology. One promising area is in the treatment of periodontal (gum) disease.
Gum disease is a bacterial infection triggered by plaque, a thin film of bacteria and food particles caused by inadequate oral hygiene. The disease is highly destructive and can eventually lead to both tooth and bone loss. Treatment procedures vary widely, but they all have the same goal: remove the offending plaque and calculus (tartar) from tooth and gum surfaces. Without plaque the infection subsides and the gums can heal.
For decades now, dentists have removed plaque and calculus manually with special hand instruments or ultrasonic equipment. If the disease has advanced below the gum line or formed deep voids filled with infection called periodontal pockets, the dentist may also employ surgical techniques to access the infected areas.
While all these techniques have a long track record for effectiveness, they can cause the inadvertent destruction of healthy tissue, as well as create discomfort for some patients afterward. This is where a new protocol called Laser Assisted New Attachment Procedure (LANAP®) may be able to make a difference in the future.
With the LANAP® protocol, surgeons direct a laser beam of light through a fiber optic the width of three human hairs onto diseased tissue. The particular color of light interacts with the tissue, which contains the darkly-pigmented bacteria causing the disease, and “vaporizes” it. The beam, however, passes harmlessly through lighter-pigmented healthy tissue; as a result diseased tissue is eradicated with little to no harm to adjacent healthy tissue.
With these capabilities, trained dentists using LANAP® for gum disease treatment might be able to achieve conventional results with less tissue removal and bleeding, less discomfort for patients, and less tissue shrinkage than traditional procedures — and without scalpels or sutures. And some post-surgical studies have indicated LANAP® might also encourage gum tissue regeneration in the months following.
LANAP®, however, is still developing and requires further research. Thus far, though, the results have been encouraging. As laser technology advances, it’s quite possible tomorrow’s patient may experience less discomfort and more effective healing with their gum disease treatment.
If you would like more information on gum disease treatment, 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 “Treating Gum Disease with Lasers.”
Although periodontal (gum) disease starts with the gums, the teeth may ultimately suffer. An infection can damage the gum attachment and supporting bone to the point that an affected tooth could be lost.
The main cause for gum disease is dental plaque, a bacterial biofilm that accumulates on teeth due to ineffective oral hygiene. But there can be other contributing factors that make you more susceptible to an infection. Smoking tobacco is one of the most harmful as more than half of smokers develop gum disease at some point in their life. If you’re a heavy smoker, you have double the risk of gum disease than a non-smoker.
There are several reasons why smoking increases the risk of gum disease. For one, smoking reduces the body’s production of antibodies. This diminishes the body’s ability to fight oral infections and aid healing. As a smoker, your body can’t respond adequately enough to the rapid spread of a gum infection.
Another reason for the increased risk with smoking are the chemicals in tobacco that damage the connectivity of gum tissues to teeth that keep them anchored in place. The heavier the smoking habit, the worse this particular damage is to the gums. This can accelerate the disease and make it more likely you’ll lose affected teeth.
Smoking can also interfere with getting a prompt diagnosis of gum disease because the nicotine in tobacco reduces the blood supply to the gums. Usually a person with an infection may first notice their gums are reddened or swollen, and bleed easily. Smoking, however, can give a false impression of health because it prevents the infected gum tissues from becoming swollen and are less likely to bleed. As a result, you may learn you have the disease much later rather than sooner, allowing the infection to inflict more damage.
There are ways to reduce your disease risk if you smoke. The top way: Kick the smoking habit. With time, the effects of smoking on your mouth and body will diminish, and you’ll be better able to fight infection.
You should also practice daily brushing and flossing to keep plaque at bay, followed by regular dental cleanings to remove hard to reach plaque and calculus (tartar) deposits. You should also see your dentist at the first sign of trouble with your gums.
If you would like more information on the prevention and treatment of 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 “Smoking and Gum Disease.”