Periodontal disease, also referred to as gum disease, is a leading threat to dental health, affecting around two out of every five adults in the United States. In its earliest stages, gum disease can be treated, but as it advances, it cannot be reversed—a fact that underscore the need for regular dental checkups and early intervention. Gum disease treatment depends on the disease’s stage, the overall health of the patient, and how the patient responded to previous attempts to treat the disease.

Gum disease is more complex than just inflammation or infection in the soft tissue of the gums. Periodontal disease can have repercussions not just on your oral and dental health and the beauty of your smile, but also on your overall general well-being and wellness. In fact, gum disease and the bacteria that comes with it have been linked to diabetes, heart disease, and some types of cancer.

A Progressive Disease

Gum disease progresses in four stages, with dental professionals classifying a patient’s current stage based on the symptoms experienced and an examination of the gums. The gum disease treatment options available to a patient with gum disease depend largely on the stage of the disease. Gum disease can be quite serious, since it progresses from minor gum irritation to a disease that affects the bones and supporting ligaments of the mouth.

Nonsurgical Treatments for Gum Disease

The first stage of gum disease is known as gingivitis, and it is gum disease in its mildest form. The hallmarks of gingivitis include minor irritation of the soft tissue, redness of the gums, inflammation, swelling, and some minor bleeding during brushing or flossing. A diagnosis of gum disease when it is in this first stage usually leads to a full reversal of the disease process. Still, because side effects of gingivitis and its symptoms are quite mild, many patients do not notice them, and it is only when the patient comes in for a dental checkup and/or dental cleaning that the dentist recognizes the onset of gum disease.

If your dentist determines that you have gum disease during a checkup or cleaning, then they may recommend that you have your teeth cleaned more often than the standard recommendation of every six months. While dental cleaning does not treat active gum disease, it is a critical preventive procedure that may help keep the disease from progressing as quickly.

When periodontal disease reaches its second stage, early periodontitis, the disease is not completely reversible, but it can be managed. At this stage, the patient’s soft tissue has sustained damage and there is a weakening of the smile’s supportive bone structure.

Scaling and root planning procedures may be recommended for gum disease after this point. This nonsurgical remedy—performed under a local anesthetic—removes tartar and plaque from below and above the gum line and involves planing away rough spots on the teeth. For some patients, scaling and root planning may be enough to treat their periodontal issues and avoid surgery.

At-home therapies such as antibiotic rinses may help, as can special nonprescription toothpastes containing triclosan. There are also in-office therapies to treat the disease at this point that can be effective at managing it. All nonsurgical treatments for gum disease have one main goal: helping to stop or slow-down bacterial growth.

Surgical Gum Disease Treatment

Nonsurgical treatment of periodontal disease is not always possible or effective to manage the disease or repair the problems that it has caused. Because of that, surgical intervention for gum disease is sometimes necessary to treat the problem and prevent further tooth loss and other issues. The main goal of a surgical gum disease treatment approach is to restore the gum tissue that surrounds and supports the teeth.

The most common type of surgical intervention for gum disease is osseous surgery—sometimes called flap surgery or pocket-reduction surgery. This surgery involves lifting the gums back, removing tarter, and sometimes smoothing irregular areas of bone, effectively limiting the number of places where bacteria can thrive. Next, the gums are restored to their natural position, which involves fitting them in a natural way around the teeth but in a way that decreases the amount of space that bacteria have available to develop.

Depending on the patient’s treatment plan, a periodontist may place a gelatin-filled chip containing a special antibiotic in the periodontal pocket during osseous surgery. These antibiotics such as chlorhexidine and minocycline HCI, help control inflammation and plaque, and feature a slow-release formula that delivers the antibiotics over the course of a week or so. Oral antibiotics, including minocycline, tetracycline, and doxycycline, are also sometimes prescribed to combat the ill effects of gum disease.

This type of surgery for gum disease benefits the patient in myriad ways. First and foremost, it helps to reduce the spread of bacteria that can enter the blood stream and result in inflammation, so your whole body is healthier. The procedure also halts bone loss that results from the bacteria-inducted inflammation that can otherwise destroy bone tissue. The result is a more natural-looking jawline and the ability to save your natural teeth.

Recovery time from this type of dental surgery for gum disease is relatively simple and uncomplicated. The majority of patients undergoing osseous surgery experience a fast recovery, with the biggest side effect being mild swelling. Generally, over-the-counter NSAID pain relievers, such as ibuprofen, for example, are recommended following the surgery.

Professional Treatment for Gum Disease

The time needed to treat gum disease, the level of discomfort involved, and the healing time for any procedure depends on the patient’s individual circumstances and severity of disease. Dr. Roll and the team at Pinnacle Center – Dental Implants & Periodontics are among the best when it comes to treating periodontal disease, with most procedures performed in the office. Schedule an appointment to discuss your treatment plan now.

Leaves falling off of the trees is seasonal and it is expected. Gums falling off of your teeth, well that is a different story. Your teeth are supposed to be protected by the gums that cover them. When the gum begins to disappear from a tooth the following happens:

• • The gum tissue disintegrates and disappears
  • The supporting bone underneath disappears: Note lower bone means a lower gum level
  • Exposure of the soft root surface known as “long in the tooth!”
  • Root abrasion, root wear/destruction
  • Sensitivity
  • A greater tendency towards decay

You don’t have to live with sensitive exposed roots. In most cases, they can be covered back up. Over the past 50 years, several different methods have been created to reverse the damage that has occurred. Several examples are shown below.

Gum recession is not fun to cope with no matter how old you are, but it is a common dental problem that we see very often. A lot of patients don’t realize that they have gum recession until they spot some of the common signs and symptoms of it. Gum recession is the exposure of the roots of the teeth after a loss of gum tissue.

Most of the time, patients over the age of 40 commonly experience gum recession; however, even teenagers can notice the signs occurring. Recognizing the signs and symptoms of gum recession is essential if you want to reverse it before it develops into periodontal disease.

Signs & Symptoms To Look Out For

Here are some very common signs and symptoms that you should be aware of so that you can recognize gum recession.

Sensitive Teeth

When the gums pull back from the teeth, the root is exposed. The build-up of plaque or tartar causes the gum to pull away from the tooth This can destroy the structural support of the tooth. It becomes difficult to keep clean. Sensitivity arises with root exposure. If you notice added sensitivity, you need to book an appointment with us today. We will conduct an exam and discuss a course of treatment with you.

Sore Gums

In the early stages of gingivitis or gum disease, your gums may bleed when you brush or touch them. Gum disease is one of the causes of recession, and the early stages can be recognized by:

• Red and swollen gums
• Bleeding gums
• Bad breath

Long Teeth

Have you ever heard of the phrase, “looking a little long in the teeth?” It refers mainly to those of advanced age, as this is when the gum recession is common. When the gums recede, your teeth look much longer than normal. It’s something that can negatively affect your oral health, not just your appearance.

Root Exposure

Additional exposure can become very uncomfortable to experience when sensitivity to hot and cold is increased. It can be another sign of gum disease. Of course, discomfort can also happen when you brush and floss. When you brush your teeth, use soft bristles and gentle pressure..

Loose Teeth

If you have noticed your teeth feel loose, you could be dealing with bacteria under the gums and around the teeth. When this happens, the gums move away from the teeth, which diminishes the support around the tooth.

Your gums are as important as any other area of your body, and when it comes to your health, you need to watch your gums first. If you are in any way concerned about the way your gums feel and look, speaking to us will help. Schedule an appointment today, and you could be on your way to healthier gums in no time at all.

 

“My teeth are crooked-can I get them straightened at Walgreens or do it myself?Why do I need to go to an orthodontist-they are so expensive.”

Consider this: An orthodontist trains for 11 years to be able to straighten teeth and fix smiles. A periodontist trains for 11 years. A dermatologist trains for 12 years. A cardiologist trains for 14 years. Do you really think that there are short cuts to becoming a board certified specialist?  Let me tell you…there are not. Patients seek the care of a specialist to receive top notch medical care from highly skilled professionals to get the most predictable long term outcomes possible.

“But they are just crooked teeth. My regular dentist says they can straighten them. Or, I see on line there is a company called Smile Direct and both of them say they can straighten my teeth. What is the difference?”

Ok, here is the difference. If you go to a board certified orthodontist you will get a complete examination including a proper analysis that includes models of your mouth and a special x-ray called a ceph to evaluate the bone structure of your face and possibly a CT scan to check your airway, your TMJ and the bone structure around your teeth. Then you will get a diagnosis based your tooth positions, facial bone structure, and the overall health of your foundation. The diagnosis is the basis for a proper treatment plan.

Would you let someone you don’t know, someone whose qualifications you can’t check – pack your parachute, remove a skin cancer, or place your heart stent? Would you buy a “do-it-yourself kit” and mail it in for one of these procedures? If not, why would you ever want a do it yourself home tooth straightening kit? Would you let your dermatologist put in a heart stent? Why not? They both went to medical school.

Now, some Walgreens stores are offering the Smile Direct straightening. Some patients are going there and some are going straight to Smile Direct. What they do is the following: They make an image of your mouth either from a scan of your teeth or from a mold of your mouth that you create at home using their at-home impression kit.

Next, a dentist or possibly an orthodontist will make the clear aligner trays that will move your teeth.This will be done without the benefit of the completed exam and x-rays as described above.

“OK so now I understand that it is not the same but all I really want is straight teeth for the lowest cost and I want it to be convenient. Are there any downside risks with the short cut approach to straightening my teeth?”

Yes, there are. I am glad you asked. Any tooth movement can put you at risk for moving teeth outside of the bone foundation and that will cause your gums to drop and will expose the soft roots to the sugars and the acids that cause decay. Roots are not supposed to be exposed in the mouth. They decay easily and also wear away easily when exposed. When this happens sometimes gum surgery can fix it and sometimes it can’t. Also, if your jaws are not properly aligned and if you move the teeth to try to make the jaws lineup instead of dealing with the jaw issues this can also affect your jaw joints causing painful TMJ issues and help create severe headaches from misaligned bites.

Now, please consider this if you decide to use an at home do it yourself kit:

• NO one has examined you.
• NO one has seen x-rays of your teeth and jaws.
• NO one has determined if you have foundation issues and whether your foundation can withstand teeth being moved safely. If not, you will lose gum and bone and weaken your teeth.
• NO one has evaluated your TMJ health.
• NO one has looked at your airway
• Without a complete and thorough exam and without proper x-rays you may have foundation damage that is worsened by moving the teeth that cannot be corrected afterwards.

If this kind of treatment is predictable and if it is truly in your best long-term interest then I am a one legged parrot. Anyone see me with a crutch and a cracker? I don’t think so!

THERE IS NO SUCH THING AS A FREE LUNCH.

8 things to check out before you MOVE your teeth:

• Measurements for bone health
• Gum health measurements including any exposed roots (recession) and any signs of bleeding/inflammation
• Cephalometric x-ray and evaluation of the facial bones
• X-rays of the bone foundation around the roots of the teeth
• Cone beam scan if needed
• TMJ health
• Airway evaluation
• Education and qualifications of the person(s) responsible for moving your teeth

 

BE VERY CAREFUL. THE DECISIONS YOU MAKE TODAY WILL AFFECT YOU FOR THE REST OF YOUR LIFE.

 

 

That’s an easy question to answer. It is because dental insurance is not insurance in the traditional sense. The best way to think about dental insurance is that it’s a rebate. With all dental insurance there are several guidelines that apply to almost every plan.

1. Most dental plans are purchased by employers and not individuals. Most companies look for low cost options. Low costs mean lower coverage for you.
2. All plans have annual maximums and the average is $1000. There are exceptions.
3. Dental insurance is different than medical insurance. Medical insurance is good for big procedures like hip and knee replacements and even heart surgery. Dental insurance is good for small procedure and not for big expensive procedures. Dental insurance was designed to pay for small procedures on otherwise healthy people. It is good for tooth cleanings, routine x-rays, fillings, a crown or even an extraction. That $1,000 allowance was never designed to pay for care to rehabilitate your mouth. It was designed for people that needed minimum care.
4. Most treatments are not covered at 100% or even 80% but at some secret percentage that varies from company to company and from geographic region to region. That means that your company will pay more for the exact same procedure that is done in Philadelphia Pa than is done 300 miles away in Pittsburgh. So, if your dentists charges $100 for a procedure the insurance company may decide to pay 60% of $80 in Philadelphia and 60% of $7o dollars in Pittsburgh  and not the $100 charge for reasons that they will make up to suit their bottom line because they want to pay out as little as possible. Each year this number is being reduced to increase their profit margins and decrease reimbursements to you and to your dentist.
5. The premium that your employer pays for your plan is very low cost and since the cost is low they have $1000 maximums in place for a very good reason: ”There is no such thing as a free lunch!” The $1,000 maximum has been the same since around 1975 and has not kept up with inflation. The average cost of dental insurance is $45 a month. If you need an extraction and an implant and a tooth on top of the implant you will most likely get your $1000 towards the cost of your treatment and the rest will be out of pocket. If your plan excludes certain procedures, and many do, you may not even get the $1000.

The bottom line is this: If your employer provides dental insurance as a benefit it is a bonus. Most people have unrealistic expectations about what “dental insurance” is and what it should provide. Certainly, maximize the benefit and realize that any procedures that you need will most likely require additional out of pocket expenses.

You are the one that must determine the quality of life that you desire. We are living to 80 to 100 years these days and quality of life is critically important. Every birth, every funeral, every wedding and birthday celebration revolves around food and being able to laugh, chew, taste and enjoy that food. That can only happen if you have real teeth. The quality of your life…the life in your years is as important as the years in your life. You must be the one to make the decisions that will affect you for the rest of your life and not the insurance company, so make those decisions very carefully. If you don’t care about the quality of your life…who will?

Live long- Smile big -Eat well.

https://youtu.be/yujUpe7YW1k

 

 

 

Sometimes gum tissue disappears and teeth appear to be getting longer. Since the destruction is rarely painful, patients do not complain until moderate to extreme sensitivity is present. Most often they don’t notice until it becomes advanced. Consider what is actually occurring when gums disappear. The issues are as follows

• The gum tissue disintegrates and disappears
• The supporting bone underneath disappears: lower bone means a lower gum level
• Exposure of the soft root surface                                             
• Root abrasion, root wear/ destruction
• Sensitivity
• Greater tendency towards decay

 

Which patients have the greatest need to have recession treated?

Younger individuals definitely have a greater need for treatment. If we observe 3 mm of recession in both a 30 and a 70 year old, who is at the greater risk for continued destruction? Under similar conditions, it is clearly the 30 year old. What are the chances that the 30 year old will arrive at age 70 with the tooth still intact when there are 40 more years of chemical and mechanical stress that will be placed on the exposed root?

Note above photo: Patient age 20… apx.12 months after orthodontics was completed.

Can bonded restorations be successfully and predictably used to treat recession?

No. We must be clear about one important fact. Bonding exposed root surfaces does not treat or stop recession and merely attempts to cover the exposed root surface. As you can see in the photo above, recession most often continues beyond the bonding. Thus, there is more loss of gingiva, more bone loss and more root damage occurs.

Can we predictably recover exposed roots with reconstruction procedures?

Yes. Several different techniques have been developed over the past 60 years that can predictably reattach to the root surface and recover the exposed root. The key is to treat early before any bone loss occurs. The bone levels determine the height of tissue.  When bone levels drop we cannot regain lost tissue to the original level. Studies that have followed gum reconstruction for up to 20 years indicate remarkable stability.

Do we really know what causes recession?

What we do know is the result of observation and case study. CT scan studies now show that many people have roots that stick through the bone and that alone or combined with any kind of orthodontic tooth movement causes recession. Individuals with a thin tissue type are more prone to recession than people with thick tissues. When we treat recession with reconstruction procedures, the new gum is thicker tissue over the areas where recession has occurred and that helps resist future destruction.

How serious a problem is recession?

Recession gets too little respect as a real issue. Recession not only damages the supporting structures but also very often promotes the destruction of the root as you can see in the above photos. Since root structure is so much softer than enamel, our ability to predictably restore these teeth long-term is very limited. The key is early diagnosis and treatment.

3 Different Cases

Traditional Inside Approach

Traditional Outside Approach

Pinhole Technique

3 Different Cases

 

Have you thought about your New Years resolutions yet? Although most people are quick to name dieting or hitting the gym, all too many people forget about their dental health—which can have a profound effect on other areas of the body.

The mouth is sometimes referred to as the window to a person’s health because so many conditions show symptoms there. Tooth decay and gingivitis can also cause oral bacteria to leach into the bloodstream and cause widespread inflammation, contributing to health problems like heart disease, diabetes, and even some types of cancer. Fortunately, you can help your body ward off these kinds of problems by focusing on proper dental care.

Resolve to Take Care of Your Teeth in 2017

This holiday season, focus on turning over a new leaf and resolving to take better care of your teeth in 2017. Here are just a few dental care tips that could help you to have a comfortable smile that you can be proud of.

Regular Dental Appointments

The American Dental Association recommends meeting with your dentist regularly in order to spot problems and address them quickly. In addition to saving you from the pain of advanced tooth decay, keeping regular dental appointments and getting complete periodontal evaluations can help your dentist and periodontist in Pittsburgh to address problems before they become more complex, saving you time and money.

A Focus on Dental Hygiene

Think about your daily dental hygiene routine and what you can do to perfect it. Focus on brushing and flossing carefully and consistently. If you have questions about the toothbrush and floss that you are using, don’t be shy about talking with Dr. Silberg. He can recommend great tools that are well suited for your dental concerns.

Avoid Dental Dangers

In addition to polishing up your daily hygiene routine, also focus on avoiding dental dangers. Don’t try to bite through foods that are hard, rinse after eating anything extremely chewy, and never open packages with your teeth. If you play sports, invest in a protective athletic mouth guard to protect your teeth from impact.

Be Proactive About Problems

Last but not least, pay attention to preventive care and be proactive about new problems. By making appointments regularly and addressing new dental issues, you can stay on top of your dental health.

At the Silberg Center for Dental Science, we want to make you smile in 2017. Contact our office to schedule your next checkup.  

As your Pittsburgh periodontist, we at the Silberg Center for Dental Science want our services to be convenient and comfortable. We’ll always do our best to meet your needs, provide amenities, and talk to you about your procedures. But we understand that sometimes you need more than just reassurances, which is why we offer sedation dentistry.

Sedation has benefits for both you and us which help the procedure go more smoothly. First and most obviously, dental sedation can greatly reduce the discomfort that comes with some restorative procedures. It helps you to stay still and relaxed, so that the dental work is more precise and efficient. It can also soothe the anxiety some people experience in association with dental procedures, so that they feel at ease and have access to the care they need. We are happy to provide dental sedation wherever it’s called for. For your convenience, we offer both anesthesia and nitrous oxide.

Anesthesia can be either local or general. A local anesthetic causes numbness in that specific location, while you remain awake and alert. A general anesthetic puts you to sleep so you’re unaware of the procedure. Both will wear off after a few hours. When you come to our office, we’ll consult with you about your dental and medical history to make sure that you don’t have any unexpected reactions to these medications. In this way, we make sure that these options are safe for you.

Nitrous oxide, also known as “laughing gas” is a sedative that is inhaled throughout your procedure in a carefully adjusted dosage. Depending upon the person, nitrous oxide makes patients feel peaceful, giggly, or sleepy, all of which mean a relief from anxiety. The sedation wears off almost immediately after you stop receiving the gas, leaving no lasting effects, which makes it ideal for patients who will drive to and from their appointments or who don’t need general anesthesia.

If you’re concerned about your upcoming procedure, contact our office today. Your Pittsburgh periodontist, Dr. Silberg, will be happy to discuss your options with you and help you see how sedation dentistry can give you the comfortable care you deserve.