Dentist - Chicago
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Chicago, IL 60654
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Posts for: September, 2015

By Reuben D. Collins, DDS
September 24, 2015
Category: Dental Procedures
Tags: gum disease  
DontDelayTreatmentofGumDisease

Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.

One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.

It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.

We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).

Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.

Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.

If you would like more information on treatments for gum disease, please contact us or schedule an appointment for a consultation.


PeriodontalSurgerymaybeNeededtoHaltGumDiseaseandEncourageHealing

There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.

As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.

Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.

There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.

Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.

If you would like more information on surgical procedures for 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 “Periodontal Surgery: Where Art Meets Science.”


By Reuben D. Collins, DDS
September 08, 2015
Category: Dental Procedures
RegularCleaningsBenefitBothYourDentalHealthandYourSmile

Dental cleanings are an important part of regular dental office visits. Performed by a dental hygienist or dentist, cleanings serve two purposes: to remove bacterial plaque and calculus (hardened deposits of plaque) from tooth surfaces missed during daily brushing and flossing; and to remove stains that can dull your smile.

There are different degrees of cleaning, including root planing that removes plaque and calculus deep below the gum line, usually for patients affected by periodontal (gum) disease. For patients in good oral health, the basic cleaning approach is known as prophylaxis, a term derived from the Greek for guarding or preventing beforehand. The techniques used in a prophylaxis remove both “coronal” (tooth surfaces visible above the gum line) plaque and staining, providing both therapeutic and cosmetic benefits.

A typical prophylaxis includes a procedure known as scaling. Hygienists use special instruments known as scalers to remove plaque and calculus by hand, or an ultrasonic device that vibrates plaque loose and is flushed away with water. The procedure removes that rough coating you often feel as you rub your tongue against your teeth, leaving the tooth surfaces feeling smooth.

Tooth polishing is a subsequent procedure to scaling that also removes plaque and surface stains. Polishing is carried out with a motorized instrument with a rubber cup in which a polishing (or “prophy”) paste is contained. The hygienist moves the rapidly rotating cup filled with the paste over the tooth surface to remove plaque and stains. The end result is a highly smooth surface and a much shinier appearance.

People with dental insurance plans are often concerned tooth polishing may be viewed strictly as a cosmetic procedure, and thus not fully qualify for benefits. This should not be the case if coded properly: tooth polishing is part of the overall prophylaxis to remove plaque and staining. The primary purpose is therapeutic and preventive; the cosmetic effect is a by-product. Most dental plans will cover one or two prophylaxes (scaling and tooth polishing) a year, but there are variations so individuals should check their plans.

If you would like more information on dental cleaning, 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 “Tooth Polishing.”