Posts for: March, 2012
When it comes to your oral healthcare, we strive to provide state-of-the-art care along with education to both our patients and community. One way we do this is by taking a moment to answer some of the questions we are most often asked about a certain topic. And one topic that almost always ignites questions is the subject of lumps and bumps in the mouth.
Help! I just found a small lump in my mouth — what should I do?
Not to alarm you, but your first priority is to contact us as soon as possible to schedule an appointment so that we can review it. Most often, we will know what it is by taking a history, knowing how long it's been there and what it looks like. Depending on what we find, we may want to take a biopsy so that we can determine exactly what it is and how we need to treat it.
What is involved in having a biopsy performed?
A biopsy is a normal and routine procedure that is used to definitively diagnose and confirm exactly what the abnormal lump, bump or other tissue is. It is typically performed with local anesthesia so that a small tissue sample can be removed without any pain for examination under a microscope. Depending on the size of the wound, it may require two to three sutures (stitches), leaving a flat and flush surface that heals in a few days to a week. The procedure usually lasts between 10 and 15 minutes with the lab results processed within a few days.
Does this mean I have cancer?
No, the chances are slim that you actually have cancer. However any change or sore in the mouth that does not heal in a week or two should be evaluated by a dentist and if necessary biopsied. If it is pre-cancerous and removed, it could save your life. The most important fact you need to remember is that no one can tell for sure what the abnormal tissue growth is until an expert in oral pathology (“patho” – disease; “ology” – study of) examines it under a microscope. While it is human nature to be concerned, until you have the facts, you are suffering needlessly.
To learn more about this topic, continue reading the Dear Doctor magazine article “Common Lumps and Bumps In The Mouth.” Or you can contact us today to schedule an appointment to discuss your specific questions so that we can put your mind at ease.
The term “root canal” strikes fear into many dental patients. But rest assured that this procedure is the best solution to many severe dental problems. It can be pain-free and will actually relieve pain and suffering from infections and dental injuries.
Why would you need root canal treatment? This procedure becomes necessary when the pulp, the nerve tissue on the inside of a tooth's root, becomes inflamed or infected because of deep decay, or when it has suffered a severe injury as a result of an accident or blow to the mouth. The pulp is composed of living tissues including nerves and blood vessels.
Root canal treatment may be necessary if you have a wide variety of signs or symptoms. The pain can feel sharp or intense when biting down, or linger after eating hot or cold foods. Sometimes it can be a dull ache or there may be tenderness and swelling in your gums near the site of the infection.
After trauma, the pulp of a tooth can be exposed or damaged because a tooth has fractured or cracked, necessitating root canal treatment. And the procedure is often needed for permanent teeth that have been dislodged or knocked out.
What exactly is root canal treatment? Root canal treatment is also called endodontic treatment, from the Greek roots “endo” meaning “inside” and “odont” meaning “tooth.” During the procedure, the area is numbed to relieve pain. A small opening is created in the chewing surface of the tooth and very small instruments are used to remove dead and dying tissue from the inside. The pulp is needed during a tooth's growth and development, but a mature tooth can survive without it. The canal is disinfected and then sealed with filling materials. Sometimes root canal specialists use microscopes to work at an intricate level of detail on these tiny areas of the tooth's root.
By having root canal treatment, you prevent inflammation and infection from spreading from the root of a particular tooth to other nearby tissues. Infection can result in resorption, an eating away of the root and its anchoring bone, and you could lose your tooth or teeth. So please don't hesitate when we recommend this treatment. It's not as bad as you think, and you will feel significantly better afterwards.
Contact us today to schedule an appointment to discuss your questions about root canal treatment. You can also learn more by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Trauma & Nerve Damage to Teeth.”
What does it mean when your dental hygienist recommends root planing? To put it simply, root planing is a method of cleaning the roots of your teeth in order to avoid periodontal (“peri” – around, “odont” – tooth) disease.
Periodontal disease happens when dental plaque, a biofilm of bacteria, is not regularly removed and begins to build up on teeth near the gum line. The bacteria cause inflammation, and this in turn causes the gum tissue to detach from the teeth. The widening spaces between the gum tissue and the teeth, called pockets, are environments in which bacteria can continue to collect and cause further inflammation and infection. Ultimately, this can lead to infection, bone loss, and loss of teeth.
Root planing is a technique designed to avoid such dire results. The bacteria, along with products they manufacture as part of their metabolism, can become ingrained in the surfaces of the tooth's root (the part of the tooth that is below the enamel). These bacterial products will form hard deposits called tartar or calculus.
Deep Cleaning Your Teeth
Of course, the best idea is to brush and floss away the plaque before the bacteria begin to build up on your teeth. If this is not done and pockets begin to form, the bacteria and toxic products are more difficult to remove in order to deep clean your teeth.
The first step is scaling. My hygienist or I will remove superficial collections of calculus. If material still remains within deep pockets, root planing is the next step. It involves actually planing the surface of the root, smoothing the surface free of calculus, bacteria, and toxins that have ingrained into the root surfaces.
Root planing is most often done under local anesthesia so that you remain comfortable while the cleaning procedures are done. The initial cleaning may be done by an ultrasonic instrument that vibrates particles off the root surfaces and flushes the pockets with water. Small hand instruments called curettes are used to finish the process. Antibacterial medication may then be used to help clear away infection from the pockets. Sometimes you may experience some tooth sensitivity to hot and cold after the root planing. If needed, this can be treated by applying fluoride to the root surfaces.
Depending on the extent of your gum disease, it may not be possible to remove all the deposits at one appointment, and it may be necessary to have multiple appointments over a few weeks to remove the remaining deposits. Often after three to four weeks the inflamed tissues have healed, leaving you with healthy gums once again.
Gum recession is a common problem affecting millions of Americans to some degree. If you have it, you will notice that the pink gum tissue surrounding one or more of your teeth has shrunk or receded and left the tooth-root surfaces exposed. How does this happen? And does it require treatment? The answers to both of these questions will vary from person to person. The good news is that treatment is available for those who need it.
The way you care for your teeth can be a major factor in gum recession. If you do not effectively remove plaque (bacterial biofilm) from your teeth daily, you may develop gum inflammation, gum disease and/or recession. Conversely, if you brush or floss too hard or for too long, you can also damage your gums. Please remember that it doesn't take a lot of pressure to remove biofilm; you just need to make sure you get to each tooth, right down to the gum line.
Other causes of gum recession include: mal-positioned and/or prominent teeth that are not fully encased in supporting bone; muscle attachments (frenums) pulling at the gum line; habits such as holding foreign objects (nails, pins) between the teeth that press on the gum tissues; and badly fitting oral appliances such as dentures, braces Ã¢Â€Â“ even tongue bolts and lip piercings.
Besides not looking too great, gum recession can lead to anything from minor tooth sensitivity to tooth loss in the most severe cases. If you are experiencing any discomfort from a loss of gum (also called “gingival”) tissue, we'd certainly like to know about it. We would be happy to examine your condition and make recommendations.
There are surgical procedures that are very effective in treating these problems. Procedures such as gingival grafting or periodontal plastic surgery (“peri” – around; “odont” – tooth), often involve taking a small piece of healthy gingival tissue from the roof of your mouth and grafting it to the area where it is needed. Ultrafine sutures hold the graft in place until it “takes.” Laboratory-processed donor tissue can also be used. In either case, the procedure has a terrific success rate.
If you have any questions about gum recession, please contact us or schedule an appointment for a consultation. To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Periodontal Plastic Surgery.”
Since the dawn of man, periodontal (gum) disease has impacted humans. And while dental health has dramatically improved over the generations, the facts are still clear Ã¢Â€Â” millions of Americans are suffering from gum disease and probably do not even know that they have a problem. This is because periodontal disease most often starts without any symptoms or ones that most people tend to discount or ignore.
Stage 1: Gingivitis. The first stage of gum disease is inflammation of the gingiva (gums) without bone loss. While nearly all people will develop gingivitis in the absence of good oral hygiene, only 10 to 15% of them will go on to develop more advanced stages of the disease.
Stage 2: Early periodontitis. With this stage, gingivitis progresses into the deeper periodontal structures — the tissues that attach the teeth to the bone resulting in early or beginning bone loss. About 10% of the population develops full-blown periodontitis with progressive bone loss.
Stage 3: Moderate periodontitis. The third stage of gum disease results in moderate bone loss (20 to 50%) of root surfaces of the teeth due to continued destruction of the surrounding tissues and bone. Periodontal disease is “cyclical” — it goes in cycles with bursts of activity, followed by a period in which the body tries to recover. This is called chronic inflammation, or frustrated healing.
Stage 4: Advanced periodontitis. With the final stage of gum disease, there is severe bone loss (50 to 85%) from the tooth's root. This stage includes looseness of teeth, moving teeth, abscess formation with red, swollen and painful gums. The end results — eating and even smiling is difficult and uncomfortable, and you could lose all your teeth.
You can learn more about gum disease in the Dear Doctor article, “Understanding Gum Disease.”
Have We Described Your Mouth?
If any of the above stages sounds like we are talking about your mouth, contact us today to schedule a consultation, discuss your questions and receive a thorough exam. If addressed promptly and with commitment to following your treatment plan, your mouth can return to good oral health.