Local Dental Care - Gum Sores

Dental Disease And Ridge Augmentation

Whether a tooth has been lost to periodontal disease, tooth decay, or trauma, one may be left with a cleft, an indentation, or uneven gum margins. This happens because after a tooth is removed, the bone that was encasing it disintegrates and the gum around it collapses. If this occurs in the front of the mouth, it can result in an esthetic problem. No matter how well designed the replacement teeth are, they may appear to be too long and unattractive. To have a pleasing smile, the shape, color, and texture of the gums is just as important as that of the teeth they frame.

Ridge augmentation is a cosmetic periodontal procedure that may include gum and/or bone grafting. A dentist will determine which option is better suited to a patient's esthetic needs. Regardless of what treatment method a dentist chooses, ridge augmentation is a very predictable procedure with long-lasting results.

What to Expect from Periodontal Ridge Augmentation

Ridge augmentation is a surgical procedure that is done in the dentist's office with local anesthesia (lidocaine). Stitches (sutures) are placed to aid in healing. Post-surgical discomfort can last a few days and is usually minimal. It can be easily managed with commonly available over-the-counter medications such as aspirin, acetaminophen, or ibuprofen. Patients can expect to follow their normal routine the day after oral surgery. The dentist will provide special instructions related to diet, exercise and medications.

To ensure more esthetic results, ridge augmentation procedures should always be done before new crowns are made. Although a temporary (provisional) tooth replacement can be made at the time of tooth loss, the final restoration should not be fabricated until after six to eight weeks of gum healing.

Alternatives periodontal treatments

It is possible to help prevent collapse of the gum tissue by doing a bone grafting procedure or by placing an implant at the time of extraction. Although sometimes it may still be necessary to do further periodontal plastic surgery procedures, these treatments can help maintain the space that was previously occupied by the tooth and prevent bone loss. If this was not feasible, ridge augmentation can be done to improve esthetics after tooth extraction.

Ridge augmentation should be considered as part of an individual's cosmetic dentistry options when there are uneven gum contours, clefts, or indentations on the gums. The most beautiful teeth will not look natural if the gum surrounding them is not cosmetically pleasing. Talk to a dentist about esthetic concerns and the possibility of incorporating cosmetic periodontal procedures as part of a "smile lift."

By Laura Minsk, DMD

Periodontal Disease is a Risk Factor for Systemic Disease

It is well known that periodontal (gum) diseases are a series of bacterial infections that destroy the gum tissue and bone that support the teeth. Left untreated, periodontal disease can lead to tooth loss. What is commonly not thought of is how this oral infection can also affect the rest of the body.

An infection in the mouth can affect the overall health and have serious systemic (general body) manifestations. Like other infections, the bacterial cells that cause periodontal disease, or their toxic products, can enter the blood system and affect other organs.

Research studies indicate that periodontal infections can affect the overall health and that periodontal disease is a risk factor for many health problems.

Bacteremia: Bacteremia is an infection caused by infectious organisms in the blood system. The bacteria that cause periodontal disease can enter the blood system through cuts in the gum provoked by normal chewing or brushing habits.

The bacteria can also enter the blood system directly through the infected gum tissue in a periodontal pocket. The more infected the gums are, the more likely bacteria are to enter the blood system. These bacteria can travel and infect other organs. The best way to prevent bacteremia caused by oral bacteria is by maintaining oral health.

Infective endocarditis: People that have damaged heart valves, a history of rheumatic fever with subsequent heart valve damage, aortic stenosis, certain heart murmurs, and mitral valve prolapse with regurgitation are at greater risk of developing infective endocarditis -- an infection of the lining and valves of the heart.

If not treated immediately with antibiotics, this infection can be fatal. The best way to prevent infective endocarditis is by minimizing the amount of bacteria in the mouth. Several periodontal treatments, like meticulous home care with brushing and flossing, combined with professional cleanings and modification of risk factors related to periodontal disease, are essential in controlling the bacterial infection.

In addition, the American Heart Association has recommended antibiotic treatment prior to certain dental procedures for people that are at high risk of infective endocarditis. These dental procedures include tooth extraction, surgical treatment, scaling and root planing, and implant treatment. Your dental care provider needs to be aware of your medical history in order to better treat you and prevent systemic complications.

Cardiovascular disease: Evidence suggests that having periodontal disease puts you at greater risk for cardiovascular disease. The bacteria that are normally found in the mouth have been found in the artery walls of people with cardiovascular disease. These bacteria can irritate the arteries, leading to fatty deposits and eventual blockage of the arteries resulting in heart attacks or strokes.

Heart attacks: The bacterial infection that causes periodontal disease may also affect the heart. In fact, all other conditions being equal, people with periodontal disease may have twice the risk of having a fatal heart attack as people that don't have periodontal disease.

Strokes: Strokes occur when a blood vessel in the brain becomes blocked and there is reduction in the oxygen delivery to the brain cells. This can lead to paralysis, speech problems, and even death. A research study of 10,000 people found that periodontal disease can increase your risk of having a stroke by two-fold.

Artificial joints: Artificial joints or prosthetic devices may be vulnerable to infection by the bacteria that cause periodontal disease. These bacteria can enter the blood stream through small ulcerations in the gums or as a result of dental treatment. To prevent infection of artificial joints maintain meticulous oral hygiene and consult your dentist and physician about the possibility of antibiotic treatment before dental procedures.

Diabetes: Periodontal disease can increase insulin requirements and diabetic complications. Treating periodontal disease can actually reduce the need for insulin.

Respiratory disease: People with advanced periodontal disease are four and a half times more likely to have chronic respiratory disease. The bacteria that cause periodontal disease can be aspirated into the lungs increasing the risk for pneumonia and other respiratory diseases.

Once again, to prevent the serious systemic complications related to periodontal disease infection, see your dentist or periodontist for a periodontal screening and treatment as indicated. Treatment of periodontal disease may save your life!

Premature, low-birth weight babies: If you do have periodontal disease and are pregnant, you may have a higher risk of having a premature, low-birth weight baby. Pregnant women who have periodontal disease are seven and a half times more likely to have a baby that is born too early or too small. This time, treating periodontal disease can help improve your health and that of your baby.

So, because periodontal infections can affect the overall health and periodontal disease is a risk factor for many health problems, seeking periodontal treatment can help improve your oral and overall health.

By Laura Minsk, DMD

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