The Many Faces of Periodontal Disease

Teeth and Gum Damage from Smoking

Above are two distinctly different photos.  The picture to the left shows a 49 year old male with Diabetes Mellitus Type 2 with a half pack day smoking history for 16 years. He brushes once a day and does not floss. He presented to our office with very obvious signs of periodontal disease including erythematous (red), edematous (inflamed) and bleeding gingiva (gums), calculus (tartar) build-up, long loose teeth, missing teeth among other signs.

To the right is a picture of a 27 year old female patient who is systemically healthy, does not smoke nor does she take any medications. She presented with “normal” looking teeth and gingiva. The teeth appear clean and healthy.  She brushes two times a day and flosses every night.  She has not experienced any typical symptoms associated with periodontal disease.

Interestingly, both patients have severe bone loss and active periodontal disease!  The patient to the left has a common chronic form of periodontal disease whereas the patient on the right has an aggressive form of the disease which is rare but arguably more difficult to stabilize.  After comprehensive periodontal therapy with Dr. Anderson both patients are now disease free! Now that they have reached oral health, they are on a 3-4 month maintenance cleaning  to maintain the results.

Regular visits to your dentist and periodontist are critical to identifying and treating periodontal disease as it can occur without typical signs and symptoms.

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What Is Gum Recession?

Gum Recession Before and After Treatment

Above, JR’s before and 1 year after tissue grafting with Dr. Anderson on lower front teeth (central incisors #’s 24 and 25).

Gum or what dentists refer to as “gingiva” is the pink tissue that surrounds your teeth. A thick band of gingiva is needed around all of your teeth for proper oral health. For a variety of reasons (aggressive tooth brushing, problematic anatomy, staggered teeth, bone loss, infection etc.), some patients experience gum shrinkage and become vulnerable to variety of dental issues.  Teeth look longer and gums look shorter. In most cases, periodontists can correct gums back to a stable level in about an hour. Results can be lifelong if taken care of properly.

Meet “JR”

JR is a 19 year old systemically healthy (ASA 1) female who presented to our office with sensitive lower teeth.  She and her dentist found that her lower two front teeth (central incisors 24, 25) were looking longer and experiencing gum recession. Note that the roots (yellow part) are exposed and there is very little pink tissue (gingiva).  In cases like JR, the gum recession will continue to get worse if not treated.  Please see above for before and one year post-op results from gum grafting (free gingival graft) with Dr. Anderson.  Note the increased pink gum (attached gingiva) that is needed for oral health and full coverage of the roots that is needed to reduce sensitivity. JR is now happy that her oral condition is now stabilized, her yellow roots are covered, and her tooth sensitivity is gone!

If you have been referred for or believe you may have gum recession, ask Dr. Anderson if you would be a candidate for the treatment that helped JR reach better oral health.

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How Should I Best Care For My Teeth?

Adopt a Schedule

Typically, oral hygiene procedures should not take more than 7 minutes of your day. Brush for 2 minutes in the morning and after dinner for 2 minutes. In each quadrant 30 seconds are devoted to top (coronal), outside (buccal) and inside (lingual) surfaces. Floss at night before bed. You should go to bed at your cleanest! If this is not your current technique, oral hygiene procedures may take you longer initially. Mouth rise is optional and can be used twice a day after brushing. Brushing and flossing mechanically remove bacteria whereas mouthwash cannot.

Tips for Better Brushing

Brush with the bristles aimed up at the gum at a 45 degree angle. Only soft and extra soft brushes are recommended because harder bristles can brush your gums away leading to recession or “gum loss”. Use your tooth brush with gentle circular movements for 30 seconds in each quadrant (upper right, upper left, lower left, lower right). Spend equal time in each area on the cheek and tongue sides. Both electric and manual brushes are used in the same way! Even though the electric brush bristles move on their own, they are to be used in a circular scrubbing motion just like a regular brush.  If used incorrectly, gum disease may develop. Dr. Anderson uses a manual extra soft tooth brush in the morning and the electric brush at night. Ask the doctor if this is something that might work well for you if you have thin gums and gum recession.

Best Way To Floss Your Teeth

Wrap the floss string around middle fingers and use pointer fingers and thumbs to manipulate floss between the contacts. Most importantly, the floss should glide along the root surfaces in a “C” shape on both teeth associated with one contact. Flossing under the gum will not hurt your gum but rather not flossing at all will encourage disease to form! If flossing causes your gum to bleed, you need to floss more and see your periodontist. Although counter-intuitive to most, not flossing with cause more bleeding due to bacterial retention between the teeth. The body cannot flush bacteria out between your teeth and brushing cannot reach these areas either! Floss the ones you want to keep! Floss with textured or waxed floss as it is more effective than “gliding” or “silky” versions as they remove more bacterial plaque than their smoother counterparts. Ask Dr. Anderson for the floss she recommends and try it out!

Ask Dr. Anderson and her staff if you have any further questions!

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Crown Lengthening Fixes a Gummy Smile

fix gummy smile before and after

Above, before and after esthetic crown lengthening with Dr. Anderson

When you smile do you see short teeth and more gums than teeth?

If so, chances are your gums are covering your teeth.  This is called “excessive gingival display” and is usually caused by the gum and supporting structures failing to recede after the tooth grows into your jaw.

This phenomenon, also known as “altered passive eruption”, is easy and quick to fix.  If you see too much gum or short teeth ask Dr. Lauren Anderson if you may be a candidate for esthetic crown lengthening treatment.

Learn more today by scheduling an appointment or by calling (248) 480-4910.

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