Tooth brush abrasion occurs when a medium or hard bristled tooth brush is used in a back and forth manner. Over time, horizontal brushing of teeth leads to wear of the protective gum layer around the neck of the teeth.  This exposes the root of the tooth, which in turn exposes the nerves that reside inside the dentin.  This often causes temperature sensitivity.  Having the dentin exposed also increases the chance of tooth decay.

With periodontal disease, gum recession occurs when inadequate brushing and flossing causes bacterial buildup. This process causes a chronic gum infection that can lead to damages the gums and leads to receding gums.

Dentists will most often encourage patients to use desensitizing toothpaste and a soft toothbrush when brushing. This will minimize pain and create better oral health. In all cases of gum recession, the first line of gum treatment is better brushing and flossing techniques. However, if receding gums have reached the point where sensitive root surfaces are exposed causing continual pain additional options may be explored.

The best option for cases of gum recession is to do gum grafts (soft tissue grafts) to cover the exposed roots again. These procedures are best performed by a periodontist who specializes in gum treatment for receding gums.

The biggest influence on feeding the public a steady diet of mis-information are the large pharmaceutical/medical device companies.  When their profits depend on selling drugs or products then they will manipulate the studies, the doctors and the government however they can to convince the public that taking a pill or using their product is a much better option than other proven alternatives.

Profits also drive these companies to hold educational seminars and weekend “mini residencies” where they teach general practitioners to perform complex procedures that only specialists are qualified to perform.  Their logic is that the more doctors they have in their pipeline the more product they can sell.  So they tailor make these seminars to make the general practitioners believe that placing dental implants or doing gum grafts or treating periodontal disease are very profitable procedures that can easily be done.  They give them a false sense of security and then unleash them on the unsuspecting public.

So who can you trust?
When I was going through my training we had a very rigorous course called literature review.  What they trained us to do in this class was to read published studies, and breakdown the data and analyse it ourselves to conclude if the results were really true, or if the study was flawed (or influenced).  So we became pretty good at deciphering between junk science and real science.  Unfortunately most of the public (or general practitioners) does that have this skill set so they must rely on experts to guide them through this process.  But who is an experts and who is not?  Expertise is not something that develops over night or over a couple of weekends.  It is a combination of rigorous structured training, and a devotion to mastery of the subject.

Here are some basic rules of thumb for finding a real expert:

• For most complex dental issues such as bone grafts, gum grafts or dental implants  you should seek the advice of a specialist such as a periodontist.  You would never allow your family physician to take out your appendix, nor should you allow your general dentist do complex surgery on you. Try to seek out the masters in the field.  Masters are those that have practiced their craft at least 10,000 hours.
  
• Ask specific questions about your doctor, such as the  length of time in practice, number of procedures that they perform, their training, hours of continuing education they take etc.  You want to find out how devoted they are and where they are getting their information from. The more you know about your doctor the better.
  
• Generally doctors that offer the lowest price on something then they are working on volume.  Do you want to be part of an assembly line?  Dentistry and medicine do not lend themselves to mass production.  The quality and the outcomes ALWAYS suffer.
  
• Lastly you want to see a doctor that takes their time with you and listens to your concerns and carefully evaluates you.  You also want to see that they can offer you multiple options and work with your needs.  If they are dismissive or rushed when they see you then they don’t have your best interest at heart.

Vitamin D is essential for proper metabolism of calcium which aids in the development and maintenance of healthy teeth and bones.

Many scientific articles indicate that Vitamin D and calcium deficiencies result in bone loss and increased inflammation, which are well recognized symptoms of periodontal (gum) disease.

Research also shows that the best means of obtaining the required amount of vitamin D is from sunshine. The recommended exposure is 10 to 15 minutes of sun exposure at least two times per week to the face, arms, hands or back.  People who live in an area with limited sun exposure may want to eat foods fortified with vitamin D such as milk, eggs, sardines and tuna fish.

I am not encouraging people to forget about their sunscreen nor to spend prolonged periods of time in the sunbathing.  According to the American Academy of Dermatology, there is no such thing as a total UV block. Even the most effective sunscreens currently on the market let through enough UV to allow for adequate vitamin D formation.  But if you feel that you are not getting proper sun exposure then supplementation may be necessary.  A simple blood test can determine vitamin D blood levels.

Periodontal diseases are bacterial infections that, if left untreated, may cause damage to the bone and even tooth loss. A number of other infectious diseases have also been linked with low levels of vitamin D.  It has been demonstrated that vitamin D can suppress proinflammatory cytokine production. (Proinflammatory cytokines are molecules that circulate in the blood and have destructive effects throughout the body.)

Periodontal disease increases the production of cytokines, but it has been demonstrated that vitamin D can suppress cytokine production, and possibly decrease the risk of periodontal disease.
Research has shown improvement in response to periodontal disease treatment for those patients who were being supplemented with Vitamin D and calcium.  Vitamin D and calcium supplementation alone does not combat periodontal disease.  The most effective treatment options are those that combine effective and gentle periodontal treatment with adequate supplementation.

At Beverly Hills Periodontics & Dental Implants, we offer state of the art laser dentistry and technology. Laser dentistry, together with Dr. Miles Madison’s expertise, can mean less time in the chair, little to no down time for patients, and quicker healing.

If you would like to schedule an appointment for laser dentistry, please contact Dr. Madison by calling (310)553-2940.

How Laser Dentistry Works

Laser dentistry works well because it removes the need to cut the gums with metal surgical instruments or suture them. By using a soft tissue laser beamed through a fiber, bacteria infecting the gums can be removed more precisely, removing only the infected areas in the tissue or bone.

The laser also has a sterilizing effect, which helps reduce the amount of bleeding and swelling, making the procedure less discomforting overall. Perhaps the biggest advantage of laser periodontal treatment, however, is less post-operative pain. Oftentimes, patients are back to work within 24 hours, with minimal pain or soreness.

Scaling and Root Planing (SRP)

Studies have shown that laser dentistry is good for patients undergoing scaling and root planing (SRP). This procedure is one of the most conservative methods of treating periodontal disease. Scaling removes calculus (also known as tartar) and plaque that has hardened on the tooth as well as below the gum line, near the root. Root planing removes the rest of the calculus and plaque by smoothing the uneven surfaces of the root.

A Quick Procedure

Laser periodontal treatment is a fast procedure, always at a premium in today’s quick-paced culture. Patients who undergo laser periodontal treatment can be in and out of the dentist’s chair in as little as two hours. Of course, proper follow-up is important to gauge the success of the treatment, and it is recommended that patients be seen every three months for post-laser maintenance.

If you would like to schedule an appointment for laser dentistry, please contact Dr. Madison by calling (310)553-2940.

If you have any other questions or comments regarding this article, please contact us at (310) 553-2940 or by email at periodontics@earthlink.net.

Dr. Miles Madison, D.D.S., is an award-winning periodontist in Beverly Hills, California.

Periodontal Disease – A Closer Look

Periodontal (gum) disease, including gingivitis and periodontitis, is a serious infection that, left untreated, can lead to tooth loss. The word “periodontal” literally means around the tooth. Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.

If you think you might be experiencing periodontal disease, please make an appointment with Dr. Madison by calling (310)553-2940.

Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional periodontal disease treatment and good oral home care.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed.

Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed without periodontal disease treatment.

What Causes Periodontal Disease?

The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like the following also affect the health of your gums.

Smoking/Tobacco Use – As you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know is that tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

Genetics – Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interceptive treatment may help them keep their teeth for a lifetime.

Pregnancy and Puberty – As a woman, you know that your health needs are unique. You know that brushing and flossing daily, a healthy diet, and regular exercise are all important to help you stay in shape. You also know that at specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy.

During these particular times, your body experiences hormonal changes. These changes can affect many of the tissues in your body, including your gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.

Stress – As you probably already know, stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

Medications – Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

Clenching or Grinding Your Teeth – Has anyone ever told you that you grind your teeth at night? Is your jaw sore from clenching your teeth when you’re taking a test or solving a problem at work? Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

Diabetes – Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body’s ability to use blood sugars) or the body’s inability to use insulin correctly.

According to the American Diabetes Association, approximately 16 million Americans have diabetes; however, more than half have not been diagnosed with this disease. If you are diabetic, you are at higher risk for developing infections, including periodontal diseases. These infections can impair the ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.

Poor Nutrition – As you may already know, a diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. Because periodontal disease is a serious infection, poor nutrition can worsen the condition of your gums.

Other Systemic Diseases – Diseases that interfere with the body’s immune system may worsen the condition of the gums.

Types of Periodontal Disease

There are many forms of periodontal disease requiring treatment. The most common ones include the following.

Gingivitis -Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.

Mild Periodontitis – If gingivitis, the mildest form of periodontal disease, is left untreated, it can advance to periodontitis. In the mild stage, periodontal diseases begin to destroy the bone and tissue that support the teeth.

Moderate to Advanced Periodontitis – Moderate to advanced periodontitis develops if earlier forms of the disease like gingivitis and mild periodontitis are left untreated. This is the most advanced form of the disease in which extensive bone and tissue loss occurs.

Juvenile Periodontitis – Localized juvenile periodontitis (LJP) occurs in adolescents and is characterized by the rapid loss of bone around permanent teeth. Ironically, youngsters with LJP form very little dental plaque or tartar. Generalized juvenile periodontitis is often considered a disease of young adults, although it can begin around puberty.

It is characterized by marked inflammation and heavy accumulations of plaque and calculus. Pockets can form around the affected teeth, filling with infection. If not treated early, infection can lead to bone loss which may cause the teeth to become loose.

Diagnosing Periodontal Disease

You may not realize that persistent swollen, red or bleeding gums, tooth sensitivity, and bad breath are warning signs of periodontal disease. While we can determine if you do have this problem, here are ten questions you can ask yourself about the warning signs behind periodontal disease so that you can seek treatment.

• Do you ever have pain in your mouth?
• Do your gums bleed when you brush your teeth or eat hard food?
• Have you noticed any spaces developing between your teeth?
• Do your gums ever feel swollen or tender?
• Have you noticed that your gums are receding?
• Do your teeth appear longer than before?
• Do you have persistent bad breath?
• Have you noticed pus between your teeth and gums?
• Have you noticed any change in the way your teeth fit together when you bite?
• Do you ever develop sores in your mouth?

Methods of Periodontal Disease Treatment

If you’re diagnosed with periodontal disease, your periodontist may recommend periodontal surgery to correct and prevent problems. Periodontal disease treatment or surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment.

Depending on the severity of your periodontal disease, some of the following periodontal disease treatments may be prescribed:

Pocket Reduction Surgery

Microtherapy

Regenerative Procedures

Crown Lengthening

Soft Tissue Grafts

Dental Implants (if you’ve already lost a tooth due to periodontal disease)

At Beverly Hills Periodontics, we offer the most advanced periodontal disease treatment techniques available for safe and effective management of periodontal issues.

To schedule an appointment with Dr. Madison, please call (310)553-2940.

For more information on periodontal disease or to set up an appointment to discuss options, please contact us for a consultation.

The effective control of anxiety and pain (implemented through an array of methods including sedation dentistry) has been an integral part of dental practice since the early development of the profession. Use of a wide variety of anxiety and pain control techniques has enabled the profession to extend oral health care to millions of individuals who would otherwise remain untreated.

Without effective anxiety and pain control, numerous dental procedures are virtually impossible and many patients do not seek needed dental treatment. In addition, both anxiety and pain control techniques are often essential for the management of special patients, young children and the mentally and physically challenged. The use of sedative and anesthetic techniques by appropriately trained dentists in the dental office and other settings continues to have a remarkable record of safety.

According to the Dental Organization for Conscious Sedation (DOCS Education), 30 percent of the population avoids the dentist due to fear. This all-too-common “dental phobia” prevents people from receiving necessary routine dental care, potentially compromising the health and functionality of their mouth and smile. So if you have sensitive teeth, a fear of dentists, have a bad gag reflex, hate needles, or have limited time to spend on dental care at the dentist, sedation during dentistry procedures can help you.

If you would like to experience sedation dentistry, please schedule an appointment with Dr. Madison by calling (310)553-2940.

If you have any other questions or comments regarding this article, please contact us at (310) 553-2940 or by email at periodontics@earthlink.net.

Dr. Miles Madison, D.D.S., is an award-winning periodontist in Beverly Hills, California.