What Is It?

Periodontitis is a term used to describe a group of conditions that involves inflammation of the gums and other structures that support the teeth. Periodontitis is caused by bacteria found in dental plaque and often, but not always, starts as gingivitis.

In trying to eliminate the bacterial infection, your body produces substances that destroy the structures that hold the teeth in the jaw, including the periodontal ligament and underlying bone. As this process continues, the teeth become loose. Pockets form between the teeth and gums, allowing more bacteria to accumulate. Left untreated, periodontitis can result in tooth loss.

Periodontitis usually is relatively painless. The onset of significant pain may signal the development of an abscess.

Older adults are more likely to have periodontitis.

People who smoke are four to seven times more likely than nonsmokers to get periodontitis. Smoking may impair the body's defense against bacteria.

Symptoms

Symptoms include:

• Reddened, swollen or bleeding gums
• Receding gums
• Loose Teeth
• Bad breath
• An unpleasant taste in the mouth

However, many people are unaware of these symptoms or do not believe they are signs of a serious problem.

Diagnosis

Your Tacoma dentist will examine your mouth, paying special attention to your gums and teeth. If you have periodontitis, a dental probeinserted between your tooth and your gums will penetrate deeper than it normally would.

Your dentist may also test for loose teeth. Teeth have a normal range of mobility, but in people with periodontitis, the teeth are looser due to the destruction of the fibers and bone supporting the teeth.

Your dentist may also order X-rays to help diagnose periodontitis. These can be compared with older X-rays to see if changes have occurred in your teeth and gums.

Expected Duration

Unlike gingivitis, periodontitis cannot be completely reversed. In some situations, the supporting fibers and bone that have been lost can be regenerated. In most cases, however, particularly in advanced stages of the disease, the effects are permanent. However, treatment and improved oral hygiene at any stage can improve the health of your gums and prevent further destruction.

Prevention

Daily brushing and flossing (morning and night) and regular visits for professional cleaning can help prevent periodontitis or allow you to have it treated during its earliest stages. If you smoke, quitting will reduce your risk significantly.

Treatment

Treatment depends on how severe your periodontitis is. Dentists classify the disease as mild, moderate or severe.

Mild periodontitis is usually treated first with a thorough cleaning called scaling and root planing. Scaling removes plaque or calculus that has accumulated on the crowns of your teeth (the parts that show) and slightly below the gum line. Root planing has two purposes: 1) to remove plaque or calculus from the roots of your teeth and 2) to smooth the roots of the teeth, making it more difficult for bacteria to cling to them. This, combined with good oral hygiene at home, often is enough for successful treatment.

Moderate periodontitis may require more than scaling and root planing. Typically, your dentist will scale and root-plane your teeth. If this does not take care of the problem, he or she may decide that you need surgical treatment. Surgery can involve reshaping the gums to fit the teeth (resective surgeries) or encouraging lost bone to regrow (regenerative surgeries). Your dentist will decide whether you will need surgery and what type you need.

Severe periodontitis likely will require surgical intervention and, in some instances, antibiotics. At this stage of disease, tooth loss is a distinct possibility.

No matter which treatment you undergo, you should start a strict regimen of brushing and flossing to help restore your teeth to health.

When To Call Your Tacoma Dentist

The best course of action is to get regular dental checkups. If you have persistent bleeding or swelling of your gums or notice loose teeth, call your dentist.

Prognosis

The outlook is good if the disease is recognized early and treated aggressively. Once bone loss occurs, the prognosis depends on the severity of the loss. Quitting smoking is very important for periodontal therapy to be successful. Lifelong maintenance will be required once the disease is controlled.

In order to achieve a sparkling smile, you’ll need to treat your teeth to more than just regular brushing. Healthy teeth start with healthy habits — from your brushing routine to the foods you should and shouldn’t eat.

"Your mouth is your body’s initial point of contact with the nutrients you consume," says Kimberly A. Harms, DDS, a spokesperson for the American Dental Association (ADA). "So naturally, what you put in your mouth impacts not only the health of your teeth and gums, but also your overall health." That includes beverages, the type and frequency of snacks, and even the gum you chew.

It’s important to go beyond brushing and change your daily habits to get the bright, healthy smile you want. Here's how:

• Avoid enamel damage. The layer of protective enamel on your teeth is your first defense against cavities, but certain foods and drinks strip it away, putting your smile at risk. Opting for sugar-filled sodas, sticky sweets (such as taffy), sweetened fruit drinks, and sugary snacks promotes tooth decay, Dr. Harms says. "When you eat sugary foods or sip sugary drinks for long periods of time, plaque bacteria use that sugar to produce acids that attack your enamel." Be sure to read food labels and choose foods that are lower in sugar.
• Eat nutrient-rich foods. Your teeth need nutrients to stay strong, white, and cavity-free. "For good dental health, it’s important to eat a variety of foods from each of the five major food groups," Harms says. This ensures that your teeth get the essential nutrients they need. Calcium, found in dairy products and leafy greens, is especially important for your teeth. Phosphorous, which can be found in proteins such as eggs, fish, poultry, meat, and dairy, is also essential. Both of these nutrients help protect and restore the enamel on your teeth, according to the ADA.
• Limit snacks. Too much snacking isn't only bad for your waistline; it's bad for your smile, too. "Foods eaten as part of a meal cause less harm to teeth than eating lots of snacks throughout the day do because more saliva is released during a meal," Harms says. "Saliva helps wash foods from the mouth and lessens the effects of acids, which can harm teeth and cause cavities." Some snacking is inevitable, so make sure to opt for something healthy such as cheese, veggies, nuts, or fruit, the ADA recommends.
• Don’t smoke or use tobacco. Smoking and using any kind of tobacco stains your teeth, but it also affects your whole mouth, the ADA says. It causes gum disease, which can lead to tooth loss as well as oral cancer. If you have oral surgery or a tooth extraction, smoking can slow your healing time. If you smoke or use other tobacco products, find a plan that works for you to quit. Ask your doctor or dentist for help or look for local or online quit programs.
• Limit teeth-staining culprits. Your favorite beverages might be dulling your smile. Coffee, tea, and red wine are some of the biggest culprits, Harms says. "They have intense color pigments called chromogens that attach to the enamel, which is the white, outer part of your tooth." For whiter teeth, cut back on these teeth-staining beverages. To help counteract existing stains, consider using fluoride toothpaste that also whitens teeth, or ask your dentist about whitening treatments to help reverse any damage.
• Drink plenty of water. It's healthy, it's free, it's widely available, and it's great for your oral health — so try to carry a water bottle with you everywhere and sip all day long. "Drinking water is also one of the best things you can do for your teeth, especially if it’s fluoridated," Harms says. Fluoride is considered "nature's cavity fighter," according to the ADA. It helps strengthen your teeth and ward off tooth decay. Water also helps keep your mouth moist and clean and washes away food particles that bacteria feed on.
• Chew sugar-free gum. It's always beneficial to brush between meals, but if you can't get to a sink, chew sugar-free gum. "Chewing sugarless gum increases the flow of saliva, which washes away food and other debris, neutralizes acids produced by bacteria in the mouth, and provides disease-fighting substances throughout the mouth," Harms says. "Increased saliva flow also carries with it more calcium and phosphate to help strengthen tooth enamel." Opt for gum with a seal from the ADA on the package to be sure it's sugar-free.
• See your dentist regularly. Be sure to get regular cleanings and checkups in order to spot dental problems before they get out of hand. Early diagnosis and treatment of dental issues is often simpler and more affordable, Harms says, and regular dental visits can help prevent many problems from developing. "Visiting your dentist is also important because some diseases or medical conditions have symptoms that can appear in the mouth," she says. Schedule regular checkups with your dentist so your smile is bright, white, and healthy, and to know you're doing all you can for your teeth.

If you are overdue for a dental cleaning, please contact our Tacoma Dentist today.

What is Gum Disease?

Gum disease is an inflammation of the gums that can progress to affect the bone that surrounds and supports your teeth. It is caused by the bacteria in plaque, a sticky, colorless film that constantly forms on your teeth. If not removed through daily brushing and flossing, plaque can build up and the bacteria infect not only your gums and teeth, but eventually the gum tissue and bone that support the teeth. This can cause them to become loose, fall out or have to be removed by a dentist.

There are three stages of gum disease:

• Gingivitis: this is the earliest stage of gum disease, an inflammation of the gums caused by plaque buildup at the gumline. If daily brushing and flossing do not remove the plaque, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. You may notice some bleeding during brushing and flossing. At this early stage in gum disease, damage can be improved, since the bone and connective tissue that hold the teeth in place are not yet affected.
• Periodontitis: at this stage, the supporting bone and fibers that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gumline, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.
• Advanced Periodontitis: in this final stage of gum disease, the fibers and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, if aggressive treatment can't save them, teeth may need to be removed.

How do I Know if I Have Gum Disease?

Gum disease can occur at any age, but it is most common among adults. If detected in its early stages, gum disease can be improved so see your dentist if you notice any of the following symptoms:

• Gums that are red, puffy or swollen, or tender
• Gums that bleed during brushing or flossing
• Teeth that look longer because your gums have receded
• Gums that have separated, or pulled away, from your teeth, creating a pocket
• Changes in the way your teeth fit together when you bite
• Pus coming from between your teeth and gums
• Constant bad breath or a bad taste in your mouth

How is Gum Disease Treated?

• The early stages of gum disease can often improve with proper brushing and flossing. Good oral health will help keep plaque from building up.
• A professional cleaning by your dentist or hygienist is the only way to remove plaque that has built up and hardened into tartar. Your dentist or hygienist will clean or "scale" your teeth to remove the tartar above and below the gumline. If your condition is more severe, a root planing procedure may be performed. Root planing helps to smooth irregularities on the roots of the teeth making it more difficult for plaque to deposit there.

By scheduling regular checkups, early stage gum disease can be treated before it leads to a much more serious condition. If your condition is more advanced, treatment in Tacoma dentist office will be required.

Jennifer Flach was a college junior when her wisdom teeth started making themselves known.

"My other teeth started moving around," she remembers. "The wisdom teeth were pushing out and undoing some of the orthodontic work I had done in high school."

At the same time, her brother — who's two years younger and was also in college — had no symptoms. But the family dentist suggested his wisdom teeth should come out too.

Jen and her brother had back-to-back wisdom tooth extractions and recovered together at home during spring break. "It was quite a week at my parents' house," she says.

Patrick Grother was 26 when his dentist mentioned that his wisdom teeth might need to be removed. His bottom left wisdom tooth had partially erupted into his mouth and a flap of gum still covered it. "The dentist said food would get trapped there and it could get infected," he says. Patrick then visited a periodontist, who said that the gum flap could be cut away but it would grow back.

"I put it off for awhile," Patrick said, but he eventually had the wisdom teeth on the left side of his mouth extracted.



A few people are born without wisdom teeth or have room in their mouths for them, but like Jen and her brother, many of us get our wisdom teeth taken out during our college years. And like Patrick, many of us are first alerted to the problem when our wisdom teeth don't emerge (erupt) into the mouth properly because there is not enough toom for them to fit.

"A part of the tooth may remain covered by a flap of gum, where food particles and bacteria can get trapped, causing a mild irritation, a low-grade infection called pericoronitis and swelling," says Dr. Donald Sadowsky, professor emeritus of clinical dentistry College of Dental Medicine and the Mailman School of Public Health. This usually happens with the lower wisdom teeth. Pericoronitis and the pain it causes is the most common reason people need their wisdom teeth taken out.

Pericoronitis is just one of the reasons that you may need to have a wisdom tooth or more than one removed.

In many people, the wisdom teeth never even partially enter the mouth. Often the teeth are tilted under the gum and blocked from coming in by bone or other teeth. Dentists call these impacted teeth; they may cause pain, but you may feel nothing at all for years. You may not even be aware that you have wisdom teeth until your dentist sees them on an X-ray.

Regular dental visits are important during your teens and early twenties because this is the time when teeth are most likely to decay. Regular visits allow your dentist to follow the progress of your wisdom teeth with X-rays.

Even if your wisdom teeth aren't causing any pain or other problems, they may cause problems at some point. The most common problems are decay, infection, and crowding or damage to other teeth. But more serious complications can occur, including the development of a cyst that can cause permanent damage to bone, teeth and nerves.

However, not all wisdom teeth need to be removed.

If removing wisdom teeth is necessary, it's easier in younger people because the tooth roots are not fully developed and the bone in which the teeth sit is less dense. Extracting your wisdom teeth before any complications develop also allows for shorter recovery time and less discomfort after the surgery.

Teeth for a Lifetime

Thanks to better at-home care and in-office dental treatments, more people than ever before are keeping their teeth throughout their lives. Although some diseases and conditions can make dental disease and tooth loss more likely, most of us have a good deal of control over whether we keep our teeth into old age.

The most important thing you can do to maintain good oral health is to brush and floss your teeth regularly.

Most mouth woes are caused by plaque, that sticky layer of microorganisms, food particles and other organic matter that forms on your teeth. Bacteria in plaque produce acids that cause cavities. Plaque also leads to periodontal (gum) disease, a potentially serious infection that can erode bone and destroy the tissues surrounding teeth.

The best defense is to remove plaque daily before it has a chance to build up and cause problems. Brushing removes plaque from the large surfaces of the teeth and, if done correctly, from just under the gums. Flossing removes plaque between teeth.

Brushing

Most of us learned to brush our teeth when we were children and have kept the same technique throughout our lives. Unfortunately, many of us learned the wrong way. Even if we learned the correct method, it's easy to become sloppy over the years. Brushing correctly isn't instinctive. Getting the bristles to remove plaque without damaging your gums is a little trickier than you might think.

There are different ways to brush teeth, and your dentist or dental hygienist can show you the method that he or she feels would be best for you. The modified Bass technique is among the most popular for adults and is very effective in removing plaque above and just below the gum line. Children, however, may find it difficult to move the toothbrush this way. A dentist or dental hygienist can explain to your child the best way to brush. Parents should supervise their children's oral hygiene until age 9 or 10.

Here are a few general pointers about brushing:

• Brush at least twice a day: Many oral health professionals recommend brushing just before going to bed. When you sleep, saliva decreases, leaving the teeth more vulnerable to bacterial acids. Teeth should also be brushed in the morning, either before or after breakfast, depending on your schedule. After breakfast is ideal so food particles are removed. But if you eat in your car, at work or skip breakfast entirely, make sure you brush in the morning to get rid of the plaque that built up overnight.
• Brush no more than three times a day: Brushing after lunch will give you a good mid-day cleaning. Remember, though, that brushing too often can cause gums to recede over time. Brush lightly —Brushing too hard can cause gums to recede. Plaque attaches to teeth like jam sticks to a wooden spoon. It can't be totally removed by rinsing, but just a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can't remove it, so brushing harder won't help. Try holding your toothbrush the same way you hold a pen. This encourages a lighter stroke.
• Brush for at least two minutes: Set a timer if you have to, but don't skimp on brushing time. Longer is fine, but two minutes is the minimum time needed to adequately clean all your teeth. Many people brush for the length of a song on the radio. That acts as a good reminder to brush each tooth thoroughly.
• Have a standard routine for brushing: Try to brush your teeth in the same order every day. Some oral health professionals feel that this helps patients remember to brush all areas of their mouths. If you do this routinely, it eventually will become second nature. For example, brush the outer sides of your teeth from left to right across the top then move to the inside and brush rights to left. Repeat the pattern for your lower teeth.
• Always use a toothbrush with "soft" or "extra soft" bristles: The harder the brush, the greater the risk of harming gum tissue.
• Change your toothbrush regularly: As soon as the bristles begin to splay, the toothbrush loses its ability to clean properly. Throw away your old toothbrush after three months or when the bristles flare, whichever comes first. If you find your bristles flaring much sooner than three months, you may be brushing too hard. Try easing up.
• Electric is fine, but not always necessary: Electric or power-assisted toothbrushes are a fine alternative to manual brushes. They are especially useful for people who are less than diligent about proper brushing technique or for people with physical limitations that make brushing difficult. As with manual brushes, choose soft bristles, brush for at least two minutes and don't press too hard or you'll damage your gums.
• Choose the right toothpaste for you: It can be overwhelming to face the huge number of toothpaste choices in the average supermarket. Remember, the best toothpaste for you may not be the best toothpaste for someone else.

Toothpastes don't merely clean teeth anymore. Different types have special ingredients for preventing decay, plaque control, tartar control, whitening, gum care or desensitizing teeth.

Most toothpastes on the market today contain fluoride, which has been proven to prevent, stop or even reverse the decay process. Tartar-control toothpastes are useful for people who tend to build up tartar quickly, while someone who gets tooth stains may want a whitening toothpaste. Whitening toothpastes will remove only surface stains, such as those caused by smoking, tea or coffee. To whiten teeth that are stained at a deeper level, talk with your dentist.

Your needs will likely change as you get older, so don't be surprised if your hygienist recommends a type of toothpaste you haven't used before. Look for the ADA seal of approval, which assures that the toothpaste has met the standards set by the American Dental Association. Once these conditions are met, choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint — these work alike, so let personal preference guide your decision.

Some people find that some toothpaste ingredients irritate their teeth, cheeks or lips. If your teeth have become more sensitive or your mouth is irritated after brushing, try changing toothpastes. If the problem continues, see your dentist.

Flossing

Many people never learned to floss as children. But flossing is critical to healthy gums and it's never too late to start. A common rule of thumb says that any difficult new habit becomes second nature after only three weeks. If you have difficulty figuring out what to do, ask your dentist or dental hygienist to give you a personal lesson.

Here are a few general pointers about flossing:

• Floss once a day: Although there is no research to recommend an optimum number of times to floss, most dentists recommend a thorough flossing at least once a day. If you tend to get food trapped between teeth, flossing more often can help remove it.
• Take your time: Flossing requires a certain amount of dexterity and thought. Don't rush.
• Choose your own time: Although most people find that just before bed is an ideal time, many oral health professionals recommend flossing any time that is most convenient to ensure that you will continue to floss regularly. Choose a time during the day when you can floss without haste.
• Don't skimp on the floss: Use as much as you need to clean both sides of every tooth with a fresh section of floss. In fact, you may need to floss one tooth several times (using fresh sections of floss) to remove all the food debris. Although there has been no research, some professionals think reusing sections of floss may redistribute bacteria pulled off one tooth onto another tooth.
• Choose the type that works best for you: There are many different types of floss: waxed and unwaxed, flavored and unflavored, ribbon and thread. Try different varieties before settling on one. People with teeth that are closely spaced will find that waxed floss slides more easily into the tight space. There are tougher shred-resistant varieties that work well for people with rough edges that tend to catch and rip floss.

If you have any further questions regarding keeping your teeth healthy, please contact our Tacoma dentist today!

Any injury to the gums or teeth can be very painful. In some cases, however, the cause of severe dental pain is not obvious. For example, pain that comes on suddenly may be caused by particles of food that got lodged in a cavity and have started to irritate the nerve inside the tooth. If you lose a filling or a crown, the nerve inside the tooth may be exposed, and you may feel severe pain when air or hot or cold substances touch the uncovered part of the tooth.

Pain that becomes more severe over a period of time is commonly caused by debris lodged under the gum. Popcorn is a common offender. Because the hard cellulose fibers of the popcorn kernel don't break down, it can remain stuck between your gum and your tooth. The longer a food particle stays trapped between the gum and tooth, the greater the chance the gum will become irritated and infected and the pain will get worse. If you develop an infection, called an abscess, it can become a serious health problem if left untreated.

Pain when you bite or chew, especially if it is accompanied by a foul odor and a bad taste, can be a sign of an abscess that needs immediate treatment.

What You Can Do

First, call your dentist and make an appointment.

In the meantime, here are a few steps you can take at home to try to relieve some of the pain:

• Take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). However, be aware that you need to see your dentist. If you mask the pain with a painkiller and ignore it, the infection can spread and could become life threatening.
• Rinse your mouth with warm water every hour or as needed to ease the pain.
• If the pain is caused by debris lodged in a cavity, washing the area may relieve the problem.
• Floss your teeth, then run a toothpick around the gum line. This may remove debris that's lodged under the gum.
• If you've lost a filling or crown, dip a cotton swab in clove oil and apply it to the exposed part of the tooth. Clove oil, available in pharmacies and supermarkets, works well to relieve tooth pain. You also can use a topical anesthetic, such as Anbesol, also available in pharmacies and supermarkets.
• Putting an ice pack on your face over the area that hurts also may relieve the pain. Apply the ice for 10 to 20 minutes of every hour, as necessary.
• If you will be traveling in an airplane, the change in pressure when the plane takes off or lands may make you feel more uncomfortable. You should get dental treatment before traveling by air.

What Our Tacoma Dentist Will Do

Even when dental problems cause a lot of pain, the problems — and the treatments — often are relatively simple if you seek help right away.

If you have a cavity, your dentist will clean out any debris, remove the decayed part of the tooth, and place a filling. Once the inner part of the tooth is protected, the pain will usually disappear immediately.

If your problem is related to debris under your gums, our dentist in Tacoma will use special instruments to remove the debris. If you have an infection, you may be given a prescription for antibiotics and pain medicine. If an antibiotic is prescribed, it is important that you take it as directed until you have finished all the medication.

An abscess in the tooth or gum may require more extensive treatment, such as drainage of the abscess, root canal treatment or tooth extraction.

To learn more about severe tooth pain, please call our Tacoma dentist office today!

If you’re serious about learning what’s causing your bad breath, consider scheduling an appointment with your dental professional. Given your full medical and dental history along with an oral examination, your dentist should be able to identify the culprit. The causes of bad breath are numerous and include certain foods, alcohol or cigarettes, poor oral hygiene, periodontal disease, diabetes, dry mouth, sinus or throat infections, lung infections or abscesses, kidney/liver failure, gastrointestinal issues and severe dieting.

Treatment of Bad Breath

It is important to conduct thorough oral hygiene at home twice daily utilizing tooth brushing with a fluoride antibacterial toothpaste and flossing to remove food debris and plaque on teeth, bridgework and implants, and brushing the tongue to remove odor-causing bacteria. A published study reported that tongue and tooth brushing in combination with dental flossing significantly decreased bleeding of the gum tissue over a two week period of time as well as reduced bad breath. Another clinical study conducted by the University of Buffalo dental researchers confirmed that brushing twice a day with an antibacterial toothpaste and using a tooth brush with a tongue cleaner can eliminate bad breath.

Tongue Cleaning is the Key to Fresher, Cleaner Breath

Cleaning your tongue is very important. You can purchase a Colgate 360 toothbrush with the tongue cleaner on the back of the toothbrush for cleaning both your teeth and tongue. After tooth brushing your upper and lower teeth with an antibacterial toothpaste, flip the toothbrush over to the tongue cleaner and place the tongue cleaner in the posterior region of the tongue and move it forward to the anterior section of the tongue. After you have scraped that portion of the tongue, rinse the tongue brush off with warm water to remove any odor causing bacteria. Then replace the tongue brush in the next posterior section again and repeat as described above again.

Consult your dentist or dental hygienist when choosing oral hygiene aids to help you eliminate plaque and odor causing bacteria and review the techniques that should be utilized at home. Also, ask your dental professional what oral hygiene care products they would consider you use to help eliminate bad breath (antibacterial toothpaste, antiseptic mouth rinse, tongue brushes or scrapers and interproximal cleaning devices). The key to a clean, fresh mouth is optimal oral hygiene conducted at home on a regular basis and professional recommendations discussed with you by your dentist.

How Do I Know if I Need Treatment?

As with any trauma to the mouth, you should consult with your dentist immediately to determine if treatment is required. The dentist will examine the affected area and may take X-rays.

If you are in pain from a broken, cracked or chipped tooth, you may want to take an over-the-counter pain reliever. If possible, keep any part of the tooth that has broken off and take this with you to the dentist. If a tooth is completely knocked out of the mouth by an injury, take the tooth to your dentist as soon as possible. It may be possible for your tooth to be placed back into your mouth, a procedure called reimplantation.

How Does a Dentist Treat a

• Chipped tooth —If there is no pain and the chip is small, it's up to you to decide if, when and how the tooth should be repaired. Depending on the size of the chip, it can be smoothed or cosmetically corrected. Other options include veneers, crowns and fillings. Ask your Tacoma dentist to explain these options. If a filling or artificial tooth becomes chipped, it should be replaced.
  
  
• Cracked or broken tooth —Cracked and broken teeth should be repaired as soon as possible to prevent further damage. Root canal therapy or tooth extraction may be necessary. If a crack affects the enamel and dentin of the tooth, a crown is frequently the best treatment. Keep in mind that cracks are not always visible, even on X-rays. Symptoms may involve pain while chewing and Sensitivity to cold and possibly hot foods and liquids, as well as air, which may over time become more pronounced.
  
  
• Tooth knocked out —The key to successfully reattaching a tooth is to get it reimplanted in the socket as soon as possible. With each minute that passes, more of the cells on the root of the tooth die. If possible, rinse the tooth with water only, then reimplant the tooth at the site and hurry to a dentist as quickly as possible. The tooth should be picked up by the crown only and must not be allowed to dry. The best chance for success is reimplantation within the first 30 minutes, with chances still good for up to two hours. It may be necessary for your dentist to do a Root canal treatment one to two weeks after the tooth has been stabilized.
  
  
• Permanently lost teeth, whether they've been removed by a dentist or accidentally knocked out, should be replaced. This is to avoid problems such as difficulty chewing and speaking, a shifting of position among remaining teeth, temporomandibular joint (TMJ) disorders caused by chewing on the side with more teeth, and a weakening of the jawbone. Options for replacing lost teeth include bridges, dentures and implants.
  
  
• Broken jaw —If you suspect you or someone else has a broken jaw, do not move it. The jaw should be secured in place with a handkerchief, necktie or towel tied around the jaw and over the top of the head. Cold compresses should be used to reduce swelling, if present. Go immediately to a hospital emergency room, or call your dentist.
  
  

If you have any emergencies or concerns, please contact our Tacoma dentist today!

It is estimated that 35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease. This infection attacks the tissue that keeps your teeth attached to your gums.

On average, more than 500 species of bacteria live in your mouth.2 Some of these bacteria are beneficial, while others under the right conditions can cause disease. Living a healthy lifestyle helps you keep the harmful bacteria under control. Not taking care of your overall health and your teeth and gums can cause an overgrowth of harmful bacteria, which may lead to serious health problems beyond the mouth, in addition to the threat of losing your teeth.

35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease

Factors that predispose people to gum disease include bad oral hygiene and genetics. In fact, research has proved that up to 30% of the population may be genetically predisposed to gum disease.3

Periodontitis, a severe form of periodontal disease, is caused by plaque that develops just below the gum line, in the area called the sulcus or periodontal pocket, where it causes the attachment of the tooth and its supporting tissues to break down. The mildest form of periodontal disease is known as gingivitis and is triggered by bacterial plaque that forms at the gum line.

What Is Periodontal Disease?

Periodontal disease is an infection of the tissue that supports your teeth. It attacks just below the gum line, where it causes the attachment of the tooth and its supporting tissues to break down.


WARNING SIGNS

• Pain in the mouth
• Gums bleed when brushing
• Spaces develop between teeth
• Swollen and tender gums
• Receding gums (exposing the bottom of your teeth)
• Persistent bad breath
• Pus between teeth and gums
• Sores develop

RISK FACTORS

• Tobacco use
• Systemic diseases
• Use of certain types of medicine
• Bridges that no longer fit
• Crooked teeth
• Fillings that have become defective
• Pregnancy
• Oral cancer

If you're showing warning signs, see your Tacoma dentist. Mild gum disease may be controlled by routine professional teeth cleanings and more diligent home care. Gingivitis and early periodontitis can be kept under control by your dental team.

Scaling and root planing also may be a step your dentist or hygienist takes to control early to moderate periodontitis. Scaling removes hard and soft deposits of calculus from the crown of the tooth. Root planing smooths away calculus deposits that collect on the root surfaces beneath the gums.1

Local, needle-free methods are available to keep you comfortable during this process. Your dental professional may also choose to perform this treatment one area of your mouth at a time over a series of office visits.

For advanced gum diseases, surgical treatments using local anesthetics may be performed. To reduce the size of gingival pockets, a periodontist folds back the gum tissue and removes the disease causing bacteria. He or she may also reshape the bone and gum, add bone grafts if necessary, and then stitch the tissue back into place.

What is a Diastema and How do I Treat It?

A diastema is an area of extra space between two or more teeth. The two front teeth of the upper jaw area is where diastema is most frequently seen. Many children experience diastema as primary teeth fall out, though in most cases these spaces close when the permanent teeth erupt.

Diastemas may also be caused by a tooth size discrepancy, missing teeth or an oversized labial frenum, the tissue that extends from the inside of the lip to the gum tissue where the upper two front teeth are located. Secondary reasons involve oral alignment issues such as an overjet or protrusion of the teeth.1

What are My Treatment Options?

Once your dentist or dental specialist has determined the reason for your diastema, a treatment plan will be discussed. Options may include:

• Keep the diastema.
  
  
• Orthodontic treatment to move the teeth and close the diastema.
  
  
• Use porcelain veneers, very thin pieces of porcelain bonded to the outside of the teeth.
  
  
• Crown and bridge work or replacement of teeth with implants (adults only).
  
  

If you have an oversized labial frenum, you may be referred to a periodontist for an oral consultation and surgical procedure called a frenectomy. This procedure involves cutting the frenum and then repositioning to allow for more flexibility. If the frenectomy is conducted on a child, the space may close by itself. If it is a teenager or adult, the space may need to be closed with braces. A consultation with your dentist is essential to determine which option is the right option to treatment for you.

If you're having diastemas and looking for a treatment option, please contact our Tacoma dentist today!

According to the Academy of General Dentistry, an increase in sugar intake may lead school children to a high risk of cavities.

In the past 15 months, researchers have studied dietary habits of preschoolers and have monitored their teeth, and the study showed that cavity-free children dropped from 23 to 19 percent.

Our dentists in Tacoma recommend that parents can help their children prevent decay and cavities by monitoring their dietary habits. Instead of giving them snacks, they can have apples, carrots and other snack alternatives—something that are naturally sweet.

And more importantly, children should brush and floss at least twice a day to prevent decay and cavities.

If your children’s school lunch program doesn’t offer healthy alternatives, make sure to talk to the school about incorporating healthy lunches or snacks.

Finally, children may need sealants as another way to prevent decay and cavities. Sealant is a thin coating of bonding material applied on a tooth, and it acts as a barrier to decay and cavities.

Talk to your dentist in Tacoma at Light Dental Studios of Tacoma to learn more about dental sealants.

Toothpastes

So many toothpastes are on the market today, choosing one can be confusing. When buying toothpaste for your child, look for one that contains fluoride and tastes good. Some toothpastes also are approved by the American Dental Association (ADA). The ADA Seal of Acceptance means that the manufacturer has provided data proving that the toothpaste is safe and effective. Some manufacturers choose not to seek the ADA seal of approval. So, toothpastes without the ADA seal also may be safe and work well, but their performance has not been evaluated by the ADA.

Children only need a small pea-size amount of toothpaste on their toothbrushes. Be sure your child understands that toothpaste is not food. It needs to be spit out, not swallowed.

Toothbrushes

The type of toothbrush your child uses is important because the wrong kind can be damaging to soft tissues. Regardless of your child's age, his or her toothbrush should have soft nylon bristles. Harder bristles can cause gums to wear away over time. When your child is an infant, the toothbrush should be very small. As he or she grows, select small toothbrushes that can fit easily in the mouth and brush one or two teeth at a time. Your child's toothbrush should be able to reach all the teeth, including the molars in the very back.

Replace toothbrushes about every four months or when they begin to look worn and frayed. If a toothbrush wears out much sooner than three or four months, you or your child may be using too much pressure. It's also a good idea to replace brushes after your child has had a cold or other illness to prevent reinfection.

Powered toothbrushes are fun and may remove more plaque and stain than regular toothbrushes. That doesn't mean you should run out and buy one. Regular toothbrushes are very effective, too. However, because they make brushing easier, powered toothbrushes can be helpful for special needs children who can't sit still long enough to properly brush their teeth with a regular toothbrush.

Water Irrigation Devices

These appliances usually are not necessary, but they may benefit some children with braces or other type of orthodontics who need help getting food from between teeth. However, these devices do not remove plaque that is firmly attached to the tooth. That still needs to be done with a toothbrush.

Mouthwashes And Fluoride Mouth Rinses

Mouthwash and fluoride mouth rinse are two different products. Mouthwash freshens breath, but does nothing to clean teeth. Most mouthwashes contain alcohol and are not appropriate for children younger than 6 years old. This is because young children can easily swallow the mouthwash. If your child has chronic bad breath, he or she should see a doctor. It could be caused by a health problem.

Fluoride mouth rinse coats teeth with fluoride, which helps to prevent cavities. You should check with your child's dentist or dental hygienist to determine if your child needs to use a fluoride mouth rinse. It is typically used once or twice a day by children who are cavity prone, even if the child has only one area of decay. Children as young as 7 years old can use a fluoride rinse, if they know how to spit out a liquid without swallowing it. You can test your child to see if he or she is ready. Give him or her a half-cup of water. Ask your child to put some of the water in his or her mouth, swish it around and spit it out into a second cup. If there is a half cup of water in the second cup, your child probably can spit out the mouth rinse. You should still supervise your child to make sure the rinse does not get swallowed.

For more information about your kids' oral health, please contact our Tacoma dentist, Light Dental Studios of Tacoma Mall Blvd today!

Importance of the primary dentition

Primary teeth start to erupt in children from the age of six months. The primary dentition is complete by approximately two and a half years of age. The enamel of primary teeth is less densely mineralized than the enamel of permanent teeth, making them particularly susceptible to caries. Primary teeth are essential tools, both for chewing and learning to talk. They help to break up food into small pieces, thereby ensuring efficient digestion. A full set of teeth is an essential prerequisite in learning correct pronunciation. Primary teeth also play a vital role in the proper alignment and spacing of permanent teeth; it is therefore imperative that they are well cared for and preserved until normal ex-foliation takes place.

Establishing a proper oral care routine early on in life sets the foundation for the development of healthy and strong permanent teeth. In addition to good oral hygiene, diet also plays a key role in keeping teeth healthy. In this respect it is not only the quantity of sugar that is important, but also the frequency of consumption. As much as possible, children should be limited in the amount of sweets between meals, especially in the evening or at night.

New permanent teeth

Although permanent teeth are already partly formed in children aged 0 to 3 years, eruption only occurs later in life (from about 6 years on) when the 32 permanent teeth (16 in the upper and 16 in the lower jaw) replace the 20 primary teeth. During this time root resorption and crown shedding of primary teeth take place. With the eruption of the first permanent teeth (from about 6 years on), the mouth contains a mixture of both primary and permanent teeth, which puts children at increased risk of caries. Often the eruption of this permanent tooth is not realized neither by the child nor by the parents, because it is positioned behind the last primary molar and is not replacing any primary tooth. Although enamel is fully formed at eruption the surface remains porous and is inadequately mineralized. Subsequently, a secondary mineralization occurs (second maturation), in which ions from the oral cavity penetrate hydroxyapatite and increase the resistance of the enamel against caries. Furthermore, any primary teeth with caries form reservoirs of bacteria, which can easily attack the immature enamel of the new permanent teeth. During the eruption, the occlusal surfaces of the new permanent teeth are on a lower level than the primary teeth. Toothbrushing becomes more difficult than before, given the coexistence of loose primary teeth, gaps and newly erupting permanent teeth. The jaw is also growing significantly, making space for more teeth. The cleaning of the narrower interdental spaces becomes more important with increasing numbers of permanent teeth.

Role of Parents

Parents have a key role in helping their children to develop a proper oral hygiene routine in the first years of their life. Parents should lead and supervise their children’s toothbrushing approximately for the first 12 years, until motor and mental functions allow the child to routinely perform a proper toothbrushing technique alone. After brushing the teeth for their children for the first 2 years of life, parents will have to use playful motivation to encourage their children to brush their own teeth from about 3 years onwards – the time when children want to brush their teeth alone. Each time the child has finished brushing, parents should re-brush the hard-to-clean areas.

At the age of around 6 years, children are able to brush their teeth using a proper brushing technique. In this phase, parents have to continue supervising the regular brushing efforts of their children. The special anatomical situation of changing dentition makes it indispensable that parents still need to help their children in the daily toothbrushing task until eruption of the second molar (around the age of 12).

Development stages of children from the age 0-12

As soon as the first primary teeth erupt into the oral cavity, parents should begin brushing their children’s teeth. From the age of two years, teeth should be brushed twice daily with smaller than a pea-size amount of children’s toothpaste. Small children tend to swallow a large amount of toothpaste, so that there is a risk of developing dental fluorosis. Supervised application of the amount of toothpaste to the toothbrush is important. Due to the risk of fluorosis, the fluoride content of toothpaste for children up to the age of 5–7 years was reduced in most European countries (250 ppm to 750 ppm). Beginning with the eruption of the new permanent teeth, children should be switched from a low fluoride containing children’s toothpaste to a higher fluoride containing toothpaste (1000 ppm to 1500 ppm). This ensures the best caries protection as possible for their new permanent teeth.

Toothpaste Use

Toothpaste with an age adapted content of fluoride is recommended

Primary teeth should be brushed by parents twice a day from the first tooth onwards. Parents should re-brush thoroughly after the child has brushed first. From the age of 6 years children have the ability to brush their teeth alone twice daily. However, parents must supervise the toothbrushing (until the age of 12) and check on the condition of the toothbrush. A worn toothbrush is also less effective at cleaning teeth.

For more information about pediatric dentistry, contact our Tacoma dentist, Light Dental Studios of Tacoma Mall Blvd today!

What Is It?

The temporomandibular joint (TMJ), located just in front of the lower part of the ear, allows the lower jaw to move. The TMJ is a ball-and-socket joint, just like the hip or shoulder. When the mouth opens wide, the ball (called the condyle) comes out of the socket and moves forward, going back into place when the mouth closes. TMJ becomes dislocated when the condyle moves too far and gets stuck in front of a bony prominence called the articular eminence. The condyle can't move back into place. This happens most often when the ligaments that normally keep the condyle in place are somewhat loose, allowing the condyle to move beyond the articular eminence. The surrounding muscles often go into spasm and hold the condyle in the dislocated position.

Symptoms

The jaw locks in an open position and you cannot close your mouth. The condition can cause significant discomfort until the joint returns to the proper position.

Diagnosis

The dentist bases the diagnosis on the position of the jaw and the person's inability to close his or her mouth.

Expected Duration

The problem remains until the joint is moved back into place. However, the area can be tender for a few days.

Prevention

TMJ dislocation can continue to happen in people with loose TMJ ligaments. To keep this from happening too often, dentists recommend that people limit the range of motion of their jaws, for example by placing their fist under their chin when they yawn to keep from opening their mouths too widely. Conservative surgical treatments can help to prevent the problem from returning. Some people have their jaws are wired shut for a period of time, which causes the ligaments to become less flexible and restricts their movement. In certain cases, surgery may be necessary. One procedure, called an eminectomy, removes the articular eminence so the ball of the joint no longer gets stuck in front of it. Another procedure involves injecting medications into the TMJ ligaments to tighten them.

Treatment

The muscles surrounding the temporomandibular joint need to relax so that the condyle can return to its normal position. Many people can have their dislocated jaw corrected without local anesthetics or muscled relaxants. However, some people need an injection of local anesthesia in the jaw joint, followed by a muscle relaxant to relax the spasms. The muscle relaxant is given intravenously (into a vein in the arm). Rarely, someone may need a general anesthetic in the operating room to have the dislocation corrected. In this case, it may be necessary to wire the jaws shut or use elastics between the top and bottom teeth to limit the movement of the jaw.

To move the condyle back into the correct position, a doctor or dentist will pull the lower jaw downward and tip the chin upward to free the condyle . The doctor or dentist then guides the ball back into the socket. After the joint is relocated, a soft or liquid diet is recommended for several days to minimize jaw movement and stress. People should avoid foods that are hard to chew, such as tough meats, carrots, hard candies or ice cubes, and be careful not to open their mouths too widely.

For more information about TMJ disorders, please contact the Tacoma dentist office, Light Dental Studios today!