There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.
As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.
Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.
There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.
Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.
If you would like more information on surgical procedures for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Surgery: Where Art Meets Science.”
Do you avoid smiling because your teeth are stained? Just one professional teeth whitening session can dramatically improve the appearance of your dull teeth. Kona, HI, dentist Dr. Garrett Oka shares some information on the whitening process.
How does whitening eliminate stains?
Stains can be a natural part of aging or may occur when dark pigments from tobacco, foods and beverages sink deep into the pores of your tooth enamel. When stains penetrate your enamel, no amount of brushing will remove them. Getting rid of those stains requires hydrogen peroxide, a very effective stain buster.
Hydrogen peroxide targets the darkly colored pigments and breaks them apart, effectively eliminating stains. The chemical compound is the active ingredient in both over-the-counter and professional whitening agents. Because drugstore whitening kits contain a weak formulation of hydrogen peroxide, it may take a few weeks or months until the product begins to produce results. Professional-strength hydrogen peroxide used by dental offices offers much quicker results, which is an important consideration if you know you won't have the patience to follow through with do-it-yourself whitening.
How long does professional teeth whitening take?
When you visit our Kona office, you can choose from in-office or at-home whitening. Both options offer impressive results, although an in-office session whitens your teeth in about an hour, while you'll need to use take-home trays and whitening gel for a few weeks to achieve maximum whitening.
How can I keep my teeth white and bright after whitening?
Avoiding the things that originally caused your stains can help you maintain your results for several years. Quit smoking and avoid or limit these foods and beverages:
If you do happen to notice that your teeth are beginning to look a little dull, you can touch them up with at-home whitening gels and trays provided by our office. Regular brushing and flossing will also keep your teeth looking their best.
Teeth whitening can give you the bright smile you deserve. Call Kona, HI, dentist Dr. Garrett Oka at (808) 329-0889 to schedule your appointment.
Your teeth and gums have a highly sensitive network of nerves. But while it can signal even the most subtle discomfort we may not be able to identify the cause with pinpoint accuracy. As a result, tooth pain could indicate more than one kind of problem including a decayed tooth, root sensitivity, infected gum tissues (like an abscess) or a dying pulp signaled by diseased nerve tissue inside the tooth.
On the other hand, not all tooth pain is the same: it can be dull or sharp, continuous or intermittent. It can feel like a constant, throbbing ache or a sharp wince when you eat or drink something cold or hot, or when you bite down. These differences could point our diagnostic examination in the right direction.
For example, sharp, throbbing pain could indicate deep tooth decay, especially if it suddenly stops. That would likely mean the nerves within the tooth pulp under attack by the infection have died and can no longer transmit pain. The infection, on the other hand is still very much active — this usually requires a root canal treatment (cleaning out the pulp and root canals of diseased and dead tissue and filling the empty spaces) if we’re to save the tooth.
If, however, you’re experiencing sensitivity from temperature or pressure, we could be facing at least a couple of scenarios. For one, your tooth could be fractured. More likely, though, periodontal (gum) disease triggered by bacterial plaque has caused the gum tissues to shrink back (recede) from the affected teeth so that the sensitive dentin layer is exposed and no longer protected by the gum tissue.
If we diagnose gum disease, we’ll need to aggressively remove bacterial plaque from all tooth and gum surfaces. This procedure might require more than one appointment and the possibility of surgery if we encounter deep pockets of infection, especially around the roots. If gum recession is severe you may also need grafting surgery to replace the missing gum tissue or to re-cover the exposed areas of your teeth.
So, knowing the source of tooth pain will direct the course of treatment to follow. With proper treatment, though, the chances are good we can not only restore your teeth and gums to optimum health but we can end the pain.
If you would like more information on treating tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”