Did you know that part of your dental checkup at Pasha Dental deals with having an oral cancer screening? You may be wondering why it is important to be screened for oral cancer because it is so rare. Contrary to popular belief, however, oral cancer is not as rare as it once was and there has been an increase in the number of oral cancer cases each year. 

In fact, The Oral Cancer Foundation estimates that about 145 people a day will be diagnosed with oral cancer. In the year 2019 alone, this is about 53,000 Americans. Because dentists are devoted to preserving oral health, many have begun incorporating oral cancer screening during regular checkups. Unfortunately, however, there is currently no national screening policy in the United States. 

Not only does Pasha Dental perform oral cancer screenings during regular dental checkups, but we have compiled a brief guide on oral cancer to keep our patients informed. At Pasha Dental, we believe that education is an important part of dental treatment and the maintenance of oral health. While any specific concerns should be addressed with Dr. Pasha during your dental consultation, here is some general information about oral cancer and what to expect during a screening. 

What is Oral Cancer?

Oral cancer, also known as oropharyngeal cancer or mouth cancer, is a broad term used to describe any type of cancer that affects the oral or pharyngeal region. Specifically oral cancer can affect the lips, gums, tongue, inner lining of the cheeks, hard/soft palates, salivary glands, tonsils, or the pharynx. 

Depending on the location of the cancer, there are a variety of symptoms that can be associated with oral cancer, including: 

What Causes Oral Cancer?

The most common cause of oral cancer is the Human Papillomavirus (HPV). In fact, the Centers for Disease Control (CDC) estimates that 79 million Americans are infected with HPV. Although most cases of HPV usually resolve themselves without any major complications, in some cases the virus remains in the body and leads to cancer later in life. 

HPV

It is currently estimated that HPV is responsible for about 70% of all oral cancer cases. A report from the Department of Health and Human Services (HHS) has also found that the number of oral cancer cases caused by HPV has doubled from the year 1999 to the year 2015. Furthermore, oral cancer caused by HPV is one of the fastest-growing segments of oral cancer. 

Another common cause of oral cancer is tobacco use through chewing tobacco, smoking, and vaping. It is no secret that smoking causes cancer, and oral cancer is only one type of cancer it can cause. The chemicals in tobacco smoke weaken the body’s immune system and can even damage or change a cell’s DNA, causing a cancerous tumor. 

However, many people now opt for electronic cigarettes as healthier alternatives to smoking. These electronic cigarettes can go by many names, such as: e-cigarettes, e-cigs, electronic nicotine delivery systems (ENDS), alternative nicotine delivery systems (ANDS), e-hookahs, mods, vape pens, vaporizers, vapes, and tank systems.  

Hand holding a vape surrounded in smoke

The main difference between traditional cigarettes and these more “modernized” cigarettes is that an individual in inhaling a vapor created by a heated liquid, usually accompanied with a flavor. Although they still contain nicotine, e-cigs do not burn tobacco. For this reason, they are believed to be “safer” than traditional cigarettes. 

Nevertheless, vaping or smoking e-cigs is still considered harmful to your oral health and Dr. Pasha considers them to be just as harmful as smoking traditional cigarettes. The vaporized liquid can increase your risk for tooth decay, as well as irritate the soft tissues within you mouth, making them more susceptible to developing oral cancer. Additionally, the vaporized liquid delivers carcinogenic materials directly to the hard and soft tissues of your mouth. 

Oral Cancer Screenings: 

To protect you and your family from oral cancer, Pasha Dental performs regular oral cancer screenings to identify possible cases early on. When detected in the early stages, oral cancer has an 80-90% survival rate as compared to the 43% fatality rate at five years when diagnosed in the later stages. This is one reason, among many, that regular dental checkups at Pasha Dental are so important. 

An oral cancer screening at Pasha Dental consists of a visual exam, physical exam, and the possible use of specialized screening devices. Prior to the exams, all dental appliances must be removed from the mouth so that Dr. Pasha can have an unobstructed view of everything. 

Close up of a dental mirror inside a patient's mouth

To start the visual exam, Dr. Pasha will carefully evaluate the inside and outside of the mouth, as well as the throat. He will look for any tissue abnormalities such as swelling, asymmetry, bumps, irregular coloration, or ulcerations. During this phase, he will likely use a light and a dental mirror to carefully visualize each structure. He may also use a tongue depressor to expose areas in the back of your mouth. 

During the physical portion of the exam, which may take place during or after the visual exam, Dr. Pasha will gently palpate the head, cheeks, jaw, under the chin, and within the oral cavity to check for nodules, masses, or sources of pain. He may also check your jaw and swallowing functions. 

Doctor's hands checking a woman's lymph nodes

In some cases, a special blue light or an acidic mouthwash may be used to obtain better visualization of certain areas. The blue light works by highlighting damaged tissues and the mouthwash works in a similar way by gathering around damaged tissue. Both methods can quickly signal the presence of tissues that require further testing. 

It is important to note that your oral cancer screening is precautionary and not diagnostic. This means that everyone will receive a screening, whether or not oral cancer is suspected. It also means that if nothing abnormal is found, no further testing is needed. Finally, it can also mean that if something odd is found, you will likely be referred out for further testing. It is also important to note that being referred for further testing does not automatically mean you have oral cancer. Rather, it is simply to find out more about what is going on. 

To get yourself and your family screened for oral cancer, schedule a consultation with Dr. Pasha Javaheri Saatchi of Pasha Dental today for your dental care appointment. Pasha Dental is proud to provide dental services for residents in the Brooklyn, NY area as well as to residents of Staten Island, Queens, and Manhattan. 

As you are skimming through your calendar, you fill with dread as you notice that your six month dental appointment is coming up. With each passing day, you find yourself growing more and more anxious wondering why you have to go to the dentist at all. If this sounds like you, you’re not alone. In fact, 9-20% of Americans avoid going to the dentist because they are afraid. 

At Pasha Dental, we want your dental experience to be the best that it can be. While no one necessarily “looks forward” to their dental appointment, we at Pasha Dental have done everything we can to ensure that at the very least, you won’t dread it. To help make things even easier for you, we have taken the time to compile this article about dental fear in the hopes that it will put you at ease before your next appointment. 

What is dental fear?

Many people suffer from what is known as “dental fear”. Dental fear can be exhibited in one of two ways: dental anxiety or dental phobia. With dental anxiety, patients are generally fearful of the dentist, but will still come in for appointments. Patients with dental anxiety may have trouble sleeping the night before their appointment, may feel increasingly nervous leading up to their appointment, may cry or feel physically ill at the thought of their appointment, or may experience shortness of breath during their exam. 

Woman looking fearful at dentist and covering her mouth

Dental phobia, however, is much more severe and usually results in the complete avoidance of dental appointments until the patient is in extreme pain and has no other option. Mental Health America defines notes that phobias, also known as anxiety disorders, “are not just a case of “nerves”. [One] can’t overcome an anxiety disorder just through willpower, nor can the symptoms be ignored or wished away”. 

It is also highly important to note that the Diagnostic and Statistical Manual of Mental Disorders (DSM) recognizes dental phobia as one of the specific phobias that currently affect 19 million Americans. The DSM categorizes dental phobia under mutilation. The other three categories for specific phobias include natural, animal, and situational. Because dental phobia is a recognized anxiety disorder, people with dental phobia generally need to consult a licensed mental health professional for help in managing their symptoms. 

What causes dental fear?

Dental fear can be caused by a number of different factors. Dentophobia and dental anxiety are often  related to fears of different sub-elements. Some people with dental fear will only fear one element, while others with extreme cases may fear every element equally. These sub-elements include: 

How to overcome dental fear:

Now that we know a little more about what dental fear is and what it’s caused by, let’s take a look at how we can overcome dental fear. 

Dentist having a discussion with female patient and both are looking at a tablet
Hypnotherapist using hypnosis to relax a patient

For an anxiety-free approach to dentistry, schedule a consultation with Dr. Pasha of Pasha Dental today!  Pasha Dental is proud to provide dental services for adults and children residing in the Brooklyn, NY area as well as to residents of Staten Island, Queens, and Manhattan. 

Everyone has heard about cavities. We also all know that we are supposed to brush our teeth twice a day and floss once a day to avoid them. But beyond that, what do we actually know about cavities? Do we actually know anything about cavities other than the fact that we don’t want them? While cavities may not be the most interesting topic to study, understanding more about them can definitely help provide you with some inspiration to practice daily dental hygiene and schedule those dental checkups you’ve been putting off. 

Let’s start at the beginning with the simple question about what is a cavity? Back in 1000 B.C, early Babalonian and Chinese civilizations believe that cavities were caused by a worm that drank the blood of teeth and ate the tooth roots. While their theory wasn’t entirely correct, it did have some level of truth to it. 

The simple definition of a cavity is just as it sounds: a cavity is a hole in your mouth. This hole in your mouth forms when acid erodes the tooth’s enamel and causes it to wear down. There are different types of cavities and the three most common are root, pit and fissure, and smooth-surface. 

Diagram showing the different types of cavities: smooth surface cavity, pit and fissure cavity, and root cavity

Root cavities form on the tooth’s roots and are common in seniors or those with gum recession. Pit and fissure cavities are commonly found on the rear molars within those grooves on the chewing surface of your teeth. This is a common location for cavities because food can easily get stuck within these grooves. Finally, smooth-surface cavities are those that form on the flat, exterior surfaces of teeth. Out of the three types of cavities, these are the slowest-forming and least common type. No matter the type, all these cavities are caused by acid formation. How does acid form in your mouth you might ask?

Acid is a waste product of the thousands of bacteria that reside in your mouth. These bacteria, known as streptococcus mutans, are able to feed off of the foods you eat and the beverages you drink. While everyone’s mouth contains bacteria, certain people may have less or more bacteria depending on their oral habits. The more bacteria your mouth has, the more acid is produced and the higher your risk of developing cavities is. 

This brings us to our next question of how do cavities form? This question does not have an easy answer, because cavities do not form as the result of a single action. This is why some people struggle with preventing cavities. Cavities form as a result of various factors such as the state of your teeth and saliva, the amount of bacteria in your mouth, the types of foods you eat, and the frequency that a cavity-friendly environment occurs in your mouth. 

A cavity-friendly environment refers to one that promotes the active growth of bacteria. Because bacteria must adhere to the tooth in order to cause tooth decay, a cavity-friendly environment is one that promotes plaque. Plaque, also known as dental plaque, is a film of saliva, food debris, and bacteria that sits over the tooth’s enamel. 

Once on your teeth, the bacteria will begin to consume any of the foods you eat, digesting it in as little as 15 minutes. Bacteria are especially drawn to carbohydrates and sugars because these are easily digestible, and tend to avoid foods like broccoli because cellulose is not as easily digestible. This is why eating healthier can improve your oral health, while eating lots of sugars can be detrimental. 

Microscopic image of the bacteria that cause tooth decay

Like any other living organism, what goes in the bacterium must come out. This is where it gets gross. After the bacteria eats, they will then defecate, or poop, into your mouth. This process is called an “acid attack” because bacteria defecate acids that can concentrate in a single area and destroy calcium. As several of these acid attacks are excreted over time, the area being attacked will begin to dissolve, giving way to a cavity. 

However, not all acid attacks directly lead to cavities. For a cavity to form, there has to be no disruption to the bacteria, meaning that the acid is constantly being applied to the same place. If, however, the bacteria are dislodged or even moved, then the acid is not applied to the same place. Depending on how much acid was present, the enamel has the potential ability to re-mineralize any dissolved areas. This is why daily brushing and flossing is important. 

But, why do we have to brush twice a day and why is recommended that we floss at night? Well, this is because our bodies do not produce saliva at night. During the day, we have a constant flow of saliva, which dilutes the acid and reduces its ability to dissolve enamel. At night, however, there is not a steady flow of saliva, which means the acid is not diluted and can render more damage. By brushing and flossing before bedtime, we remove plaque and decrease the severity of an overnight acid attack. 

Despite our best efforts, many adults will still develop cavities at some point in their lifetime. In fact the National Institute of Dental and Craniofacial Research notes that as many as 92% of adults ages 20-64 have had a dental cavity affecting their permanent teeth. They continue to note that, on average, adults ages 20-64 have about three decayed or missing permanent teeth. 

Although these statistics may seem daunting, all hope is not lost! In most cases, cavities can easily be treated and the sooner they are identified, the easier treatment is. This is why the American Dental Association recommends visiting your dentist at least once every six months for regular dental checkups and professional teeth cleanings. 

When identifying cavities, there are various stages cavities can occur at. The earlier the stage, the easier it is to reverse the damage. However, in the later stage damaged cannot be reversed, but it must be treated. If left untreated, cavities will continue to cause harm to the tooth until the entire tooth is lost. Tooth loss is stage 6 and it is completely preventable by seeking early treatment. 

Diagram showing the various stages of cavity development

The first two stages affect only the enamel, or outermost layer of the tooth. Stage one is the presence of white spots on the tooth that indicate a loss of calcium. These white spots can generally be reversed by using a fluoride treatment to strengthen the enamel. Stage two occurs when the enamel layer has begun to disslove forming what dentists call an incipient lesion. In some cases, fluoride treatments may also be used for stage two cavities. 

Stage three occurs when the dentin layer begins to decay. The dentin layer is the middle layer of the tooth that lies just below the enamel. When cavities reach the dentin layer, there is generally some pain or discomfort within the tooth. Because of the pain, this is when dentists generally see patients who don’t otherwise come in regularly. At stage three, a dental filling is usually needed to remove the bacteria, relieve pain, and restore the tooth. 

Stage four occurs when the bacteria have reached the pulp, or innermost layer. Because the pulp is composed of nerves and blood vessels, it becomes increasingly painful when the infection sets in. Once the pulp layer has become infected, the only course of action is to have a root canal and a dental crown placed to restore the tooth. 

Stage five occurs when the pulp infection is not treated and it continues to persist. Once the bacteria reach the tooth’s roots, they cause an abscess to form at the base of the roots. Not only is this extremely painful, but it can cause the surrounding bone to become infected and puts you at a higher risk for other complications. Once decay has reached stage five, oral surgery is generally needed to restore the tooth. 

As mentioned before, stage six it tooth loss. However, there are five other stages of warnings before this point. Most people will seek help once their tooth begins to ache, around stage two or three. However, if you are attending regular dental checkups, it is very likely that you can have early signs of decay diagnosed and treated before tooth pain even develops. Regular dental checkups also means that early signs of decay may be able to be reversed, sparing you from more invasive dental procedures in the future. 

Not only that, but professional teeth cleanings are also part of regular dental checkups. Professional teeth cleanings remove the plaque and tartar from your teeth. Tartar is plaque that has been left in place over time and is hardened to the surface of your teeth. While plaque can be removed by brushing, tartar can only be removed using specialized dental tools. Just as bacteria reside in plaque, they can also reside in tartar. This is why regular teeth cleanings are so important, because they decrease the amount of bacteria in your mouth and make it a hard environment for bacteria to thrive in. 

While many people are intimidated by dental visits because they are afraid they are going to be told they have cavities, it is important to realize that having a cavity is not the end of the world. It is also important to realize that avoiding the dentist does not magically make your cavities disappear, rather it allows them the possibility to continue to grow into deeper and more serious cavities. Out of everything you’ve ever wanted to know about cavities, the most important thing to know about cavities is that you can minimize their damage with regular dental care. 

How long has it been since your last dental appointment? To minimize your risk of cavities and improve your oral health, schedule a consultation with Dr. Pasha of Pasha Dental today!  Pasha Dental is proud to provide dental services for adults and children residing in the Brooklyn, NY area as well as to residents of Staten Island, Queens, and Manhattan. 

Regular dental care is important for everyone, but it can be especially important if you are an expecting mother. Did you know that your dental health is altered by pregnancy hormones? In fact, pregnant mothers are more susceptible to various dental issues and these dental issues can also affect the pregnancy, as well as the baby.

This is primarily due to the fact that a woman’s body changes drastically during pregnancy. More specifically, certain hormones associated with pregnancy are increased while pregnant. Namely these pregnancy hormones are estrogen and progesterone.

Estrogen levels start to increase during the first trimester and are the primary cause of morning sickness, or overall nausea. Throughout pregnancy, estrogen levels will continue to increase and hit their highest point during the third trimester. In a single pregnancy, more estrogen is produced than a female produces in the rest of her non-pregnant lifetime. Estrogen is essential because it allows the uterus and placenta to form blood vessels, facilitate the transfer of nutrients to the fetus, and provide support to the fetus during its development and maturation.

Pregnant woman suffering from morning sickness

Progesterone levels also increase to unusually high levels during pregnancy. While estrogen is primarily responsible for fetal development, progesterone is associated with ligament laxity. The loosening of ligaments allows the uterus to increase in size as the fetus grows. It also causes the ureters between the bladder and kidneys to increase in size.

In addition to the increase of estrogen and progesterone, several hormone levels also fluctuate in response to a pregnancy. These hormones include human chorionic gonadotropin (HGC), relaxin, oxytocin, and prolactin. Although these hormone changes are essential to facilitating the pregnancy, they can affect your oral health.

What dental issues affect pregnant women?

The most common dental issues that affect pregnant women are pregnancy gingivitis, tooth decay, and pregnancy tumors. The Centers for Disease Control (CDC) notes that about 60-75% of women are affected by pregnancy gingivitis and one out of every 4 pregnant women have cavities, while WebMD notes that only 10% of pregnant women are affected by pregnancy tumors. Ultimately, everyone is different and so certain conditions may affect some, while others may not be affected at all. However, pregnant women are more susceptible to the following dental health issues:

Pregnancy Gingivitis:

Gingivitis is a mild form of gum disease caused by the buildup of plaque on the tooth’s enamel. The bacteria within plaque can cause the gums to become inflamed, tender, and even bleed when flossing or brushing. The main concern with gingivitis is that it can progress to periodontitis if not treated. Periodontitis is a more severe form of gum disease that can cause tooth loss. In fact, gum disease is the top cause of tooth loss in adults.

Symptoms of gum disease can include:

Tooth Decay:

Pregnancy also increases the risk of developing cavities. This is primarily because morning sickness increases the acidity in the mouth and wears away the teeth’s enamel. Additionally, some women tend to crave and eat more carbohydrates during pregnancy, which contain excess sugars that feed the bacteria responsible for tooth decay.

Symptoms of tooth decay can include:

Pregnancy Tumors:

Although less common than gum disease and tooth decay, some women are also affected by small gum tumors known as pregnancy tumors, pyogenic granuloma, granuloma of pregnancy, lobular capillary hemangioma, or pregnancy epulides. These are non-cancerous tumours that are red in color and have a raspberry appearance. They often form on the gums between teeth during the second trimester and are often caused by excess plaque. In most cases, they will resolve themselves once the baby is born, however they can cause discomfort and interfere with eating or speaking.  

How Do Dental Issues Affect Pregnancy?

According to the American Dental Association (ADA), dental issues can cause premature delivery, intrauterine growth restriction, gestational diabetes, and preeclampsia. Although the exact relationship between the two is still being researched, there has been a correlation between periodontitis and premature delivery as well as low birth weight.

The American Academy of Periodontics has published a study about the connection between the two, as well as the American Academy of Family Physicians. The Oral Health Foundation also notes that women who experienced premature labor were one and a half times more likely to have gum disease. They also note that premature birth was also more likely to occur in women who had untreated cavities.

Dental Care Tips During Pregnancy:

During pregnancy, you should visit your dentist regularly. Ideally, you should be already visiting Pasha Dental at least once every six months. However, when you become pregnant, you should schedule an additional appointment to have Dr. Pasha begin monitoring your oral health during your pregnancy. Depending on how your initial consultation goes, Dr. Pasha will advise you on how often to visit because some people may require more frequent exams and cleanings than others. Generally, preventative dental care is the type of dental care you can expect to receive during pregnancy. Preventative dental care services at Pasha Dental will consist of dental exams, x-rays, and a professional teeth cleaning.

During a dental exam, Dr. Pasha will examine your teeth, gums, and bite to ensure there are no signs of gum disease or tooth decay. He will also measure your gum pockets to ensure there is no gum recession present. Your medications and any prenatal vitamins you’re taking will also be discussed, as this can affect treatment.

Digital dental x-rays may also be used as an additional diagnostic tool if needed. Finally, a professional teeth cleaning will remove plaque, tartar, and bacteria from your mouth which will decrease the likelihood of developing tooth decay, gum disease, or pregnancy tumors.

Before you leave, Dr. Pasha will also provide you with information on how to take care of your teeth in-between appointments. The basics include brushing your teeth twice a day and flossing once a day. He may also recommend a bland tasting toothpaste and mouth rinsings during morning sickness periods. It is also important to eat a balanced diet and to try and limit the amount of sugary snacks since your teeth are more likely to develop cavities.

Is Dental Care During Pregnancy Safe?

Yes! Dental care during pregnancy is not only safe, but it is highly recommended by dentists and physicians alike to increase the odds of a smooth pregnancy. Most dental care during pregnancy consists of preventative services, but it can also consist of restorative services.

Pregnant woman looking off in the distance with her hands on her belly

It is also important to note that both dental x-rays and local anesthetics are safe for the mother and developing fetus. Compared to regular x-rays, digital dental x-rays use a much smaller amount of radiation that has not been found to cause any problems with pregnancy. As an additional measure, you will also be asked to wear a lead apron to further minimize the amount of radiation that reaches the abdomen.

In August 2015, the Journal of the American Dental Association published a study about pregnant women who were exposed to local anesthetics during dental treatment. Within this study two groups of pregnant women were compared: those who had been given local anesthetics and those who had not. Ultimately the study concluded that there were no differences in miscarriage rate, birth defects, prematurity, or birth weight.

If you plan on becoming or already are pregnant, schedule a consultation with Dr. Pasha Javaheri Saatchi of Pasha Dental today for your pregnancy dental care appointment. Pasha Dental is proud to provide dental services for pregnant women residing in the Brooklyn, NY area as well as to residents of Staten Island, Queens, and Manhattan.

Treating Gum Disease

Your gum disease treatment will depend on several factors, including your personal health history and the stage of your gum disease. This page covers:

  • Professional Cleaning
  • Deep Cleaning – Scaling and Root Planing
  • Periodontal Surgery
  • Bone Graft Surgery and Guided Tissue Regeneration
  • Keeping your teeth and gums healthy after treatment

Professional Cleaning

In the very early stages – when it is gingivitis – you may just need a professional cleaning from your dental team. They can also give you some great advice and tips on how you can keep your teeth and gums healthy.

Deep Cleaning – Scaling and Root Planing

If your gum disease is beyond gingivitis, the first step in treating gum disease usually involves a special deep cleaning called scaling (SCAY-ling) and root planing (PLAY-ning). This treatment may be done over more than one visit, depending on your personal needs.

Scaling: Your dentist or hygienist removes plaque and tartar down to the bottom of each periodontal pocket.

Root Planing: Then, the root surfaces of your teeth are smoothed, or “planed”, to allow the gum tissue to heal and reattach to the teeth.

Your dentist or hygienist may recommend certain medicines to help control infection and discomfort or to aid healing. You may be given pills, a mouthrinse or they may place medication directly into the periodontal pocket after the treatment.

Scaling removes plaque and tartar from below the gumline.
Root planing smoothes the tooth root and helps the gums reattach to the tooth.
Healed pocket after treatment.

Periodontal Surgery

Sometimes, scaling and root planing isn’t enough treatment on its own. If pockets do not heal enough after scaling and root planing, gum surgery may be needed.

Surgery allows your dentist to remove plaque and tartar from hard-to-reach areas. Afterwards, your gums will be stitched into place to tightly hug your teeth.

Surgery can also help to shrink pocket depth and make it easier for you to keep your teeth clean.

Probe shows pockets due to gum disease. Gums are inflamed and bone loss has occured.
The bone is contoured and any remaining tartar is removed.
Healed site after periodontal surgery.

Bone Graft Surgery and Guided Tissue Regeneration

If bone has been damaged or lost by gum disease, then you may need surgery to rebuild or reshape the bone in your mouth. This kind of surgery is called a bone graft.

First, your dentist may use splints, bite guards or other types of tools to hold loose teeth in place and help tissues heal. If too much gum or bone tissue has been lost from your gum disease, he or she may need to also do a bone graft.

Your dentist may place a membrane layer at the surgical area to help your gums stay in place while the tooth root reattaches to the supporting bone tissues. This is called guided tissue regeneration.

To help you heal after surgery, your dentist may put a protective dressing over the area and recommend or prescribe a medicated mouthrinse. You may also be given a prescription to treat infection or for pain relief.

Diseased tissue is removed from the pocket. In some cases, the bone may be reshaped.
Bone has been reshaped.
Grafting material is placed over the bone. A membrane covers the grafting material.
After the healing period

Keep your Gums Healthy After Treatment

Periodic periodontal cleanings help you stay on top of your gum disease
Once your gum disease is under control, it is very important for you to get dental care on a consistent basis. The periodic cleanings recommended after these treatments are called periodontal maintenance care. These cleanings are more extensive than the standard cleaning and will help you keep your gums healthy. Your periodontal maintenance involves cleanings that are deeper than a normal cleaning in the dental office. With periodic maintenance, the amount of plaque bacteria is lowered. Then, the inflammation can get better, pockets can shrink and your gums can become healthier.

Your gum disease won’t go away on its own
Once your gum disease is brought under control, it is very important that you get dental care on a periodic basis. You have a better chance of keeping your teeth if you do. Your gum disease may get worse if you don’t!

Plan for more visits to the dentist
You will need to see your dentist more often than other people. The pockets and other issues from your gum disease will make it harder for you to clean plaque from your teeth.
Your dentist will talk to you about a treatment plan that works best for you, and he or she will recommend a maintenance care schedule that is based on your personal case. Over time, fewer appointments may be necessary. Once your gums are healthy, your dentist will determine a maintenance schedule based on your clinical evaluations.

Once your gums are healthy, your dentist will determine a maintenance schedule based on your clinical evaluations.

Medication

You may also need special medications than can help control the infection and pain or to help your gums heal. The medicine could be a pill, a special mouthrinse, or a medication that your dentist places directly into the pocket right after deep cleaning.

You may have sensitive teeth and gums after your treatment
Your teeth and gums may be sensitive after your treatment. This soreness may make you want to avoid cleaning the treated areas. But it’s important to follow your dentist’s instructions on home care! If plaque is not removed, root decay may form. Talk with your dentist or hygienist if a special toothpaste or other treatments can lower your tooth sensitivity.

Keep up your oral care at home

It is very important that you brush and floss every day – especially if you are healing from gum disease.
• Brush two times every day for two minutes each time. Use a toothbrush with soft bristles and a toothpaste with fluoride (FLOOR-ide). Fluoride is a mineral that helps keep teeth strong.
 Clean between your teeth every day to remove plaque and bits of food from in between your teeth.
If your gums have pulled away from your teeth, it may be best to use special tiny brushes, picks or wider types of floss and picks to clean between your teeth.
• Your dentist may also recommend regularly using a specific mouthrinse.
• Look for the American Dental Association Seal of Acceptance on all of your dental care products. The ADA Seal means these products have met ADA standards for safety and effectiveness.

Don’t Use Tobacco!
Smoking, chewing, vaping and dipping puts you at a higher risk for cancer and other life-threatening diseases. Tobacco use also can make gum disease worse and make it harder to treat it. If you use tobacco, ask your dentist or physician for information about how to quit.

Healthy Mouth, Healthy Body – Making the Connection

Your mouth is a window into the health of your body

Insight about your overall health can sometimes be seen in your mouth. In fact, periodontal (perry-oh-DON-tal) – or gum – disease is common in people with chronic diseases like heart disease or diabetes. This page explains the connection between your oral health and your overall health.

What you should know about gum disease

Gum disease is an infection and inflammation that affects the tissues and bone that support your teeth.The infection is caused by the bacteria in plaque, a sticky film that’s always on your teeth. Your body reacts to the infection and your gums will become inflamed – red, puffy and swollen. If left unchecked, gum disease affects the tissues and bone that support your teeth. It is the most common reason why adults lose teeth.

Gingivitis

When your body reacts to this infection and your gums are inflamed, this condition is called gingivitis (jin-ja-VY-tis), and it can lead to more serious types of gum disease. The good news about gingivitis is that it can be reversed. If the gum disease is caught early enough (when it is gingivitis), you may simply need a professional cleaning. Your dental team can also give you advice for improving your daily oral hygiene.

Periodontitis

If gingivitis is not treated, it can turn into periodontitis (perry-o-don-TIE-tis). Periodontitis is usually not painful, but it can lead to bone loss.

 

Effects of gum disease

Healthy gums and bone hold teeth firmly in place.
Periodontitis happens over time, as plaque builds up along the gum line.

Your body responds to the toxins that the bacteria produce by breaking down the gum tissues and bone around your teeth.

Warning signs of gum disease:

• gums that bleed when you brush or floss • gums that are red, swollen, puffy or tender • gums that no longer tightly hug your teeth • bad breath that doesn’t go away • pus between your teeth and gums • feeling that your teeth are loose • a change in the way your teeth fit together when you bite • a change in the way your partial dentures fit You may notice one or some of these warning signs, or you may not have any signs of gum disease at all. This is why it’s important to see your dentist regularly – treatment of gum disease is most successful when it’s caught early.

The Mouth-Body Connection

Certain chronic diseases are sometimes shown to raise your risk of gum disease. And, sometimes having gum disease is shown to raise your risk and severity of chronic disease. While it may not be clear whether one drives the other, some of the chronic diseases that commonly occur with gum disease are: • arthritis • diabetes • emphysema • heart disease • high blood pressure • liver diseases like the hepatitis C virus • obesity • stroke

Using tobacco raises your risk of gum disease

Keeping your teeth and gums healthy is very important. Using tobacco products of any kind (cigarettes, dip/chew, e-cigs, hookah, etc.) is a common risk factor for many chronic diseases including gum disease. Tobacco increases the risk of getting gum disease. The disease can also get worse the longer you use tobacco. Many of the medications used to treat other diseases can affect your mouth by causing dry mouth. These include medications used to treat blood pressure, allergies, and pain. Dry mouth can increase your risk of tooth decay and gum disease.

Periodontal disease is also known as gum disease

Periodontal (perry-o-DON-tal) Disease is an infection and inflammation that affects the tissues and bone that support your teeth. It’s also called gum disease.

A surprisingly wide variety of bacteria are normally found in your mouth. When certain types of bacteria outgrow the others, this starts the process of gum disease.

When your gums are healthy, your gum tissues tightly hug each of your teeth. When you have gum disease, your gums pull away from your teeth. As the gum disease gets worse, the tissues and bones that support your teeth become damaged. Over time, your teeth may fall out or need to be removed. Treating periodontal disease in the early stages can help prevent tooth loss.

What is the connection between gum disease and other health issues?

Gum disease has been linked to some other diseases. People with diabetes or heart disease are more likely to get gum disease. Strokes and high stress also may be related to gum disease. Researchers are still studying these links.

It is important to talk to your dentist if you suffer from any long-term health problem. Together, you can work out an oral care plan for your best oral and overall health.

Warning Signs of Gum Disease

If you notice any of the signs below, see your dentist. However, you can have gum disease and not notice any of these warning signs. That is why regular dental checkups are very important.

• gums that bleed when you brush or floss
• gums that are red, swollen, puffy, or tender
• gums that no longer hug your teeth tightly
• bad breath that doesn’t go away
• pus between your teeth and gums
• feeling that your teeth are loose
• a change in the way your teeth fit together when you bite
• a change in the way your partial dentures fit

What Causes Gum Disease?

Plaque is a sticky film of bacteria that is always forming on your teeth. Bacteria that live in the plaque can make your gums become red, puffy and swollen. When plaque is left on your teeth and gums, it hardens. Hardened plaque is called tartar (TAR-ter) and can only be removed when your teeth are cleaned in the dental office.

Before professional dental cleaning

When your gums are red, puffy and swollen, they can start to pull away from your teeth. Spaces called pockets start to form between your gums and teeth. These pockets give bacteria a place to collect and grow. The bacteria in your pockets will cause your gum disease to get worse. These bacteria produce toxins, which causes your body to break down the gum tissues and bone around your teeth.

Before treatment

Follow these healthy habits to help prevent gum disease

It generally costs much less to keep your teeth and gums healthy than to wait until you have a problem that needs to be treated. These healthy habits can help:

• Brush your teeth twice a day with fluoride toothpaste and for 2 minutes each time.
• Clean between your teeth with floss or another between-the-teeth cleaner every day to remove plaque and food from areas your toothbrush can’t reach.
• Your dentist or hygienist may recommend using a germ-killing mouth rinse or other products.
• Eat a healthy diet and limit snacks and sugary drinks. Learn more online at www.choosemyplate.gov.
• Visit your dentist regularly.

Tobacco use harms gums

Don’t use tobacco!

If you smoke, chew, or dip tobacco, then it is very important you quit. Using tobacco in any form slows down your healing and raises your chances of getting gum disease again or it getting worse if you already have it. Talk to your dentist or doctor about ways you can quit.

Are You at Risk?

Anyone can get gum disease, but there are things raise your risk of getting it. These include:

• Not taking care of your teeth and gums. 
• Using tobacco of any kind. 
• Diseases that affect the whole body – such as diabetes and HIV infection.
• Older Age.
• Stress. 
• Clenching/Grinding your teeth.
• Many medications.
• Pregnancy, use of birth control pills, or changes in female hormone levels. 
• Family history.
• Passing the bacteria that causes gum disease through saliva.

 

Healthy Gums
Your teeth are held in place by gums, bone and connective tissues. Your gums tightly hug your teeth and there is little or no buildup of plaque and tartar on them.

Periodontitis
In time, your body responds to the toxins that the bacteria produce by breaking down the gum tissues and bone around your teeth.

Advanced Periodontitis
Your teeth become loose or fall out or need to be removed by a dentist. Loose or missing teeth can create problems, like making it hard for you to eat the foods you like.

Checking for Periodontal Disease

Periodontal Probe

Your dentist or hygienist uses an instrument called a periodontal probe to gently measure the depth of the pockets around each tooth. When your teeth are healthy, the pocket depth is 3 millimeters (mm) or less. Usually, the more severe the disease, the deeper the pocket, which give bacteria more room to grow and cause serious damage to your teeth, gums and bone.

Periodontal probe of healthy gums.

Periodontal probe showing a pocket forming between the tooth root and the gums.

Dental X-Rays

Dental x-rays can check on the amount of bone that is supporting your teeth. If low bone levels are spotted, it could be a sign of damage from gum disease.

Healthy gums have bone that supports the teeth.

Gum disease can create bone loss.

You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a healthy diet and schedule regular dental visits for a lifetime of healthy smiles.

Advanced Periodontitis image courtesy of Dr. John C. Hall.

With good oral care at home and regular dental visits, children can reach adulthood without suffering from tooth decay and other oral health problems.

Diet can affect your child’s teeth

The food and drinks you give your child can affect their oral health. Everyone, including your child, has plaque – a sticky film of bacteria that forms on teeth. Plaque can build up if it isn’t removed from your child’s teeth every day. The plaque bacteria feed on the sugar that’s found in the food and drinks you give your child. The bacteria create acids from this sugar supply.

These acids can attack the hard, protective layer of enamel on your child’s teeth for up to 20 minutes after they finish eating and drinking. Repeated acid attacks can affect your child’s teeth, causing problems like erosion or decay, which can lead to infection in other parts of the body.

For good dental and overall health, be sure your child eats a healthy diet. If your child needs a between-meal snack, choose healthy foods, like fresh fruits, vegetables, and low-fat/high protein foods. To help prevent tooth decay, save sweets for mealtime. For ideas about healthy foods and drinks to give your child, see www.choosemyplate.gov.

Ways to keep your child’s mouth healthy

• Brushing teeth twice a day and cleaning between teeth once a day are important to keep teeth and gums healthy. • Choose a child-sized toothbrush with soft bristles. Replace it every three months or sooner if the bristles are frayed. Worn toothbrushes won’t clean teeth properly.
• Use the right amount of fluoride toothpaste for your child. Be sure you are in charge of the toothpaste and your child knows it is not food. Do not use more toothpaste because your child likes the flavor!
• Teach your child to spit out the toothpaste.
• Supervise children while they brush their teeth. If they can’t tie their shoes, they shouldn’t brush their teeth alone.
• As soon as your child has two teeth that touch, clean between them every day. If floss will not work, use another type of between-the-teeth cleaner. Your dentist can help you decide which type works best for your child’s mouth.

 

Use the right amount of toothpaste for your child

For children under 3 years old.

For children 3 to 6 years old.

Look for the ADA Seal of Acceptance

Choose oral health products that display the American Dental Association Seal of Acceptance. This means they are both safe and effective in keeping your child’s mouth healthy.

Fluoride if nature’s cavity fighter!

Fluoride helps make teeth stronger and protects them from decay. It is a mineral that occurs naturally and is found in many water sources. Children who drink water that has the recommended levels of fluoride are less likely to get cavities than children who do not drink fluoridated water. Fluoride is also found in anti-cavity toothpastes, mouthrinses and treatments applied in the dental office. Talk to your dentist about your child’s fluoride needs. Be sure to tell your child’s dentist if you use well or bottled water; or if you use a water treatment system at home.

Protect teeth with sealants

A sealant is a plastic material that your dentist can easily apply to the chewing surfaces of your child’s back teeth. The sealant flows into the pits and grooves in the teeth – places where a toothbrush might miss. Sealants protect teeth from plaque and acid attacks.

Why regular dental visits are important

Regular dental checkups and dental care – such as cleanings, fluoride treatments and sealants – provide your child with “smile insurance.” Plan your child’s first dental visit within 6 months after the first tooth appears, but no later than the first birthday. Consider it a “well-baby checkup” for your child’s teeth.

Prevent sports-related dental injuries

Many sports-related dental injuries can be prevented by wearing a mouthguard. Mouthguards can be custom-made by your dentist to fit your child’s mouth. Or, you can purchase a “boil-and-bite” mouthguard at sporting goods stores that has the ADA Seal.

 
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