Gums and bone hold your teeth in your mouth. As part of your initial office visit, Dr. Isaacson or Dr. Barclay will do a thorough evaluation of the supporting structure that holds your teeth into your jaw, known as a periodontal examination. They will measure how much bone you have around each tooth by using a small millimeter ruler called a periodontal probe and compare it to your X-rays. You will be checked for gum recession and your teeth will be tested to see if any of them are loose. The gum exam, together with your X-rays, will give your doctor a general idea of the health of your teeth and jaw. This information will help your doctor create a treatment plan just for you, which may include special teeth cleaning procedures.  We keep detailed records of our findings and refer back to them over the years to see if there are any changes, both good and bad.

Saliva, bacteria and the food substrates in your mouth accumulate into a paste that adhers to your teeth called plaque.  When the plaque is left undisturbed by inadequate brushing or flossing, it calcifies and turns into a hard, barnacle like substance known as calculus.  Calculus can only be removed by specialized instuments or a ultrasonic machine called a cavitron. Dental hygienists have completed a two year program in dental hygiene and are licensed to remove this accumulation, as well as other procedures.  The bacterial accumulation contributes to periodontal disease and has been associated with numerous medical conditions, such as diabetes, heart disease and low birth weight babies.  Frequently we are asked by physicians to prepare our patients to optimum periodonatal health prior to medical procedures, such as hip and knee replacements, organ transplants and cancer treatments.

Fighting Plaque

By fighting plaque you can keep your teeth for a lifetime. Today, in fact, older adults are keeping their natural teeth longer because of scientific developments and an emphasis on preventative dentistry.

Good oral hygiene requires an understanding of plaque. Plaque is a sticky, colorless layer of bacteria. When you eat carbohydrates (foods made of sugar or starch) you feed this plaque, which in turn produces acids that attack tooth enamel, cause cavities, and develop a hard substance called calculus (tartar). Uninterrupted, the acid attacks can result in tooth decay and gum disease (also known as periodontal disease). If left untreated, gum disease can cause loss of teeth and bone.

At any age, you can begin the fight with plaque and keep your teeth and gums healthy. It’s really quite easy. Simply:

• Brush your teeth twice a day with a soft-bristled toothbrush and fluoride toothpaste to remove food particles and plaque from the tooth surfaces. While you’re at it, brush the top surface of your tongue to eliminate bad breath and bacteria build up.
• Clean between your teeth daily with floss or an interdental cleaner. Decay-causing bacteria can linger between teeth where toothbrush bristles can’t reach. Flossing removes plaque and food particles from between the teeth and under the gum line.
• Eat a balanced diet and limit between-meal snacks. If a snack is needed, nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit should be chosen.
• Schedule regular check-ups. Visit Dr. Isaacson regularly (every 6 months) for professional cleanings and oral exams.
• Ask Dr. Isaacson about dental sealants, a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts.
• Wear mouth protection such as a mouthguard when you play contact sports or extreme sports.

Preventing Gum Disease

Gum disease (also called periodontal disease) is an infection of the tissues that support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. At each regular checkup the dentist will measure the depth of the shallow v-shaped crevice (called a sulcus) between your tooth and gums to identify whether you have gum disease.

Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket; generally, the more severe the disease, the greater the depth of the pocket.

Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis.

In the early stage of gum disease, called gingivitis, the gums become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.

In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. The teeth can become loose, fall out, or have to be removed by a dentist.

Some factors increase the risk of developing periodontal disease:

• Tobacco smoking or chewing
• System-wide diseases such as diabetes
• Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives
• Bridges that no longer fit properly
• Crooked teeth
• Fillings that have become defective
• Pregnancy

If you notice any of the following signs of gum disease, see Dr. Isaacson immediately:

• Gums that bleed easily
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath or bad taste
• Pus between your teeth and gums
• Permanent teeth that are loose or separating
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures

It is possible to have periodontal disease and have no warning signs.

That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed.

Good oral hygiene at home is essential to keep periodontal disease from becoming more serious or recurring. You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.

Normal, healthy gums: Healthy gums and bone anchor teeth firmly in place.

Gingivitis: Gums are red, swollen and bleed easily.

Periodontitis: Unremoved plaque hardens into calculus (tartar). As plaque and calculus continue to build up, the gums begin to recede (pull away) from the teeth, and pockets form between the teeth and gums.

Advanced periodontitis: The gums recede farther, destroying more bone and the periodontal ligament. Teeth — even healthy teeth — may become loose and need to be extracted.

The good news is that you can help prevent gum disease by taking good care of your teeth every day and having regular dental checkups.

How to Brush Your Teeth

• Place your toothbrush at a 45-degree angle against the gums.
• Move the brush back and forth gently in short (tooth-wide) strokes.
• Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
• Use the tip top of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
• Brush your tongue to remove bacteria and freshen your breath.

Note: You should replace your toothbrush every three or four months — or sooner if the bristles become frayed. A worn toothbrush will not do a good job of cleaning your teeth. Children’s toothbrushes often need replacing more frequently than adults because they can wear out sooner.

How to Floss Your Teeth

• Break off about eighteen inches of floss and wind a loop of it around one of your middle fingers. Wind another loop around the same finger of the opposite hand. This finger will take up the floss as it becomes used. Hold the floss tightly between your thumbs and forefingers.
• Use your thumbs and forefingers to guide about one inch of the floss between your teeth. Move the floss toward the gum in a gentle rubbing motion. Never snap the floss into the gums.
• When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.
• Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
• Repeat this method on the rest of your teeth.
• Don't forget the back side of your last tooth.

Note: People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner. These aids include special brushes, picks, and sticks. If you use interdental cleaners, ask Dr. Isaacson about how to use them properly to avoid injuring your gums.

Choosing Dental Products

When choosing any dental product, look for the American Dental Association Seal of Acceptance, an important symbol of a dental product's safety and effectiveness. Talk to Dr. Isaacson about what types of oral care products will be most effective for you. The ADA Seal on a product is your assurance that it has met ADA criteria for safety and effectiveness. Look for the ADA Seal on fluoride toothpaste, toothbrushes, floss, interdental cleaners, oral irrigators and mouth rinse.

By taking care of your teeth, eating a balanced diet, and visiting Dr. Isaacson regularly, you can have healthy teeth and an attractive smile throughout your entire life.