Posts for: December, 2014
Since their development in the laboratory over five decades ago, lasers have found increasing use in our everyday lives. In the field of medicine, it’s not uncommon to find lasers in the offices of dermatologists, ophthalmologists and surgeons, to name just a few. Now, some dentists are finding that lasers can offer an alternative means of treating gum disease — and one that may have advantages in certain situations.
You probably know that a laser produces a special kind of light — in fact, its name is an acronym for “Light Amplification by Stimulated Emission of Radiation.” Essentially, a medical laser uses electrical energy to produce an intense and narrow beam of concentrated light. This light can be directed to a particular area, often via a fiber-optic channel. The laser’s precision allows a doctor or technician to focus the light energy exactly where it’s needed — to remove diseased tissue, seal off blood vessels, and sterilize a wound, for example.
For several years, periodontists — dentists who specialize in treating diseases of the gums — have been researching the use of lasers for treating certain types of gum disease. In standard clinical practice, hand-held instruments and ultrasonic cleaning tools are used at regular time intervals (3 – 6 months) to remove the sticky bacterial biofilm, as well as calculus (tartar), that forms in between teeth and gums. If that still isn't effective, gum surgery may be required to access the affected area, remove diseased tissue, and reduce pocket depth (the space below the gum line that gets larger as bone loss occurs) to prevent reinfection.
Recently, however, several new procedures have been developed that use lasers to accomplish some or all of these goals. One type of therapy uses a special laser that emits pulses of light with a specific wavelength (color) of 1064 nanometers. This light passes through healthy cells like a sunbeam through a window — but when it encounters darkly-pigmented bacteria, it vaporizes them instantly!
One of the potential advantages of laser treatment is its precision: focused directly on the area where trouble occurs, it targets diseased tissue but leaves healthy tissue alone. Another is that laser treatment is less invasive: It requires less tissue removal, and may cause less discomfort and tissue shrinkage (gum recession) than conventional periodontal surgery. And because it produces small amounts of heat, it can seal blood vessels and help control bleeding.
While lasers have long shown promise for treating gum disease, until recently it wasn’t clear if they offered any advantages over traditional methods. Now, several studies have shown that certain laser treatments can be just as effective as traditional gum surgery in many cases — with the potential benefit of being less invasive. In the future, the use of lasers for periodontal procedures is likely to increase.
It’s important to remember that no single treatment — not even a laser — can “zap” gum disease in one fell swoop. Controlling periodontal disease requires effective at-home oral hygiene combined with regular professional care. If you have questions about periodontal disease, please call our office to schedule a consultation.
While she was pregnant with her son Camden Jack Cutler, 25-year-old Kristin Cavallari noticed an odd occurrence in her bathroom sink: “Every time I floss, my sink looks like I murdered somebody!” the actress and reality-TV personality exclaimed. Should we be concerned that something wicked is going on with the star of Laguna Beach and The Hills?
Before you call in the authorities, ask a periodontist: He or she will tell you that there's actually no mystery here. What Cavallari noticed is, in fact, a fairly common symptom of “pregnancy gingivitis,” a condition that affects many expectant moms in the second to eighth month of pregnancy. But why does it occur at this time?
First — just the facts: You may already know that gingivitis is the medical name for an early stage of gum disease. Its symptoms may include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. Fundamentally, gum disease is caused by the buildup of harmful bacteria, or plaque, on the teeth at the gum line — but it's important to remember that, while hundreds of types of bacteria live in the mouth, only a few are harmful. A change in the environment inside the mouth — like inadequate oral hygiene, to use one example — can cause the harmful types to flourish.
But in this case, the culprit isn't necessarily poor hygiene — instead, blame it on the natural hormonal changes that take place in expectant moms. As levels of some female hormones (estrogen and/or progesterone) rise during pregnancy, changes occur in the blood vessels in the gums, which cause them to be more susceptible to the effects of bacterial toxins. The bacteria produce toxic chemicals, which in turn bring on the symptoms of gingivitis — including painful and inflamed gums that may bleed heavily when flossed.
Is pregnancy gingivits a cause for concern? Perhaps — but the condition is generally quite treatable. If you've noticed symptoms like Kristen's, the first thing you should do it consult our office. We can advise you on a variety of treatments designed to relieve the inflammation in your gums and prevent the harmful bacteria from proliferating. Of course, your oral health (and your overall health) are prime concerns during pregnancy — so don't hesitate to seek medical help if it's needed!
How did things work out with Kristen? She maintained an effective oral hygiene routine, delivered a healthy baby — and recently appeared on the cover of Dear Doctor magazine, as the winner of the “Best Celebrity Smile” contest for 2012. And looking at her smile, it's no mystery why she won.
If you would like more information about pregnancy gingivitis, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Expectant Mothers” and “Kristen Cavallari.”
Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.
First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.
At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:
- An artificial heart valve, or a heart valve repaired with artificial material
- A history of endocarditis
- A heart transplant with abnormal heart valve function
- Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
- A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
- Repaired congenital heart disease with residual defects, such as leakage or abnormal flow
In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.
The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.