Blaine P. Cusack, DDS

Gum disease – also known as periodontal disease – is an infection of the tissues surrounding and supporting the teeth and it’s a major cause of tooth loss in adults.

But it’s usually painless so you may not even know you have it.

It’s caused by plaque – a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

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

The more advanced stage of gum disease is known as periodontitis. At this stage, the gums and bone that support the teeth can become seriously damaged. The teeth may then become loose, fall out or have to be removed by a dentist.

It’s therefore very important to look out for any signs of gum disease. These signs include:

– Gums that bleed when you brush your teeth
– Red, swollen or tender gums
– Gums that have pulled away from the teeth
– Bad breath that doesn’t go away
– Pus between your teeth and gums
– Loose teeth
– Change in the way your teeth fit together when you bite
– Change in the fit of partial dentures

If you notice any of these signs, contact you dentist quickly and they’ll help you take action to make improvements.

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatenting.

So if you have any signs of swelling in your gum, contact your dentist immediately.

Mouth sores can be very annoying and painful and can have many causes.

The causes can range from infections – bacterial, viral or fungal – to a loose orthodontic wire or a denture that doesn’t fit or a sharp edge from a broken tooth or filling.

But mouth sores may be symptoms of an underlying disease or problem.

So, if you’ve had any mouth sore that lasts a week or longer, it’s a good idea to get your dentist to check it out.

Here are some of the most common mouth sores:

Canker sores: These are small ulcers with a white or gray base and a red border. They appear inside the mouth and are not contagious though they often return. Problems such as poor immune systems, viruses or fatigue and stress may be involved. They usually heal on their own after a week or two.

Cold sores: Cold sores are annoying and painful. They are also known as fever blisters or Herpes simplex and are groups of fluid-filled blisters. They often erupt around the lips and sometimes under the nose or around the chin. Cold sores caused by herpes virus type 1 are very contagious and the virus stays in the body. Cold sore blisters usually heal in a week by themselves.

Candidiasis: This fungal infection (also called moniliasis or oral thrush) occurs when the yeast Candida albicans reproduce in large numbers. It is common among denture wearers and people who have dry mouth syndrome are very susceptible to it. The focus is on preventing it or controlling the conditions that caused the outbreak.

Any mouth sores that last more than a few days should be checked with your dentist.

Braces are orthodontic apparatus used to help fix crooked and crowded teeth.

While modern braces can be comfortable and inconspicuous, you may have to take extra steps to care for your teeth when wearing them.

It’s important that you continue good oral hygiene practices while wearing braces.

You need to continue brushing regularly, following the approach suggested by your dentist, as well as flossing daily and making regular visits to the dentist.

People with braces should stick to a balanced diet and limit the number of snacks between meals.

Your dentist may suggest that you avoid certain foods that could interfere with braces or accidentally bend the wires. This can include nuts, popcorn, hard candy, ice and sticky foods such as chewing gum or caramel.

You can still continue to enjoy sports and other activities but a protective mouth guard is often recommended to reduce the risk of injury to the mouth or jaw. Your dentist will suggest an appropriate mouth guard when the braces are in place.

Braces can make a big difference to your smile and your future dental health. Modern technology � and following good practices � means you should be able to wear them with comfort and confidence.

Your child should have their first trip to the dentist by the time they are 18 months old and it’s good to make the process as easy as possible for them from the start.

Dental staff are used to dealing with young children and they will know how to make them feel comfortable.

Sometimes, children under three may be treated on the parent’s lap. In this case, the parent sits in the dental chair facing the dentist, and the child is on their lap.

The dentist will tell the child what he or she is going to do in terms they can understand. They will usually have fun dental toys they can use to help.

They will start with an oral examination checking the teeth present and looking at the development of the jaw, gums and soft tissues.

Naturally, as in any new situation, some children are initially unsettled but this is usually short-lived as they get used to it.

Parents can help by ensuring they are calm and relaxed as any anxiety will transfer to the child.

With older children, the parents may stay in the background though sometimes children behave better when the parent is not in the room!

Work with your children and your dentist to find the best way of ensuring they get the treatment they need with minimum worries for everyone.

People who have not followed adequate dental care for some years may have already lost most of their teeth and feel a little hopeless.

Sometimes they ask a dentist to remove the remaining teeth as they are often broken and have deep cavities.

It’s true that, sometimes, removal of the remaining teeth and replacing them with full dentures is the only option.

But more often there are other options available.

Some or all of the remaining teeth could be repaired and used in conjunction with a partial denture. While a full denture replaces all of the teeth on the upper or lower jaw, a partial denture replaces some of the teeth.

If only a few weak teeth remain on the upper jaw, it might be preferable to have them extracted and a full upper denture made. Full upper dentures can be more secure than lower ones as the upper denture gets added stability from the palate and is not easily dislodged by the tongue.

If only a few teeth remain on the lower jaw, however, the dentist will usually aim to save them and use a partial denture if necessary.

Ideally, all teeth that can be saved should be saved but this is not always possible – often due to finances.

In such cases, having teeth removed and dentures may be the only option.

Oral cancer hits more than 30,000 Americans every year but you can minimize the risk by taking steps to ensure it’s caught early enough.

The first indications of oral cancer may be a very small, but dangerous, oral spot or sore that you are not even aware of.

In a routine examination, your dentist will carefully examine the inside of your mouth and tongue.

If they notice a flat, painless, white or red spot or a small sore, this may be completely harmless. But harmful spots or sores often look the same as harmless ones.

To ensure that a spot or sore is not dangerous, your dentist may choose to perform a simple test, such as a brush test. This collects cells from the lesion which can them be analyzed.

Any positive results from a brush test must usually be confirmed by a biopsy before deciding the next step.

If precancerous cells are found, the lesion can be surgically removed if necessary during a separate procedure.

When caught early enough, the chances of preventing the cancer developing are high but only half of those diagnosed survive more than five years.

That’s why regular dental examinations are so important for your overall health and not just to have good teeth.

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatenting.

So if you have any signs of swelling in your gum, contact your dentist immediately.

Chronic facial pain is a problem faced by millions of Americans.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Sometimes, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ’s.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

There are several ways the TMJ disorders may be treated.

Diagnosis is an important step before treatment.

Part of your clinical examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving.

Your dentist may take x-rays and may make a “cast” of your teeth to see how your bite fits together.

To help you deal with this pain, your dentist will recommend what type of treatment you need and may refer you to a specialist.

Tooth decay or cavities result from destruction of the tooth enamel and can lead to a range of problems from toothache to bad breath.

Cavities occur when foods containing carbohydrates (sugars and starches) such as milk, sugared drinks, cakes or candy are frequently left on the teeth.

Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Many people associate cavities with children but the changes that occur with aging make cavities an adult problem, too.

Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque.

Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.

Decay around the edges of fillings is also common to older adults. As many of them did not benefit from fluoride and modern preventive dental care when they were younger, they often have a number of dental fillings.

Over the years, these fillings may weaken, fracture and leak around the edges.

Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

You can help prevent tooth decay by following these tips:

– Brush twice a day with fluoride toothpaste
– Clean between your teeth daily with floss or interdental cleaner
– Eat nutritious and balanced meals and limit snacking

It’s also worth asking your dentist about supplemental fluoride, which strengthens your teeth, and about dental sealants, a plastic protective coating which is applied to the chewing surfaces of the back teeth to protect them from decay.

In addition, it’s important to visit your dentist regularly for professional cleanings and oral examination.