It’s been a long road back to oral health for you after periodontal (gum) disease. But after several plaque removal sessions and perhaps even surgical procedures to address deep infection, your gums have regained their healthy pink appearance.
But now you must face a hard reality: because you’ve had gum disease you’ll need to be extra vigilant with your oral hygiene to avoid another round with this destructive disease. But don’t worry—you won’t have to fight your prevention battle alone. We’ll continue to provide you care that reduces your risk of re-infection. We call that care periodontal maintenance (PM).
The heart of PM care involves regular dental visits for monitoring, cleanings and treatment when necessary. While most patients may visit their dentist at least twice a year, as a previous gum disease patient we may advise more frequent visits, especially if you’ve just finished periodontal treatment. Depending on the extent of your disease, we may begin with a visit every other week or once every two to three months. If your mouth continues to be disease-free we may suggest increasing the time between visits.
During your visit we’ll carefully examine your mouth, as well as screen you for any signs of potential oral cancer. We’re looking for both signs of re-infection or new issues with your teeth and gums. We’ll also assess the effectiveness of your oral hygiene efforts and advise you on ways you can improve.
If we find any signs of disease, we’ll then formulate a treatment plan to effectively deal with it. With frequent visits we have a better chance of discovering re-infection early—and the earlier the better to minimize any further damage. We may also need to take steps to make future PM care easier. This could include gum surgery to alter the tissues around certain teeth for easier access for examination and cleaning.
Our main focus with PM care is to look ahead: what can we do now to prevent a future bout of gum disease or at least lessen its effect? With continued monitoring and care we can drastically reduce your risk for further damage from this destructive disease.
If you would like more information on post-gum disease maintenance, 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 Cleanings.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
Oral surgery. The term sounds a bit ominous, but really just refers to a series of procedures that involve more than the teeth. If you're receiving a dental implant, getting an impacted wisdom tooth extracted or need gum tissue augmented, Frederick Dental Group in Frederick, MD, is the place to be. Oral surgeries of various kinds are just a few of the procedures Dr. Dave Verma and Dr. Arpana Verma perform. You can trust us for maximum comfort and the best possible results.
What oral surgery involves
It may involve the jaw bone, gums, teeth, or other structures in the maxillofacial area. These procedures need some kind and degree of anesthesia (Oral sedation, or nitrous oxide) to ensure you're comfortable during the procedure.
Typically, the person who needs oral surgery may require:
- Tooth extraction (impacted wisdom teeth may be encased in bone or gum tissue or a tooth may be too decayed to save)
- Gum grafting to heal periodontal disease
- Osseous surgery to reduce the size of periodontal pockets between the gums and tooth roots
- Bone grafting to provide anchorage for dental implants
- Relief from TMJ/TMD (jaw joint dysfunction) or sleep apnea
- Placement of single or multiple dental implants to replace missing teeth
- Root canal therapy to remove diseased interior pulp
- Pre-procedure examinations
Rest assured that your oral surgery at Frederick Dental Group will be carefully planned by our professional team of highly qualified experts. Accurate examination, digital X-rays, 3D scans, and detailed treatment plans, including choice of anesthetics, contribute to the many positive outcomes our two dentists have achieved over the years.
You will receive important information on what to expect before, during and after your procedure, including comfort measures and any medications. Your comfort and safety are paramount at Frederick Dental Group.
Concerned about upcoming surgery in Frederick?
Dr. Dave Verma, Dr. Arpana Verma, and their team at Frederick Dental Group understand. Please feel free to call with any questions or concerns you may have before or after your oral surgery, and the dentists and their support staff will be happy to help. We can be reached at (301) 624-1001.
X-rays are an important diagnostic tool in dentistry because of their ability to penetrate and pass through body tissues. Because they penetrate at different speeds depending on tissue density (shorter and thus darker on exposed film for soft tissues, longer and lighter for hard tissues like bone or teeth), we’re able to detect decay which appear as dark areas on x-ray film.
Without x-rays, the early detection and diagnosis of dental problems would be quite difficult. But despite its obvious benefits, it’s still a form of released energy that exposes patients to a certain amount of radiation. Since the potential health risk from radiation depends on the amount released (the dosage) and for how long and often a person is exposed, we must determine if the dosage and frequency from dental x-rays is a cause for concern.
It’s a common misconception to view any radiation exposure as dangerous. The truth is, however, we’re all exposed daily to radiation from the natural environment — about 2 to 4.5 millisieverts (the dosage measurement for radiation exposure) a year, or about 10 microsieverts (one-thousandth of a millisievert) every day.
In comparison, radiation exposure from routine dental x-rays is a fraction of this if measured over time. A set of four bitewing images of the back teeth produces 4 microsieverts of radiation, less than half the average daily exposure. One of the most comprehensive x-ray sets, a full mouth series of 18-20 images using “D” speed film, results in an exposure of 85 microsieverts, equaling about a week of normal radiation exposure.
These thoroughly researched rates help demonstrate that regular dental x-rays are relatively safe. What’s more, x-ray technology has continued to advance since first used in the mid-20th Century. With innovations in film and digital processing, today’s equipment produces only 80% of the radiation exposure of earlier machines. In effect, we’ve increased our capabilities to more accurately detect and diagnose issues through x-rays, while lowering the amount of radiation exposure.
Of course, a person’s annual exposure rate may differ from others. If you have concerns for yourself or your family about x-ray radiation exposure, please feel free to discuss this with us. Our primary goal is to improve your oral health without undue risk to your health in general.
If you would like more information on x-ray diagnostics and safety, 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 “X-Ray Frequency and Safety.”
Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.
There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.
The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.
There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.
Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.
A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.
Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.
As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.
If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”
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