How can I tell if I'm at risk for gum disease?
According to MedlinePlus, a service of the U.S. National Library of Medicine and National Institutes of Health, about 80 percent of U.S. adults currently have some form of gum disease, ranging from gingivitis to serious periodontal disease. The prevalence of gum disease increases with age, because as we age, our teeth wear down, our gums naturally recede, teeth can become more sensitive, and medications can affect some oral changes. If your gums feel tender or sore, or if they look red and swollen, you may be at risk for gum disease. Other signs include bleeding and/or receding gums, pain or sensitivity in your teeth (and even loose teeth, caused by weakening gum fibers and/or bone loss), and persistent bad breath. If left untreated, gum disease can lead to tooth loss as well as various other health problems. More and more life-threatening illnesses are being linked to the presence of dental diseases.
The first thing to do is get a thorough dental evaluation. If you have any degree of periodontal disease, Dr. Kim can help. He strongly believes in and focuses on the importance of healthy gums for a healthy mouth and body. Gum disease used to require surgery more often than not. While surgery is still an option and sometimes needed, many cases are now treated with less invasive techniques first, such as deep cleanings, local antibiotics, and special rinses. Please come in and let Dr. Kim help you achieve and maintain healthier gums for a healthier you.
I have crooked teeth, but I feel like metal braces are for kids. Are there other options?
Metal braces can be a hassle and can take between two to three years of treatment to fully realign your teeth. Advancements in orthodontics are helping adults fit braces into their lives and giving them the smiles they’ve always wanted.
One option is Invisalign®. The Invisalign system involves a series of custom-made plastic trays, called aligners, that are replaced every two weeks to straighten your teeth step by step. The trays are comfortable for the sensitive tissues of your gums and cheeks, and they’re conveniently removable so you can eat and brush your teeth normally. Because the trays are made from a transparent plastic material, Invisalign clear braces are hardly noticeable. If you don’t tell them, people might not even notice you’re wearing braces!
Another orthodontic solution is Six Month Smiles®, an accelerated program that gives you great results in less time than traditional braces. Six Month Smiles uses clear braces and thin, subtle wires to realign the teeth that show when you smile. Because they are not intended to completely change your bite, these braces use low force and do not have the risk of causing root or structural damage. The average treatment lasts only 4–9 months, and post-treatment, you will be fitted with a retainer to ensure the longevity of your straight, beautiful smile. Six Month Smiles is a conservative, inexpensive, and efficient way to get the smile you’ve always wanted.
These alternatives to metal braces are great options for patients with mild to moderately crowded teeth, widely spaced teeth, overbites, crossbites, and underbites. If you’re ready for straighter teeth, ask your dentist about your treatment possibilities. A beautiful new smile could be closer than you think!
What is “comprehensive dentistry?”
Our aim is to have all concerns and issues known — to us and to you — and hopefully resolved before an emergency. We want everyone to have healthy, attractive, and stable teeth and smiles. (Nobody likes a toothache or broken tooth, especially since they never happen at convenient times.) This means that we see patients for many reasons with many different needs. Our services range from routine preventive care to life changing restorative and cosmetic treatments, so we have something to offer everyone to address their personal chief concern and needs.
The second half of this equation is the development and fulfillment of ongoing maintenance plans. This minimizes the chance of original problems reoccurring. We will do everything we can to customize your maintenance plan based on your individual situation.
Maintaining good oral hygiene at home is important, but man cannot live by toothbrush alone. In-office exams are critical to keeping your smile clean and healthy. Your dental team has the ability to remove plaque your toothbrush can’t, which reduces your risk of tooth decay and gum disease. They can also use panoramic x-rays and intraoral cameras to monitor structures that aren’t so obvious to the naked eye.
We want you to have a healthy and stable smile, but we also know that accidents happen. In a way, “comprehensive” care really refers to our commitment to the present and the future of your smile. Not only do we want to keep it healthy, we want to make it beautiful, and make it last.
A couple of my teeth have been worn down and need to be replaced. Should I opt for crowns?
Crowns, often called “caps,” cover teeth to restore them to their appropriate shape and size after large fillings, fractures, and/or weakening forces such as intense grinding. In all of these cases, crowns not only cover teeth but provide added support as well. Crowns can also be used to attach bridges, cover dental implants, restore seriously discolored or misshapen teeth, and even as a preventive measure to protect a tooth in danger of breaking. Crowns can be made of all-porcelain (ceramic) material, porcelain fused to metal (for added strength), gold alloys (high noble), or base metal alloys (non-noble). Each of these restorative materials has its advantages and disadvantages. All-porcelain restorations most closely mimic natural tooth appearance. Their strength depends on adequate porcelain thickness, thus this material requires more extensive preparation. Porcelain fused to metal alloy restorations are tooth-colored and stronger than all-porcelain crowns. Gold alloy crowns are very strong and wear resistant. They are well tolerated in terms of biocompatibility, but metal colors do not match natural teeth. Base metal alloy crowns are similar to gold for strength and durability. However, allergy to the non-noble base metals may be an issue with some patients.
Crowns can be placed in as few as two appointments. For porcelain crowns, properly matching the aesthetics of teeth can take more visits, but the natural looking cosmetic results are worth it to most patients. Crowns in general are very strong restorations, and they help to protect teeth. If a crown is placed before the tooth is so badly decayed or so weak that it fractures, the necessity of a root canal can often be preempted. This can also help prevent a broken tooth from becoming so bad that it needs to be removed, which would require a bridge or implant for restoration.
In light of their excellent restorative capabilities, crowns have few disadvantages. As they are more extensive restorations than fillings, their relative cost is higher. However, if our doctors recommend a crown it is because we want to help you keep your teeth healthy and looking good for years to come. The problems crowns help to prevent and repair offset the cost.
Also, while crowns are highly resistant due to normal wear, they will eventually need to be re-cemented or replaced. Six to nine percent of teeth that are damaged enough to need a crown may someday need a root canal.
Is smoking really that bad for my teeth?
Smoking isn’t just bad for your teeth—it affects the health of your entire mouth, especially your gums. Lighting up stains your teeth, causes bad breath, and promotes the buildup of plaque and tartar. Cigarette smoking is also one of the leading causes of tooth loss. Worst of all, smoking has been linked to the development of periodontal disease and may lead to the loss of taste and smell. Smokers also tend to require more dental treatment, due to the damage done by smoking. Certain procedures, such as dental implants and oral surgeries, can be less successful in smokers due to damaged gum tissue. This results in a higher cost of dental healthcare and often more frequent (and complicated) treatment.
Pipes and cigars aren’t any safer, causing similar rates of tooth and bone loss even if the smoke is not inhaled. Smokeless tobacco products like snuff and chewing tobacco also pose great health risks to your gums, increasing your risk for both oral cancer and cancers of the throat, esophagus, and lips. Additionally, they contain a significant amount of sugar, which when pressed against your teeth for long periods of time can lead to tooth decay.
So what’s the verdict on tobacco? Seek help on how to quit using, or just don’t start.
I know certain foods are bad for my teeth, but are there any that are GOOD for them? Are there any specific oral health concerns associated with diabetes?
In fact, there are! Foods such as milk, cheese, nuts, chicken, and other meats contain calcium and phosphorous, which have been proven to strengthen bones and protect enamel. Calcium is essential for bone development, and while your teeth do not directly absorb it, a stronger jawbone leads to healthy gums, and healthy gums make healthy teeth. Fruits and vegetables are just as good for your teeth as they are for your body, especially firm, crunchy ones with a high water content (apples, pears). Water is critical for your oral health, as it rinses away food particles and keeps your mouth and gums moist. Dehydration can cause dry mouth, which makes your mouth particularly prone to bacterial growth and bad breath.
As most people know, foods high in sugar tend to stick to teeth and can lead to decay. What many people don’t know is that almost all foods contain some form of sugar — even milk products and fruit — so you can’t cut it out completely, and you wouldn’t want to. The most important part of the “dentist diet” is brushing your teeth after each meal. If you do snack between meals, especially on starchy or sweet foods, and cannot brush, drink plenty of water or chew gum to loosen any residue. For those of us out there with a sweet tooth, don’t despair: not all sweet snacks are off-limits. Chewing sugar-free gum that contains xylitol can actually prevent cavities.
Are there any specific oral health concerns associated with diabetes?
While having diabetes does not automatically put your dental health at risk, it does make a person more susceptible to certain conditions. Uncontrolled diabetes causes high glucose levels in saliva, which can promote the growth of bacteria in the mouth and increase the risk of cavities. Diabetes also reduces the body’s resistance to infection, which can make an individual more likely to develop illnesses such as gingivitis or even gum disease. Symptoms of gingivitis, which is an early form of periodontal disease, are red, sore, receding, or bleeding gums; if you notice these to any degree, be sure to make an appointment with your dentist. Other, less serious, problems that can occur include thrush (a treatable infection in the tongue and cheeks), ulcers, and dry mouth.
Interestingly enough, this connection is a two-way street. For patients with severe gum disease, the infection in the gums can affect the blood glucose levels and the immune system, actually increasing the overall risk of developing diabetes. If you have diabetes, you know the importance of a healthy lifestyle. Smoking can be particularly damaging to diabetics, as it causes excess dryness and damage to the gum tissue. Ultimately, the most important factor is blood sugar. If you keep your diabetes under control with a healthy lifestyle and maintain good oral hygiene through regular check-ups, diabetes won’t get the best of your smile.
What should I do in case of a dental emergency?
Let’s face the facts: accidents happen, and especially when it comes to our teeth and mouths, they can be pretty frightening. Being careful is good prevention, but being prepared promises reassurance in any oral health emergency. It’s important to know when home care will suffice and when a trip to the dentist is necessary, so here are some guidelines to help you through common situations:
Toothache/Sore Gums: Rinse with warm water to remove any food or debris; if you notice anything lodged between teeth, floss to remove it. Take an over the counter pain medication (but never apply the medication directly to tooth or gums), and see Dr. Kim if the pain persists.
Chipped Tooth: Save the pieces, if you can, and rinse them thoroughly. Apply an ice pack or a cold compress to the swollen lip or gum tissue near the chipped tooth to prevent swelling. If the area is bleeding, apply gauze for ten minutes, or until the bleeding has stopped. Make an appointment with Dr. Kim as soon as possible.
Broken Tooth: With recent advancements in restorative and cosmetic dentistry, you might not lose your tooth. If there’s enough remaining healthy tooth structure a dentist can create a crown that will “grab onto” your natural tooth, eliminating the need for root removal. While the success of this process, known as “crown lengthening,” depends on the severity of the break, it’s worth asking about options other than complete removal.
Knocked Out Tooth: Depending on the situation, find the tooth and, holding it by the crown only, rinse it briefly with warm water. If possible, gently reinsert the tooth into the socket and bite down on gauze or cloth to keep it in place. If you cannot reinsert it, place it in a container of milk or salt-water. See Dr. Kim as soon as possible—if treated within two hours the tooth may be salvaged.
Soft Tissue Injuries: Soft tissues such as gums, cheeks, lips, and the tongue tend to bleed heavily, only because the tissue contains a great deal of blood flow. To control the bleeding, first rinse with a warm, mild saltwater solution. Apply pressure with gauze or a moistened towel for 15 to 20 minutes. Afterwards, to reduce swelling and help stop residual bleeding, apply a cold compress to the outside of your mouth. In the event of a serious soft tissue injury, in which the bleeding is profuse or the damage is visibly traumatic, it’s best to stay calm, keep applying pressure, and go to the emergency room.
Am I a candidate for dental implant restorations?
Dr. Kim and our team work hard to stay on the leading-edge of restorative dentistry. If you or someone you love struggles with ill-fitting, uncomfortable dentures or a retainer with false teeth, we have a permanent solution. Quickly becoming the preferred method of dental replacement, implants can give your smile a second chance. They are useful in denture stabilization, but they can also be used in conjunction with crowns, bridges, and in single-tooth replacements.
Permanent implants are not only more durable and long-lasting than traditional tooth replacements, they also look and feel more like natural teeth. Most importantly, they function like natural teeth, so you can chew, talk, and smile with confidence again. Because the implant procedure allows for more of your healthy tooth structure to be saved, fixed implants can even prevent bone loss.
Many patients suffering from advanced tooth decay, root canal failure, trauma to the mouth, or just extreme natural wear and tear on teeth are benefiting from this revolutionary option in restorative dentistry. However, there are still some things to consider before you decide on dental implants. For example, they are best performed after adolescence, when the teeth and jaw bone are fully developed. Additionally, the implant procedure can be more complicated for individuals with periodontal (gum) disease, active diabetes, immune deficiencies, and for patients who smoke. To ensure that you get the treatment that’s right for you, keep Dr. Kim and his team informed and up-to-date about your entire medical history and dental habits.
I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew. What's the problem?
You could be suffering from temporomandibular disorder, or TMJ, which affects the flexibility and function of the temporal jaw joint and surrounding muscles. Because this area controls bite, speech, chewing, and all other jaw movements, the pain can be severe.
TMJ has been associated with a number of different causes, but the most common factor is the bite itself. A misaligned bite can place pressure on the jaw joint, forcing the muscles to work overtime in effort to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but it can cause a good deal of fatigue and pain in the facial muscles. Headaches, toothaches, and jaw clenching, popping, or locking are all common symptoms of TMJ. TMJ can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned.
Professional treatment of TMJ ranges from minor fixes to surgical options. If Dr. Kim determines that the main cause of your TMJ pain is an irregular bite, he may recommend a retainer-style mouthguard, or even a reshaping of the biting surfaces of your teeth, to subtly change the way your upper and lower jaws meet. If it’s a structural issue occurring in your jaw bone (especially if your TMJ is a result of injury), you may benefit from surgery. When it comes to TMJ treatment, it’s important to choose the most conservative plan for your individual needs.
In the meantime, alleviating the pain through treating the symptoms can give you some relief. Heating pads or cold compresses can reduce swelling, and limiting your jaw movement (for example, cutting especially chewy foods out of your diet) can stop the clicking or popping. Massages can temporarily relieve muscle tension, and painkillers (medicated or over the counter) can reduce inflammation and make you more comfortable.
I've heard a lot about laser dentistry lately. What is it, and what is it used for?
Advancements in laser technology have reinvented a variety of dental procedures. Lasers are not only remarkably precise, but they can also shorten procedure time, minimize pain, and speed the healing process of many treatments. Even better, lasers are as useful in common procedures as they are in complicated ones, having been incorporated into everything from cavity detection and fillings to complex periodontal surgery. During routine cleanings or surgical procedures, lasers can reduce or completely eliminate the need for drills, scalpels, anesthesia, and sutures. Surgery without sutures carries less risk of infection and need for repeat visits.
Just as doctors use different scalpels for different procedures, dentists have different lasers for the various surfaces in your mouth. There are lasers for cavity detection, for teeth whitening, for viewing purposes and lasers for surgical procedures. Hard tissue lasers are used on teeth and bone, to prepare teeth for certain treatments, remove decayed areas, or repair fillings. Soft tissue lasers, as the name implies, are better suited for gum, cheek, and tongue tissue, and as they seal blood vessels in the process, these lasers can reduce the pain and healing time associated with surgery.
The Academy of Laser Dentistry (ALD) has been actively researching technology and developing standards of excellence since 1993, and is dedicated to educating and certifying dentists internationally in the safe use of laser technology. Though most experts agree that lasers are the future of dentistry, it’s estimated that only around 5% of dentists currently offer them in their offices. With more dentists getting certified every year, though, it’s well worth searching for one near you.
What could be causing my dry mouth, and what can I do about it?
Symptoms of dry mouth can include a sticky, dry, or burning sensation in the mouth, altered taste, chronic bad breath, an altered sense of taste, and insufficient saliva. Dry mouth is particularly common in the elderly and the very young, but it can affect anyone at any given time, and there are a number of common causes.
Dry mouth is a known side effect of many medications, from prescriptions to antihistamines. Medical conditions such as diabetes can also cause recurrent dry mouth, cancer treatment (chemotherapy, radiation), hormone changes during pregnancy or menopause, and high levels of stress are other conditions that can lead to dry mouth.
Dry mouth can be uncomfortable, and is one of the leading causes of chronic bad breath, but it can also make teeth more prone to decay and soft tissue more susceptible to infection. Because insufficient saliva endangers the health of your entire mouth, it’s important to ask Dr. Kim about oral sprays, prescription drugs, or simple lifestyle changes that can provide relief.
My husband's snoring is keeping me up all night. Do you think it's an oral issue?
When your husband snores, you both miss out on the rest you need. If his snoring is not related to allergies or sinus problems, and if you notice gasping, choking, or long periods of time during which his breathing seems to have stopped, your husband could be suffering from sleep apnea. Sleep apnea is a condition that causes a person to stop breathing for short periods of time during sleep and usually results in sudden, repeated awakenings and poor quality of sleep.
Before deciding on a treatment plan, he should discern the specific cause of his sleep apnea. Occasionally, sleep apnea originates in the central nervous system, but it’s more likely that your husband is suffering from obstructive sleep apnea. In cases like these, it’s a mouth matter—either a physical obstruction in the throat, nose, or mouth, or a poorly positioned jaw during sleep. If sleeping on his side, changing up his sleeping patterns, and avoiding alcohol and sleeping pill usage at night does not help his apnea, his obstruction could require surgical attention. Dr. Kim can create a custom mouthguard to reposition the jaw, the tongue, or both, while an oral surgeon might recommend removal of excess tissue (such as the tonsils) to open up the airway. Ask us about your husband’s options, because everyone deserves a good night’s sleep!
When I floss, my gums bleed. If they don't hurt and my teeth look fine, is it really a big deal?
If your gums are not sore, it’s safe to assume your bleeding gums are not the result of hard brushing or flossing. Bleeding gums that apparently have no cause are always a warning sign, often indicating such conditions as gingivitis or even gum disease. Gingivitis (inflamed, bleeding gums) is not a one-way ticket to gum disease; in fact, if it’s caught early enough, gingivitis can be treated and even reversed. The first lines of treatment when it comes to gingivitis are lifestyle changes. Poor oral hygiene, smoking, uncontrolled diabetes, and high levels of stress can all contribute to gingivitis. Choosing a toothbrush with soft bristles can ease gum damage, too, and getting regular dental cleanings will control plaque and tooth decay. It’s important to stop gingivitis before it progresses, as studies have shown more and more serious illnesses are associated with gum disease. Heart disease, strokes, diabetes, even osteoporosis and inflammatory diseases such as rheumatoid arthritis have been linked to poor oral health.
Though not the first suspect in a simple case of bleeding gums, oral cancer is also a possibility. Oral cancer can be difficult to diagnose because many of its symptoms are associated with other medical conditions. They include sores, difficulty swallowing or moving the jaw, bleeding gums or cheeks, and a continuous pain in the mouth. If your dentist finds no other causes for your bleeding gums, he or she may recommend a visit to a specialist.
Regular check-ups are vital to cancer prevention, as are good oral hygiene, avoiding tobacco, and maintaining a balanced diet. Inform Dr. Kim if you’re experiencing any of the above symptoms. You’d go to the doctor if a cut on your hand were infected—do your gums the same service! They’ll thank you later.
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