My Blog
By George Debbaneh, DDS
May 06, 2021
Category: Oral Health
Tags: oral health  
GumDiseaseCouldImpactMoreThanYourOralHealth

Preventing periodontal (gum) disease not only preserves your teeth and gums, it might also benefit the rest of your health. There's growing evidence that gum disease has links to other systemic diseases.

Gum disease usually starts with dental plaque, a thin film of bacteria and food particles, which triggers a bacterial gum infection. Left untreated, the infection advances and steadily breaks down the gums' attachment to teeth.

This can create large ulcerated areas that are too weak to prevent the passing of bacteria and toxins into the bloodstream and other parts of the body. There's growing evidence from epidemiology (the study of the spread and control of disease) that this bloodstream transfer, as well as the inflammation that accompanies gum disease, could affect other body-wide conditions or diseases.

Diabetes. This chronic condition occurs when the body can't adequately produce insulin, a hormone that regulates sugar (glucose) in the blood, or can't respond to it. Diabetes can inhibit healing, cause blindness or lead to death. Both diabetes and gum disease are inflammatory in nature, and there's some evidence inflammation arising from either condition may worsen the other.

Heart disease. Heart attack, congestive heart failure, stroke and other cardiovascular diseases are a leading cause of death. Like diabetes and gum disease, these heart-related conditions are also characterized by inflammation. There are also specific types of bacteria that arise from gum disease that can travel through the body and increase the risk of heart disease.

Arthritis. An autoimmune disease, rheumatoid arthritis causes debilitating pain, particularly involving the joints, and leads to decreased mobility. Interestingly, many newly diagnosed arthritis patients are also found to have some form of periodontal disease—the two diseases, in fact, follow a similar development track. Although this may hint of a connection, we need more research to determine if there are indeed links between the two diseases.

Regardless of any direct relationships between gum disease and other conditions, preventing and treating it can improve both your oral and general health. You can lower your risk of gum disease by practicing daily brushing and flossing and undergoing regular dental cleanings to remove plaque. And at the first sign of gum problems, see your dentist as soon as possible for early intervention—the earlier the better.

If you would like more information on oral health care, 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 “Good Oral Health Leads to Better Health Overall.”

HeresWhatYouNeedToKnowAboutDentalInsuranceandChoosingaCrown

Millions of Americans rely on dental insurance to help them better afford dental care. Depending on the benefit package, an insurance policy can be useful in restoring dental health compromised by disease or injury.

But how life-like that restoration may appear is often a secondary concern with many insurance plans. For example, dental insurance will pay for a crown restoration that restores function to a tooth, but not necessarily of the highest aesthetic quality for achieving a truly life-like appearance.

To be sure, not all dental crowns are the same. Some are all metal, usually gold or silver. Some are “hybrids,” made of an interior metal shell with an outer fused porcelain shell (porcelain-fused-to-metal or PFM). In recent years all -ceramic crowns made of stronger life-like ceramics have become the most popular.

The type of crown used will depend a great deal on the type and location of the tooth. Teeth on the back of the jaw that encounter greater biting forces and are not as noticeable in the smile may do better with a metal or PFM crown. Visible side and front teeth are more likely candidates for all-ceramic. Your dentist will give you your best options as it pertains to your dental needs and appearance.

There's also a difference in crown workmanship. Dental laboratories now use milling machinery that sculpts a crown from a single block of material. Although some final handwork by skilled technicians is still necessary, milling has streamlined the process—and the cost—for producing a crown of high functioning quality.

But crowns that achieve the most natural smile appearance require more in the way of artistic craftsmanship. This in turn can increase the crown's price—beyond what many dental policies agree to cover. You may then be faced with a decision: an insurance-covered functional crown with an acceptable level of life-likeness or a more life-like crown for which you may have to pay more out-of-pocket.

Your dentist can advise you on your best options for a crown restoration, also factoring in what your insurance will cover. Ultimately, though, you'll have to weigh the kind of smile you desire with your dental situation and finances.

If you would like more information on dental crown restorations, 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 “Porcelain Dental Crowns.”

ListentoEllenDeGeneresDontThinkYouCanGetAwayWithoutFlossing

This year's Carol Burnett Award, presented at the Golden Globes, goes to Ellen DeGeneres for her “outstanding contributions to the television medium on or off the screen.” This is the latest in a long list of honors for the comedienne, talk show host and activist that includes Emmys, Grammys and Teen Choice Awards. And one not quite as well-known: a 2004 “Flossy” award.

DeGeneres received this honor from the National Flossing Council in recognition of her passionate promotion of oral hygiene, particularly flossing. She wrote about its virtues in her 2003 book, The Funny Thing Is…., saying, among other things, “Don't even think for a second that you can get away with not flossing.”

DeGeneres's motivational cheerleading for flossing is helpful and necessary because, well, many of us just don't like doing it. It requires more manual dexterity than its more popular sibling, brushing. And the tendency for the floss to gunk up with plaque residue for some is simply unpleasant.

Mainly, though, many folks think brushing is enough. Not so fast, according to dental professionals. While brushing removes disease-causing bacterial plaque from broad tooth surfaces, it can't effectively get into the spaces between teeth. It takes flossing to clear plaque from these more difficult areas.

But don't fret: There are ways to make flossing an easier—and more pleasant—task.

Ask us for help. As we said before, flossing does take some hand dexterity and coordination to perform. You may also wonder if you're doing it effectively. We can provide training and tips on how to be a more effective flosser at your next visit.

Practice, practice, practice. You probably think nothing of riding a bicycle, and yet it probably took you weeks or months as a kid to become proficient. Similarly, your first attempts at flossing might feel awkward, but you'll improve with practice, so don't give up.

Brush before you floss. Most people floss before brushing, but if you tend to encounter a lot of soft plaque debris that makes flossing “icky” for you, then try brushing first to clear a good portion of it out of the way before you floss. Just be aware, most professionals believe that flossing first is better because it loosens up debris between teeth so the bubbles from the toothpaste can carry it away. But any flossing is better than no flossing!

Try flossing tools. For some people, floss picks, small pre-threaded tools you can use with one hand, seem easier to maneuver than regular floss thread. If you have issues with manual dexterity, an oral irrigator can make the task easier: This handheld device uses a stream of pressurized water to loosen and flush away plaque between teeth.

So, follow Ellen DeGeneres's advice she gave Tulane University graduates during a commencement speech: “Remember to exfoliate, moisturize, exercise…and floss.” The latter, along with brushing, will certainly help keep your teeth and gums healthy.

If you would like more information about best oral hygiene practices, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By George Debbaneh, DDS
April 06, 2021
Category: Oral Health
Tags: oral hygiene  
4TipsforImprovingDailyBrushingandFlossing

Two important practices boost your protection from dental disease: twice-a-year dental visits; and daily brushing and flossing. Of the two, that second one could be the most important.

Personal oral hygiene cleans the teeth of dental plaque, a thin film of bacteria and food particles that accumulates on them each day. This plaque buildup is the number one cause for both tooth decay and periodontal (gum) disease, so removing it reduces your risk of an infection.

But it's not just a matter of doing these tasks—it's also doing them well. A quick once-over isn't going to have the same preventive power as a more thorough job.

Here then are 4 tips for improving your daily oral hygiene efforts.

Time yourself brushing. It usually takes about two minutes to thoroughly brush all tooth surfaces. So, set a timer for two minutes, focusing on methodically brushing the front, back and biting surfaces of each tooth.

Easy does it. Brushing teeth requires only a gentle bit of manual force as the mild abrasives and detergents in your toothpaste provide most of the action of loosening plaque. In fact, aggressive brushing can lead to enamel and gum damage. Practice gentle scrubbing action when you brush.

Don't neglect flossing. While brushing gets most of the hygienic attention, it can't effectively get to areas between teeth where over half of built-up plaque can accumulate. Be sure then to floss at least once a day to remove plaque between teeth that brushing can miss.

Test yourself. Your dentist may be the ultimate judge for the quality of your hygiene, but you can check your effectiveness between visits. For instance, run your tongue across your teeth—it should feel smooth, not rough or gritty. Using a plaque disclosing agent periodically can also reveal missed plaque.

And don't forget to keep up your regular dental visits, which are necessary for removing plaque you might have missed or tartar that may have formed. They're also a great time to get advice from your dentist or dental hygienist on how you can further improve your own efforts in daily dental care.

If you would like more information on best oral hygiene practices, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

HowLongIstheImplantProcessItDependsonYourBoneHealth

If you're thinking about getting dental implants, you may be curious about how long it might take. The answer depends on the health of your supporting bone.

Bone is an integral part of implant functionality as bone cells gradually grow and adhere to the newly placed implant to give it its characteristic strength. The implant also requires an adequate amount of bone to accurately position it for the best appearance outcome.

If the bone is sufficient and healthy, we can proceed with the surgical placement of the implant. The most common practice following surgery is to allow a few weeks for the bone integration described previously to take place before finally attaching the crown. With an alternative known as a “tooth in one day” procedure, we install a crown right after surgery, which gives you a full smile when you leave.

There's one caveat to this latter method, though—because the implant still requires bone integration, this immediate crown is temporary. It's designed to receive no pressure from biting or chewing, which could damage the still integrating implant. We'll install the permanent crown after the implant and bone have had time to fully mesh.

So, if your supporting bone is sound, the complete implant process may only take a few weeks. But what if it's not—what if you've lost bone and don't have enough to support an implant? In that case, the length of process time depends on the severity of the bone loss and if we're able to overcome it. In some cases, we can't, which means we'll need to consider a different restoration.

But it's often possible to regenerate lost bone by grafting bone material at the implant site. If the bone loss is moderate, it may take 2 to 4 months of regrowth after grafting before we can perform implant surgery. If it's more significant or there's disease damage to the socket, it may take longer, usually 4 to 6 months. It largely depends on the rate of bone regeneration.

In a nutshell, then, the health of your jaw's supporting bone has a lot to do with whether the implant process will take a few weeks or a few months. Regardless of the time, though, you'll gain the same result—new, functional teeth and a more attractive smile.

If you would like more information on dental implant restorations, 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 “Implant Timelines for Replacing Missing Teeth.”





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